Prevalence of Peripheral Neuropathy and Associated Factors among Adults with Diabetes Mellitus

Abstract

Peripheral neuropathy (PN) is one of the major common risk factors for diabetic foot ulcer (DFU) in people with diabetes mellitus. Proper foot care practices are important in prevention of PN, peripheral vascular disease, DFU and amputation. Prevalence of PN and DFU is not well documented in Zimbabwe. This crosssectional study was conducted to estimate the prevalence of PN in a random sample of 83 adults with diabetes mellitus aged 18-79 years at Parirenyatwa Group of Hospitals. PN was diagnosed by vibration sensation using a 128Hz tuning fork and by touch using the Ipswich touch test. Foot care practices were measured using an adapted Diabetic Foot Care questionnaire of the American College of Physicians (2007). A clinical audit form was used to collect demographic data, foot problems and foot care practices. Ethical approval was granted by the institutional research review board. All participants gave informed consent. Foot examinations and interviews were held in private rooms with strict maintenance of confidentiality. Data was analysed using the Statistical Package for Social Sciences vs 22. Mean age of participants was 52 years. The prevalence of PN as diagnosed by vibration sensation test and Ipswich touch test was 30.1% and 31.3% respectively. Level of education (p> 0.032), residence in a peri-urban area (p> 0.027) and having at least one symptom of PN (p> 0.001), were associated with presence of PN. Peri-urban residence (p=0.018), and negative serostatus (p=0.04) were significantly associated with poor foot-care practices. There was a significant association between poor foot care practice and PN (OR, 5.99, CI, 2.06-17, 40, p=0.001). Routine health education and foot examination should be incorporated in care of people with diabetes mellitus to detect PN and to prevent or delay occurrence of DFU. Both vibration sensation and Ipswich touch tests are cost effective ways of detecting PN in resource limited settings.