Lee Ping Yein, Hani Syahida Salim, Cheng Yee Gin, Zainuddin Zunayrah, Singh Harvind, Loh Kien Woon
MBBS(UM) MFamMed(UM), UM eHealth Unit, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia.
MBBChBAO(UCD) MFamMed(UM), Department of Family Medicine, University of Putra Malaysia, Seri Kembangan, Selangor, Malaysia.
Malays Fam Physician. 2022 Mar 8;17(1):36-43. doi: 10.51866/oa1297. eCollection 2022 Mar 28.
Diabetic Peripheral Neuropathy (DPN), the most common complication of Diabetes Mellitus (DM), is often under-diagnosed and inadequately treated. This study identified the proportion of undiagnosed DPN and its associated risk factors among patients with established type 2 DM (T2DM) in community health clinics in the Gombak district.
A cross-sectional study was conducted in 2 community health clinics within the Gombak district between September and December 2017. Adults with T2DM were selected via systematic random sampling and screened using the Neuropathy Symptoms Score (NSS). Clinical records of participants' foot examinations were reviewed to identify positive findings of DPN and compared with the NSS.
The study's sample comprised 425 patients. Most had co-morbidities, including hypertension, dyslipidaemia and pre-existing DM-related complications. About two-thirds of them performed no daily foot inspection and had no proper footwear. The proportion of patients with positive NSS was 49.4%. However, only 0.2% were diagnosed with positive DPN in their clinical foot examination record.
Although a positive NSS was identified in 1 out of 2 patients with established DM, only 0.2% of patients had DPN on their examination records. Most patients had never done daily foot inspections and lacked proper footwear. A positive NSS was associated with uncontrolled diabetes and lower BMI. Proper screening and examination for patients, especially those with uncontrolled diabetes and low BMI, is crucial in identifying DPN to ensure that these diabetic patients receive better preventative care, especially proper foot care and strict diabetic control, to prevent DPN-related complications.
糖尿病周围神经病变（DPN）是糖尿病（DM）最常见的并发症，常未得到充分诊断和治疗。本研究确定了哥打白沙罗地区社区卫生诊所中已确诊的2型糖尿病（T2DM）患者中未确诊DPN的比例及其相关危险因素。
2017年9月至12月在哥打白沙罗地区的2家社区卫生诊所进行了一项横断面研究。通过系统随机抽样选取患有T2DM的成年人，并使用神经病变症状评分（NSS）进行筛查。回顾参与者足部检查的临床记录，以确定DPN的阳性发现，并与NSS进行比较。
该研究样本包括425名患者。大多数患者患有合并症，包括高血压、血脂异常和既往存在的DM相关并发症。其中约三分之二的患者没有每天进行足部检查，也没有合适的鞋类。NSS阳性的患者比例为49.4%。然而，在临床足部检查记录中，只有0.2%的患者被诊断为DPN阳性。
虽然在每2名已确诊DM的患者中就有1名NSS呈阳性，但在检查记录中只有0.2%的患者患有DPN。大多数患者从未进行过每日足部检查，且缺乏合适的鞋类。NSS阳性与糖尿病控制不佳和较低的体重指数相关。对患者，尤其是糖尿病控制不佳和体重指数较低的患者进行适当的筛查和检查，对于识别DPN至关重要，以确保这些糖尿病患者获得更好的预防性护理，尤其是适当的足部护理和严格的糖尿病控制，以预防与DPN相关的并发症。
