School of Public Health, College of Medicine and Health Science, Arba Minch University, Arba Minch, Ethiopia.
School of Medicine, College of Medicine and Health Science, Arba Minch University, Arba Minch, Ethiopia.
PLoS One. 2021 Feb 16;16(2):e0246722. doi: 10.1371/journal.pone.0246722. eCollection 2021.
Peripheral neuropathy is a leading cause of morbidity and increased mortality among diabetic patients. It is characterized by significant deficits in vibration and tactile sensation. With an annual incidence of 2%, it affects as many as 110 million people worldwide. The aim of this study was to assess factors associated with peripheral neuropathy among diabetic patients in chronic care clinic in Gamo and Gofa zone, South Ethiopia.
An institution- based unmatched case control study was employed among 528 randomly selected participants using a pre-tested, interviewer-administered, and structured questionnaire. Bivariate and multivariable logistic regression analysis was conducted to identifiy determinants of peripheral neuropathy using IBM SPSS version 25.
The odds of being an urban dweller was 2.67 times higher among cases than controls [AOR = 2.67 (1.27, 5.63)]. The likelihood of fasting blood glucose level between 203 and 282 and 282 and above was 2.55 and 3.88 times higher among cases than controls [AOR = 2.55 (1.91, 7.16)] and [AOR = 3.88 (1.42, 10.60)] respectively. The probability of living with diabetes mellitus for 10 and more years was 3.88 times higher among cases than controls [AOR = 3.88 (1.42, 10.60)]. The odds of controlling glucose level after developing symptom was 5.33 times higher among cases than controls [AOR = 5.33 (1.28, 12.24)]. The probability of having high blood pressure was 2.36 times higher among cases than controls [AOR = 2.36 (1.26, 4.43)]. The likelihood of having a family history of complication from diabetes mellitus was 5.60 times higher among cases than controls [AOR = 5.60 (2.03, 15.43)]. The odds of exercising 3 times per week for 15 to 30 minutes and for less than 15 minutes were 2.96 and 4.92 times higher among cases than controls respectively [AOR = 2.96 (1.32, 6.61)] and AOR = 4.92, 95% CI (1.85, 13.04) respectively. The likelihood of having a waist circumference greater than or equal to 40 inch was 2.72 times higher among cases than controls [AOR = 2.72 (1.07, 6.94)].
This study showed that residence, duration of diabetic mellitus, family history of complication from diabetic mellitus, level of fasting blood glucose, method of glycemic control, having a high blood pressure/hypertension/, frequency and duration of physical activity and waist circumference were found to be determinants of peripheral neuropathy. Thus, the concerned health authorities and health professionals should target on these factors in their efforts to prevent peripheral neuropathy among diabetics in the study area.
周围神经病变是糖尿病患者发病率和死亡率增加的主要原因。其特征是振动和触觉显著丧失。年发病率为 2%,全球受影响人数多达 1.1 亿。本研究旨在评估在埃塞俄比亚南部 Gamo 和 Gofa 地区慢性病诊所的糖尿病患者中与周围神经病变相关的因素。
采用基于机构的病例对照研究,对 528 名随机选择的参与者进行了研究,使用了经过预测试的、由访谈员管理的、结构良好的问卷。采用 IBM SPSS 版本 25 进行了双变量和多变量逻辑回归分析,以确定周围神经病变的决定因素。
与对照组相比,城市居民发生周围神经病的可能性高出 2.67 倍[比值比(OR)= 2.67(1.27,5.63)]。空腹血糖水平在 203 至 282 及 282 以上的情况下,病例组发生周围神经病的可能性分别是对照组的 2.55 倍和 3.88 倍[比值比(OR)= 2.55(1.91,7.16)]和[比值比(OR)= 3.88(1.42,10.60)]。与对照组相比,患有糖尿病 10 年及以上的患者发生周围神经病的可能性高出 3.88 倍[比值比(OR)= 3.88(1.42,10.60)]。出现症状后控制血糖水平的可能性高出 5.33 倍[比值比(OR)= 5.33(1.28,12.24)]。与对照组相比,高血压的可能性高出 2.36 倍[比值比(OR)= 2.36(1.26,4.43)]。有糖尿病并发症家族史的患者发生周围神经病的可能性是对照组的 5.60 倍[比值比(OR)= 5.60(2.03,15.43)]。每周锻炼 3 次,每次 15 至 30 分钟和每次少于 15 分钟的患者发生周围神经病的可能性分别是对照组的 2.96 倍和 4.92 倍[比值比(OR)= 2.96(1.32,6.61)]和[比值比(OR)= 4.92,95%置信区间(1.85,13.04)]。与对照组相比,腰围大于或等于 40 英寸的患者发生周围神经病的可能性高出 2.72 倍[比值比(OR)= 2.72(1.07,6.94)]。
本研究表明,居住地、糖尿病病程、糖尿病并发症家族史、空腹血糖水平、血糖控制方法、高血压/高血压、体育活动频率和持续时间以及腰围是周围神经病变的决定因素。因此,相关卫生当局和卫生专业人员应在该地区努力预防糖尿病患者发生周围神经病变时针对这些因素采取行动。