Prevalence and Determinants of Diabetic Peripheral Neuropathy among Participants with Type 2 Diabetes Mellitus in Rural South India: A Community-Based Cross-Sectional Study.

Abstract

Background: Diabetic peripheral neuropathy (DPN) is one of the most common microvascular complications of type 2 diabetes mellitus (T2DM) and contributes substantially to morbidity and disability. Early detection and identification of associated factors are essential for preventing complications and improving diabetes care.

Objectives: To estimate the prevalence of diabetic peripheral neuropathy and identify its independent predictors among participants with T2DM in rural South India.

Methods: A community-based cross-sectional study was conducted among 390 participants with T2DM in the field practice area of a Rural Health and Training Centre, Chengalpattu district, Tamil Nadu, from October 2022 to August 2024. Participants were selected using a two-stage cluster sampling technique. DPN was assessed using the 10-g monofilament test, 128-Hz tuning fork test, and ankle reflex assessment. Data were analyzed using descriptive statistics, Chi-square test, and multivariable logistic regression. Adjusted odds ratios (AOR) with 95% confidence intervals (CI) were reported.

Results: The prevalence of diabetic peripheral neuropathy was 35.6% (95% CI: 30.8%-40.3%). Poor glycemic control and low medication adherence were observed in 47.2% and 34.1% of participants, respectively. Multivariable logistic regression showed that age ≥60 years, insulin-based treatment, alcohol consumption, the presence of comorbidities, poor glycemic control, and low medication adherence were independent predictors of diabetic peripheral neuropathy. Participants aged <60 years had significantly lower odds of diabetic peripheral neuropathy than those aged ≥60 years.

Conclusion: More than one-third of participants with T2DM had diabetic peripheral neuropathy. Early screening, routine foot examination, improved glycemic control, and strengthening primary healthcare services are essential to reduce the burden of DPN in rural communities.