Kamalarathnam Sangeetha R, Varadarajan Suresh
Department of Community Medicine, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India.
J Family Med Prim Care. 2022 Jan;11(1):113-117. doi: 10.4103/jfmpc.jfmpc_470_21. Epub 2022 Jan 31.
Diabetic neuropathy is a complication affecting almost 50% of the diabetic patients. Diabetic Peripheral Neuropathy (DPN) predominantly affects the hands and lower limbs. It leads to loss of protective sensation resulting in continuous injury to insensitive feet. The early detection of DPN using an objective screening test followed by its appropriate management is important as up to 50% of the patients may be asymptomatic.
To screen Diabetic patients attending an Urban Health and Training Centre of a medical college in Tamilnadu for Diabetic Peripheral Neuropathy. To assess the association between DPN and selected variables such as socio-demographic factors, glycaemic control, duration of diabetes, physical activity, body mass index, smoking and consumption of alcohol.
The study was conducted among 204 diabetic patients attending an Urban Health and Training Centre. Participants were assessed using Michigan Neuropathy Screening Instrument (MNSI), which involves using a questionnaire followed by a physical examination.
Of the 204 patients, 58.8% were male. The mean age was 54.8 years (SD = 8.8 years). About 79.9% were employed of which 29.4% were skilled labourers. Mean duration of diabetes was 6.2 years (SD = 5.3 years). The proportion of diabetics who screened positive for Peripheral Neuropathy was 23% and 45.6% using MNSI questionnaire and examination, respectively. An age of 60 years and above was significantly associated with DPN (OR = 2.505, value = 0.003). A duration of more than 4 years of diabetes was also significantly associated with DPN (OR = 1.872, value = 0.02820).
A high proportion of diabetics with peripheral neuropathy did not express symptoms specific for diabetics. Thus, a simple tool like MNSI would be useful in primary care settings to screen for peripheral neuropathy, and hence prevent disability".
糖尿病神经病变是一种并发症，影响着近50%的糖尿病患者。糖尿病周围神经病变（DPN）主要影响手部和下肢。它会导致保护性感觉丧失，从而使感觉迟钝的足部持续受伤。由于高达50%的患者可能无症状，因此通过客观筛查测试早期发现DPN并进行适当管理非常重要。
对在泰米尔纳德邦一所医学院的城市健康与培训中心就诊的糖尿病患者进行糖尿病周围神经病变筛查。评估DPN与选定变量之间的关联，如社会人口统计学因素、血糖控制、糖尿病病程、身体活动、体重指数、吸烟和饮酒情况。
该研究在一所城市健康与培训中心就诊的204名糖尿病患者中进行。使用密歇根神经病变筛查工具（MNSI）对参与者进行评估，该工具包括使用问卷和体格检查。
204名患者中，58.8%为男性。平均年龄为54.8岁（标准差=8.8岁）。约79.9%的人有工作，其中29.4%为技术工人。糖尿病平均病程为6.2年（标准差=5.3年）。使用MNSI问卷和检查筛查出外周神经病变阳性的糖尿病患者比例分别为23%和45.6%。60岁及以上年龄与DPN显著相关（比值比=2.505，P值=0.003）。糖尿病病程超过4年也与DPN显著相关（比值比=1.872，P值=0.02820）。
很大一部分患有周围神经病变的糖尿病患者没有表现出糖尿病特有的症状。因此，像MNSI这样的简单工具在初级保健环境中有助于筛查周围神经病变，从而预防残疾。
