Screening for peripheral neuropathy and peripheral arterial disease in persons with diabetes mellitus in a Nigerian University Teaching Hospital

Abstract

BackgroundIdentifying the risk factors for diabetes mellitus related foot ulceration would save more limbs from amputation. This report focuses on the determining the burden of peripheral arterial disease and neuropathy in persons with diabetes mellitus (DM).MethodsThis is a descriptive study carried out in the Diabetic Clinic of the Lagos State University Teaching Hospital in patients with DM who had no past/present history of foot ulceration. Biothesiometry was employed and ankle brachial pressure indices were measured to evaluate for neuropathy and peripheral arterial disease (PAD) respectively.ResultsA total of 225 persons living with DM who met inclusion criteria were recruited consecutively over a 3 months period. Age range was 28–87 years with the mean [61.4 (10.8)] and median (63) years respectively. Patients symptomatic for neuropathy and PAD were 37 and 40 % respectively of the study population. An older age of >60 years and poor glycaemic control were potential predictors of neuropathy. Neuropathy and PAD occurred commonly in the seventh decade of life.ConclusionGiven the fairly high proportions of neuropathy and PAD in our patients with DM, we recommend that they be routinely examined in persons with DM.

Peripheral arterial disease and its correlates in patients with type 2 diabetes mellitus in a teaching hospital in northern Nigeria: a cross-sectional study

“…Peripheral arterial disease was common in patients with type 2 DM in this study: 38.5% of our DM patients had PAD. Our findings are comparable to studies in Southern Nigeria where similar populations were assessed for PAD [13,15]. One reason for the high prevalence of PAD in our study is that DM co-exists with other risk factors for cardiovascular disease.…”

“…Perhaps other risk factors were more common in the younger diabetics such as dyslipidaemia. Mwebaze et al (2014) and Ogbera et al (2015) found that PAD was more common in younger DM patients, although this was not significant [14,15]. This was different from the observations made in other studies [9,29].…”

“…In patients with DM, the presence of PAD as determined by ABI varies from 9 to 20% [3,7,8] in Western countries and from 3.2-24.1% [9][10][11][12] in Asia. In sub-Saharan Africa, recent studies on PAD in patients with DM estimate the occurrence of PAD to be between 28 and 52.5% using ABI [13][14][15]. Ankle brachial pressure index, a ratio of the systolic blood pressure in the ankle to the systolic pressure in the arm, has 95% specificity and 100% sensitivity for PAD at a value of ≤0.90 [16,17].…”

Peripheral Sensory Neuropathy and associated factors among adult diabetes mellitus patients in Bahr Dar, Ethiopia

“…The above difference clearly demonstrates the limitations related to patients self perception of symptoms of DPSN and suggest insisting on MNSI examination to be administered regularly during out-patient visit. Similar finding was observed in a study conducted in Logos Nigeria [13]. The prevalence of DPSN using MNSI examination among adult diabetic participants in.…”

“…The Jima study used only a structured questionnaire but this study MSNI history version and examination version which helped identifying more cases. Studies in United Arab Emirates, India, South Africa and Nigeria reported a prevalence of 30.3%, 10.5, 37, 32.2% respectively [3, 6, 7, 13] which are lower than the prevalence of DPSN in the present study. The possible explanation for the difference in prevalence of DPSN might be the difference in study population, tools used and methodologies.…”