Prevalence and incidence of diabetic peripheral neuropathy in Latin America and the Caribbean: A systematic review and meta-analysis

Abstract

Aims The objective of this systematic review and meta-analysis is to estimate the prevalence and incidence of diabetic peripheral neuropathy (DPN) in Latin America and the Caribbean (LAC). Materials and methods We searched MEDLINE, SCOPUS, Web of Science, EMBASE and LILACS databases of published observational studies in LAC up to December 2020. Meta-analyses of proportions were performed using random-effects models using Stata Program 15.1. Heterogeneity was evaluated through sensitivity, subgroup, and meta-regression analyses. Evidence certainty was performed with the GRADE approach. Results Twenty-nine studies from eight countries were included. The estimated prevalence of DPN was 46.5% (95%CI: 38.0–55.0) with a significant heterogeneity (I2 = 98.2%; p<0.01). Only two studies reported incidence, and the pooled effect size was 13.7% (95%CI: 10.6–17.2). We found an increasing trend of cumulative DPN prevalence over time. The main sources of heterogeneity associated with higher prevalence were diagnosis criteria, higher A1c (%), and inadequate sample size. We judge the included evidence as very low certainty. Conclusion The overall prevalence of DPN is high in LAC with significant heterogeneity between and within countries that could be explained by population type and methodological aspects. Significant gaps (e.g., under-representation of most countries, lack of incidence studies, and heterogenous case definition) were identified. Standardized and population-based studies of DPN in LAC are needed.

Diabetic Peripheral Neuropathy Associated with Cardiovascular Risk Factors and Glucagon-Like Peptide-1 Concentrations Among Newly Diagnosed Patients with Type 2 Diabetes Mellitus

“…There was no statistically significant association between gender and DPN (p = 0.966). Previous studies showed that the prevalence of DPN was different among adults with diabetes depending on the nation, age, duration of diabetes, glucose control, and type 1 versus type 2 diabetes from 9.6% to 69% in Latin and American countries 1 , 26 , 27 from 30.1% to 58% in Asian countries. 28 , 29 Thus, the prevalence of DPN in our study was lower than that in other Asian countries due to several reasons.…”

“…Diabetic peripheral neuropathy (DPN) is the most common complication of diabetes in general and occurs early. 1–3 Diabetic neuropathy is a type of nerve damage all over the body and can alter autonomic motor, and sensory functions. 4 DPN is the most common form of diabetic neuropathy, affecting the outer nerves of the limbs.…”

“… 5 , 6 Previous studies show that the prevalence of DPN among patients with type 2 diabetes accounts for 2.0–78.8%, depending on the country, duration of diabetes, and examination methods. 1 , 7–9 Nerve damage not only leads to loss of feeling that allows injuries to go unnoticed and expandable but also causes serious infections and possible amputations. The risk of amputation in diabetes patients may be more than 25 times greater than that of the non-diabetic population.…”

Global morbidity and mortality of central nervous system tuberculosis: a systematic review and meta-analysis

“…Therefore, we downgraded the evidence one level j Imprecision was not present, due to a narrow CI and adequate sample size. So we did not downgrade the level of certainty * This study was downgraded below the level of very low (2 levels) † This study was downgraded below the level of very low (1 level) Refs [ 2 , 4 , 65 , 76 , 99 ]…”

“…The certain of evidence assessment was conducted as in our previously published articles [ 2 , 65 , 99 ]. We adapted the evaluation for prevalence meta-analysis using the five domains described in the GRADE handbook as follows: study limitations (the risk of bias of the primary studies), imprecision (appropriateness of the sample size and width of the CI), indirectness (generalizability of results), inconsistency (between-study heterogeneity), and publication bias [ 76 ].…”