Prevalence and grade of diabetic peripheral neuropathy among known diabetic patients in rural Uganda.

Dalton Kambale Munyambalu, Idania Hildago, Yves Tibamwenda Bafwa, Charles Abonga Lagoro, Franck Katembo Sikakulya, Bienfait Mumbere Vahwere, Ephraim Dafiewhare, Lazaro Martinez, Fardous Abeya Charles
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Abstract

Background: Diabetic peripheral neuropathy (DPN) is the most common complication of diabetes mellitus (DM). Approximately 50% of diabetic patients are estimated to develop DPN, depending on disease duration and diabetic control. Early diagnosis of DPN will avoid complications, including non-traumatic lower limb amputation, which is considered the most debilitating complication, as well as significant psychological, social, and economical problems. There is a paucity of literature on DPN from rural Uganda. This study aimed to deliver the prevalence and grade of DPN among DM patients in rural Uganda.

Methods: A cross-sectional study that recruited 319 known DM patients was conducted in an outpatient clinic and a diabetic clinic at Kampala International University-Teaching Hospital (KIU-TH), Bushenyi, Uganda, between December 2019 and March 2020. Questionnaires were used to obtain clinical and sociodemographic data, a neurological examination was carried out to assess the DPN, and a blood sample was collected from each participant (for random/fasting blood glucose and glycosylated hemoglobin analyses). Data were analyzed using Stata version 15.0.

Results: The sample size was 319 participants. The mean age of study participants was 59.4 ± 14.6 years and there were 197 (61.8%) females. The prevalence of DPN was 65.8% (210/319) (95% CI 60.4% to 70.9%), and 44.8% of participants had mild DPN, 42.4% had moderate DPN, and 12.8% had severe DPN.

Conclusion: The prevalence of DPN at KIU-TH was higher among DM patients and its stage might have a negative impact on the progression of Diabetes Mellitus. Therefore, clinicians should consider neurological examination as a routine during assessment of all DM patients especially in rural areas where resources and facilities are often limited so that complications related to Diabetic mellitus will be prevented.

Abstract Image

乌干达农村已知糖尿病患者中糖尿病周围神经病变的患病率和等级。
背景:糖尿病周围神经病变(DPN)是糖尿病(DM)最常见的并发症。据估计,大约50%的糖尿病患者会发展为DPN,这取决于病程和糖尿病控制情况。DPN的早期诊断将避免并发症,包括非创伤性下肢截肢,这被认为是最衰弱的并发症,以及重大的心理、社会和经济问题。关于乌干达农村DPN的文献很少。本研究旨在了解乌干达农村糖尿病患者DPN的患病率和等级。方法:2019年12月至2020年3月,在乌干达布申伊坎帕拉国际大学教学医院(KIU-TH)的门诊和糖尿病诊所进行了一项横断面研究,招募了319名已知的糖尿病患者。通过问卷调查获得临床和社会人口学数据,进行神经学检查以评估DPN,并收集每位参与者的血液样本(用于随机/空腹血糖和糖化血红蛋白分析)。数据分析使用Stata 15.0版本。结果:样本量为319人。研究对象的平均年龄为59.4±14.6岁,女性197人(61.8%)。DPN患病率为65.8% (210/319)(95% CI 60.4%至70.9%),44.8%的参与者患有轻度DPN, 42.4%患有中度DPN, 12.8%患有重度DPN。结论:KIU-TH期糖尿病患者DPN患病率较高,其分期可能对糖尿病的进展有不利影响。因此,临床医生在评估所有糖尿病患者时应考虑将神经系统检查作为常规检查,特别是在资源和设施有限的农村地区,以预防与糖尿病相关的并发症。
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