Mairaj Mir Khalid, Pala Nazir Ahmad, Ismail Mohd
Department of Internal Medicine, Government Medical College Srinagar, Srinagar, IND.
Cureus. 2024 Nov 8;16(11):e73304. doi: 10.7759/cureus.73304. eCollection 2024 Nov.
Diabetic peripheral neuropathy (DPN) is the most common complication of both type 2 diabetes mellitus (T2DM) and type 1 diabetes mellitus (T1DM) occurring in a majority of the affected people. DPN is the key initiating factor for the development of diabetic foot ulceration and the most common cause of non-traumatic lower-limb amputations. Whether chronic hyperglycaemia per se or altered levels of intermediate conventional risk factors in these people are responsible for the increased risk of DPN, is a matter of debate. There is little data about the profile of DPN in people with treatment-naive diabetes and prediabetes in the Asian population.
This study aimed to determine the frequency of early DPN among people with newly detected treatment-naive diabetes and prediabetes attending a tertiary care public hospital. The study further aimed to determine the risk factors associated with DPN and to investigate whether such risk factors in these people might help to explain their increased risk of peripheral neuropathy.
A total of 65 consecutive people with treatment-naive T2DM with an equal number of people with prediabetes attending a tertiary care centre, diagnosed as per standard criteria, were enrolled in a non-randomised prospective study. The presence of peripheral neuropathy was assessed by the Michigan Neuropathy Screening Instrument (MNSI). Risk factor analysis for peripheral neuropathy in both groups was carried out. Statistical significance was considered with p-values of < 0.05.
A total of 13 (20%) people with newly diagnosed treatment-naive T2DM and eight (12.3%) with prediabetes had DPN (MNSI score ≥ 2.5). Age (p < 0.001), high plasma glucose/glycated haemoglobin (HbA1c) (p < 0.001), BMI (p < 0.001), total cholesterol (p <0.001), albuminuria and hypertension (p < 0.001) were found to be strongly associated with early peripheral neuropathy.
DPN is a frequent complication among newly diagnosed treatment-naive people with T2DM and to a lesser extent among people with prediabetes. Various anthropometric, clinical, biochemical and metabolic factors in people with hyperglycaemia could account for the increased frequency of DPN in these people.
糖尿病周围神经病变（DPN）是2型糖尿病（T2DM）和1型糖尿病（T1DM）最常见的并发症，大多数患者都会出现。DPN是糖尿病足溃疡形成的关键起始因素，也是非创伤性下肢截肢最常见的原因。慢性高血糖本身或这些患者中传统中间风险因素水平的改变是否导致DPN风险增加，仍存在争议。关于亚洲人群中未经治疗的糖尿病患者和糖尿病前期患者的DPN情况，数据很少。
本研究旨在确定在一家三级护理公立医院就诊的新诊断未经治疗的糖尿病患者和糖尿病前期患者中早期DPN的发生率。该研究还旨在确定与DPN相关的风险因素，并调查这些患者中的此类风险因素是否有助于解释他们周围神经病变风险的增加。
共有65例连续的未经治疗的T2DM患者以及数量相等的糖尿病前期患者在一家三级护理中心就诊，这些患者均根据标准标准诊断，被纳入一项非随机前瞻性研究。采用密歇根神经病变筛查工具（MNSI）评估周围神经病变的存在情况。对两组患者的周围神经病变风险因素进行分析。p值<0.05被认为具有统计学意义。
共有13例（20%）新诊断的未经治疗的T2DM患者和8例（12.3%）糖尿病前期患者患有DPN（MNSI评分≥2.5）。发现年龄（p<0.001）、高血糖/糖化血红蛋白（HbA1c）（p<0.001）、体重指数（BMI）（p<0.001）、总胆固醇（p<0.001）、蛋白尿和高血压（p<0.001）与早期周围神经病变密切相关。
DPN是新诊断的未经治疗的T2DM患者中常见的并发症，在糖尿病前期患者中发生率较低。高血糖患者的各种人体测量、临床、生化和代谢因素可解释这些患者中DPN发生率的增加。
