Insufficient early detection of peripheral neurovasculopathy and associated factors in rural diabetes residents of Taiwan: a cross-sectional study

Abstract

BackgroundDiabetic peripheral neuropathy (PN) and peripheral vasculopathy (PV) are major causes of foot ulcers in patients with diabetes. The early detection of PN/PV with appropriate health counseling is the best strategy for preventing foot lesions. The objective of this study is to examine the prevalence and associated risk factors of PN/PV among rural community residents with type 2 diabetes mellitus (T2DM).MethodsThis cross-sectional descriptive study was conducted in Taiwan from February to October 2012. Type 2 diabetes mellitus and health promotion scale, Michigan neuropathy screening instrument, and ankle-brachial pressure index values were measured.ResultsA total of 404 (55% women) participated in and completed the program. The overall prevalence of PN and PV was 34.5 and 17.1%, respectively. The majority of the participants (90%) did not receive early PN/PV detection by health care providers. After adjustment for the potential confounding factors, multivariate analysis indicated that the factors determining PN/PV were age (P <0.001), living around sea coastal regions (P <0.001), high HbA1C level (P <0.01), and fewer regular health-promoting behaviors (P <0.01).ConclusionThere was a high prevalence of PN/PV among rural T2DM residents who received insufficient early detection. The early detection of PN/PV and provision of health education with customized health-promoting behaviors of people with diabetes in the rural community are important issues.

Peripheral Neuropathy and Vasculopathy; Frequency and Associated Risk Factors in Newly Diagnosed Treatment Naive Type 2 Diabetes

“…Peripheral neuropathy was detected in 57 patients (37.7%) with MNSI score of 3.3 ± 0.4 in newly diagnosed type 2 patients of DM with cut off score ≥2.5. Lee et al [23] in their study found 34.5% peripheral neuropathy detected by same MNSI instrument with same cut off ≥2.5. Chen et al [13] has shown 22.5% peripheral neuropathy however they used MNSI score cut off >3.…”

Relationship between limited joint mobility of the hand and diabetic foot risk in patients with type 2 diabetes

“…4,[31][32][33][34][35] Recognition of these risk factors and regular inspection and examination of the foot at risk, especially in those with diabetic neuropathy and a previous history of foot ulcer, are needed to prevent diabetic foot ulcer. 3,7,10,35 However, such approaches are not always implemented in practice 16 ; therefore, simple and noninvasive methods that indicate the risk of diabetic foot are needed. Limited joint mobility of the hand is one of the most frequent hand disorders of diabetes, 36 with a recent study finding that LJM of the hand was present in 63.1% of patients with diabetes.…”

“…The foot risk classification of the International Working Group on the Diabetic Foot (IWGDF) is useful for predicting ulceration and amputation due to diabetes, and this classification is widely used as a standard method in clinical practice. However, there is a wide variation in foot screening levels across the world …”

“…However, there is a wide variation in foot screening levels across the world. 16 In contrast with complications of the lower extremities, 'diabetic hand' is rarely reported and tends to be ignored. 17 Diabetic hand is a complication of the upper extremity that manifests as conditions such as limited joint mobility (LJM), Dupuytren's contracture, and trigger finger.…”

Use of Honey in Management of Diabetic Foot Infection: Patient’s Satisfaction and Outcome

“…The diabetic foot is a major economic problem, and its management has not always been performed in a most cost effective way [1]. Hydrocolloid gel applied to the wound and covered by a semi-occlusive dressing can be used.…”