Prevalence of diabetic peripheral neuropathy in Africa: A systematic review and meta-analysis

Shiferaw, Wondimeneh Shibabaw; Akalu, Tadesse Yirga; Work, Yeshamble; Aynalem, Yared Asmare

doi:10.1101/19007401

Cited by 17 publications

(25 citation statements)

References 42 publications

(56 reference statements)

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“…About 42.0% of diabetic patients were found to be suffering from peripheral neuropathy. This was similar to the ndings of other studies on diabetic peripheral neuropathy (DPN) [10], [13][14][15][16].However, this was in contrast to the ndings of Kaewput et al [17] and Perrin et al [18] in which prevalence ranged from 3.0% to 16.6%. The possible reasons for this variation could be different study settings and different classi cation used to diagnose DPN in these studies.…”

Section: Discussionsupporting

confidence: 89%

Prevalence and Determinants of Diabetic Peripheral Neuropathy/Foot Syndrome in a rural population of North India

Bashar¹,

Verma²

2020

Preprint

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Background Diabetic peripheral neuropathy (DPN), a common and troublesome complication in patients with type 2 diabetes mellitus (T2DM), contributes to a higher risk of diabetic foot ulcer and lower limb amputation. These situations can negatively impact the quality of life of affected individuals.Objectives The study aimed to assess prevalence of DPN in patients of type 2 DM from rural North India and associated risk factors. Methods A facility based cross sectional study was carried out among type 2 diabetic patients attending NCD clinic of a secondary care hospital in rural North India. A questionnaire which included socio-demographic details, clinical and laboratory parameters, and the Michigan Neuropathy Screening Instrument (MNSI) for detecting peripheral neuropathy, was administered to 100 consecutive patients. Statistical Package for Social Sciences (SPSS) version 25.0 was used for entering and analyzing data. Bivariate analysis was performed for determining the factors significantly associated with presence of DPN. Results The prevalence of DPN was 42.0%. Male gender, advancing age(≥60 years), longer duration of diabetes (>10 years ), smoking, physical inactivity, obesity, uncontrolled blood pressure, poor A glycaemic control and altered lipid profile were found to be significantly associated with the presence of DPN. Conclusion Prevalence of DPN among type 2 diabetics from rural north India is alarmingly high. There is need of essential screening of all diabetic patients by their primary care provider for early detection of DPN particularly in rural India.

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Section: Discussionsupporting

confidence: 89%

Prevalence and Determinants of Diabetic Peripheral Neuropathy/Foot Syndrome in a rural population of North India

Bashar¹,

Verma²

2020

Preprint

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“…South Asians have better preserved small nerve fiber integrity than equivalent Europeans. Corneal nerve fiber length (22.0 ± 7.9 vs 19.3 ± 6.3 mm/mm 2 ), corneal nerve branch density [(geometric mean (range): 60.0 (4.7–246.2) vs 46.0 (3.1–129.2) no./mm 2 ], and heart rate variability [(geometric mean (range): 7.9 (1.4–27.7) vs 6.5 (1.5–22.0)], were significantly higher in South Asians than Europeans. 33 , 34 …”

Section: Discussionmentioning

confidence: 99%

“…All these consequences of DPN will unavoidably end in the reduction in the quality of life and significant economic burden both to the patients and society. 2 – 5 Although up to 50% of patients with DPN are asymptomatic, some patients may manifest burning feet pain, due to progressive sensory impairment, which responds poorly to analgesics. Rarely, this sensory impairment could lead to foot ulceration and eventually to lower limb amputation; 6 , 7 diabetes is a leading cause of “non-traumatic” lower limb amputation.…”

Section: Introductionmentioning

confidence: 99%

<p>Prevalence and Risk Factors for Diabetic Peripheral Neuropathy Among Saudi Hospitalized Diabetic Patients: A Nested Case-Control Study</p>

