Prevalence and management of diabetic neuropathy in secondary care in Qatar

Georgios Ponirakis, Tarik Elhadd, Subitha Chinnaiyan, Zeinab Dabbous, Mashhood Siddiqui, Hamad Al-muhannadi, Ioannis N. Petropoulos, Adnan Khan, Khaled A.E. Ashawesh, Khaled M.O. Dukhan, Ziyad R. Mahfoud, Christopher Murgatroyd, Mark Slevin, Rayaz A. Malik

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Abstract

Aims: Diabetic neuropathy (DN) is a “Cinderella” complication, particularly in the Middle East. A high prevalence of undiagnosed DN and those at risk of diabetic foot ulceration (DFU) is a major concern. We have determined the prevalence of DN and its risk factors, DFU, and those at risk of DFU in patients with type 2 diabetes mellitus (T2DM) in secondary care in Qatar. Materials and methods: Adults with T2DM were randomly selected from the two National Diabetes Centers in Qatar. DN was defined by the presence of neuropathic symptoms and a vibration perception threshold (VPT) ≥ 15 V. Participants with a VPT ≥ 25 V were categorized as high risk for DFU. Painful DN was defined by a DN4 score ≥4. Logistic regression analysis was used to identify predictors of DN. Results: In 1082 adults with T2DM (age 54 ± 11 years, duration of diabetes 10.0 ± 7.7 years, 60.6% males), the prevalence of DN was 23.0% (95% CI, 20.5%-25.5%) of whom 33.7% (95% CI, 27.9%-39.6%) were at high risk of DFU, and 6.3% had DFU; 82.0% of the patients with DN were previously undiagnosed. The prevalence of DN increased with age and duration of diabetes and was associated with poor glycaemic control (HbA1c ≥ 9%) AOR = 2.1 (95% CI, 1.3-3.2), hyperlipidaemia AOR = 2.7 (95% CI, 1.5-5.0), and hypertension AOR = 2.0 (95% CI, 1.2-3.4). Conclusions: Despite DN affecting 23% of adults with T2DM, 82% had not been previously diagnosed with one-third at high risk for DFU. This argues for annual screening and identification of patients with DN. Furthermore, we identify hyperglycaemia, hyperlipidaemia, and hypertension as predictors of DN.

Original languageEnglish
Article numbere3286
JournalDiabetes/Metabolism Research and Reviews
DOIs
Publication statusAccepted/In press - 1 Jan 2020

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Keywords

  • diabetic neuropathy
  • painful diabetic neuropathy, diabetic foot ulceration
  • type 2 diabetes mellitus

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Endocrinology

Cite this

Ponirakis, G., Elhadd, T., Chinnaiyan, S., Dabbous, Z., Siddiqui, M., Al-muhannadi, H., Petropoulos, I. N., Khan, A., Ashawesh, K. A. E., Dukhan, K. M. O., Mahfoud, Z. R., Murgatroyd, C., Slevin, M., & Malik, R. A. (Accepted/In press). Prevalence and management of diabetic neuropathy in secondary care in Qatar. Diabetes/Metabolism Research and Reviews, [e3286]. https://doi.org/10.1002/dmrr.3286