Prevalence and risk factors for painful diabetic neuropathy in secondary health care in Qatar

Ponirakis, Georgios, Elhadd, Tarik, Chinnaiyan, Subitha, Dabbous, Zeinab, Mashhood, Siddiqui, Al-Muhannadi, Hamad, Petropoulos, Ioannis, Khan, Adnan, Ashawesh, Khaled AE, Dukhan, Khaled MO, Mahfoud, Ziyad R, Murgatroyd, Christopher, Slevin, Mark and Malik, Rayaz A (2019) Prevalence and risk factors for painful diabetic neuropathy in secondary health care in Qatar. Journal of Diabetes Investigation, 10 (6). pp. 1558-1564. ISSN 2040-1116

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Abstract

AIMS/INTRODUCTION:Painful diabetic peripheral neuropathy (PDPN) has a significant impact on the patient's quality of life. The prevalence of PDPN in the Middle East and North Africa (MENA) region has been reported to be almost double that of populations in the UK. We sought to determine the prevalence of PDPN and its associated factors in T2DM patients attending secondary care in Qatar. MATERIALS AND METHODS:This is a cross-sectional study of 1095 participants with T2DM attending Qatar's two national diabetes centers. PDPN and impaired vibration perception on the pulp of the large toes were assessed using the DN4 questionnaire with a cut-off ≥4 and the Neurothesiometer with a cut-off ≥15V, respectively. RESULTS:The prevalence of PDPN was 34.5% (95% CI: 31.7%-37.3%), but 80% of these patients had not previously been diagnosed or treated for this condition. Arabs had a higher prevalence of PDPN compared to South Asians (P<0.05). PDPN was associated with impaired vibration perception AOR=4.42 (95%CI: 2.92-6.70), smoking AOR=2.43 (95%CI: 1.43-4.15), obesity AOR=1.74 (95%CI: 1.13-2.66), being female AOR=1.65 (95%CI: 1.03-2.64) and duration of diabetes AOR=1.08 (95%CI: 1.05-1.11). Age, poor glycemic control, hypertension, physical activity and proteinuria showed no association with PDPN. CONCLUSIONS:PDPN occurs in 1/3 of T2DM patients attending secondary care in Qatar, but the majority have not been diagnosed. Arabs are at higher risk for PDPN. Impaired vibration perception, obesity and smoking are associated with PDPN in Qatar. This article is protected by copyright. All rights reserved.