Al-Eidan

Ahmad

Alotaibi

et al. 2020

IJGM

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Objective: To determine the prevalence and the risk factors of diabetic peripheral neuropathy (DPN) in hospitalized adult Saudi diabetics. Methods: This is a retrospective, nested case-control study conducted at King Abdulaziz Medical City (KAMC) in Riyadh, Saudi Arabia. All diabetic patients admitted to the hospital between the January 1, and December 31, 2018 were considered for inclusion in the study. Patients with DPN were identified and three controls per case were randomly selected from the remaining diabetic patients without peripheral neuropathy (PN). Results: A total of 2,096 adult diabetic patients were identified during the study period. Of these, 73 patients (3.5%) were confirmed to be suffering from DPN and 219 were included as controls. When comparing diabetic with the control cases, DPN cases were significantly older (p=0.002), had a significantly higher proportion of type 2 diabetes (p=0.023), chronic kidney disease (p<0.0001), cerebral vascular stroke (p=0.027), hypertension (p=0.005), dyslipidemia (p=0.002), peripheral vascular disease (p<0.0001), osteoarthritis (p=0.034), diabetic ketoacidosis (p=0.003), foot ulcers (p=0.006), gangrene (p=0.001), lower limb ischemia (p=0.001), increased duration with diabetic disease (p=0.031), increased BMI (p=0.003), higher serum creatinine (p<0.001) and lower serum albumin levels (p=0.035). In the multivariate logistic regression, only older age {odds ratio (OR) 1.02, 95% CI 1.01-1.04, p=0.031}, chronic kidney disease (OR 2.39, 95% CI 1.23-4.64, p=0.010) and peripheral vascular disease (OR 3.14, 95% CI 1.39-7.13, p=0.006) were independently associated with DPN. Conclusion: This study identified several risk factors that contributed to the development of DPN in Saudis. These must be considered in strategies and campaigns aimed at risk reduction of cardiovascular and chronic diseases, and consequently progression of DPN.

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“…Finally, longer follow-up of patients with early increases in skin AGEs is highly welcome. Clarification of all these issues will help our decisions on the implementation of AGEs measurement in everyday reality, with the aim to improve outcomes of DPN, a still valid strategic priority [46][47][48][49].…”

Section: Discussionmentioning

confidence: 99%

Skin AGEs and diabetic neuropathy

2021

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Advanced glycation end-products (AGEs) are heterogeneous molecules produced by the non-enzymatic glycation of proteins, lipids, or nucleic acids during hyperglycaemia. Accumulation of AGEs in the peripheral nerves has recently been proposed as an additional risk factor for the development of diabetic neuropathy (DN). The gold standard for measurement of tissue-bound AGEs is tissue biopsy. However, their assessment with the newer, fast and simple method of skin autofluorescence (sAF) has recently gained special interest by virtue of its non-invasive, highly reproducible nature and its acceptable correlation with the reference method of skin biopsy. Accumulation of tissue AGEs evaluated by sAF has been shown to independently correlate with DN. Importantly, increasing evidence underscores their potential value as early biomarkers of the latter. Further important associations include diabetic nephropathy, diabetic retinopathy and cardiovascular autonomic neuropathy. However, the value of the implementation of screening with skin AGEs for DN remains unclear. The aim of the present review is to critically summarise current evidence on the association between skin AGEs and diabetic microvascular complications, with a particular emphasis on diabetic neuropathy, and to note the most important limitations of existing knowledge. Longer follow-up studies are also highly anticipated to clarify its role and provide data on patient selection and cost-effectiveness.

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Prevalence of diabetic peripheral neuropathy in Africa: A systematic review and meta-analysis

Cited by 17 publications

References 42 publications

Prevalence and Determinants of Diabetic Peripheral Neuropathy/Foot Syndrome in a rural population of North India

Prevalence and Determinants of Diabetic Peripheral Neuropathy/Foot Syndrome in a rural population of North India

<p>Prevalence and Risk Factors for Diabetic Peripheral Neuropathy Among Saudi Hospitalized Diabetic Patients: A Nested Case-Control Study</p>

Skin AGEs and diabetic neuropathy

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