Profiles of Peripheral Neuropathy and Risk Factors in People With Treatment-Naive Type 2 Diabetes Mellitus and Prediabetes.

BACKGROUND

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.

OBJECTIVES

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.

METHODS

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.

RESULT: 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.

CONCLUSION

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.