The Department of Physical Therapy, University of Central Arkansas, Conway, Arkansas (Dr Wang)
The Department of Family and Preventive Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas (Dr Balamurugan)
Diabetes Educ. 2011 Jul-Aug;37(4):536-48. doi: 10.1177/0145721711410717.
The purpose of this study was to investigate the prevalence of diabetic peripheral neuropathy (DPN) and to identify at risk populations in medically underserved rural communities.
A cross-sectional study was conducted in 816 type 2 diabetic patients from 5 rural Arkansas counties who attended a diabetes education program from 2005 to 2009. The data was collected through a survey questionnaire and from medical records. Univariate and multivariate analyses were conducted.
Of the 816 patients studied, 9.6% had a DPN diagnosis, and 43% reported peripheral neuropathy symptoms (PNS). Among the patients with PNS, 79% had not been diagnosed with DPN. Multivariate analyses found that being female, being white, having less than a college education, having a longer duration of diabetes, having a history of smoking, having a professional foot examination, and performing self foot examinations are associated with a higher risk for having DPN or PNS.
The study found that the prevalence of patients with PNS was high, and that DPN was alarmingly underdiagnosed in these underserved rural communities. The high prevalence of PNS and underdiagnosis of DPN could influence the development of severe foot complications like diabetic foot ulcer, and even possibly increase the risk of lower extremity amputation in these underserved communities. The at risk population identified by this study would be a resource to help diabetes educators develop targeted education and intervention programs in underserved rural communities.
本研究旨在调查医疗资源匮乏的农村社区中糖尿病周围神经病变（DPN）的患病率，并确定高危人群。
2005 年至 2009 年，对来自阿肯色州 5 个农村县参加糖尿病教育计划的 816 例 2 型糖尿病患者进行了横断面研究。数据通过问卷调查和病历收集。进行了单因素和多因素分析。
在所研究的 816 例患者中，9.6%被诊断为 DPN，43%报告有周围神经病变症状（PNS）。在有 PNS 的患者中，79%未被诊断为 DPN。多因素分析发现，女性、白人、受教育程度低于大学、糖尿病病程较长、有吸烟史、接受过专业足部检查以及进行自我足部检查与 DPN 或 PNS 的风险增加相关。
本研究发现，这些医疗资源匮乏的农村社区中 PNS 患者的患病率较高，而 DPN 的诊断明显不足。PNS 的高患病率和 DPN 的低诊断率可能会影响严重足部并发症的发生，如糖尿病足溃疡，甚至可能增加这些医疗资源匮乏社区下肢截肢的风险。本研究确定的高危人群将为糖尿病教育工作者在医疗资源匮乏的农村社区制定有针对性的教育和干预计划提供资源。
