Prevalence of diabetic peripheral neuropathy using Michigan Neuropathy Screening Instrument (MNSI) in an urban population, in India
Background: Diabetes mellitus (DM) is a major public health problem worldwide. Diabetic peripheral neuropathy (DPN) is a microvascular complication of type 2 diabetes mellitus attributed to chronic hyperglycemia and is defined as the presence of symptoms and / or signs of peripheral nerve dysfunction in people with diabetes after exclusion of other causes. The study was conducted with the objective to estimate the prevalence of diabetic peripheral neuropathy and to identify its determinants among type 2 diabetic patients in an urban population. Methods: This cross sectional study was conducted among patients attending Urban Health Centres of Ashok Nagar and Rukmini Nagar, Belagavi in Karnataka State over a period of four months (August – November 2019). A total of 250 patients with more than 6 months duration of type 2 diabetes mellitus were screened using questionnaire version of Michigan Neuropathy Screening Instrument (MNSI) after obtaining written informed consent from them. Results: The overall prevalence of DPN among study participants based on MNSI was 35.2% (88). Based on MNSI assessment, 21.6% and 29.2% of the participants had a score of ≥ 7 in the history section of the questionnaire and ≥ 2.5 in the physical examination section, respectively. The prevalence of DPN was significantly higher among those with age more than 50 yrs and those with history of either tobacco or alcohol consumption. The prevalence of DPN was also found to be higher among patients with HBA1c ≥ 7% and those with duration of DM >10 years. The multivariate logistic regression analysis showed that DPN was significantly associated with age more than 50 years [Odds Ratio: 1.628 (CI: 1.006 – 2.635)]. Conclusions: Use of MNSI as a screening tool in the primary health care setting could be a cost effective means for early detection of DPN and to prevent diabetic foot ulcerations and infections.
2. Simmons Z, Fieldman EL. Update on diabetic neuropathy. Current Opinion in Neurology 2002;15:595‑603
3. Dipika Bansal, KapilGudala, HariniMuthyala, Hari Prasad Esam, RamyaNayakallu, Anil Bhansali. Prevalence and risk factors of development of peripheral diabetic neuropathy in type 2 diabetes mellitus in a tertiary care setting. Journal of Diabetes Investigation. 2014; 5: 714–721
4. Mehra M, Merchant S, Gupta S, Potluri RC. Diabetic peripheral neuropathy: resource utilization and burden of illness. Journal of medical economics. 2014;17(9):637–45. pmid:24888404
5. Gordois A, Scuffham P, Shearer A, Oglesby A, Tobian JA. The health care costs of diabetic peripheral neuropathy in the US. Diabetes care. 2003;26(6):1790–5. pmid:12766111
6. Happich M, John J, Stamenitis S, et al. The quality of life and economic burden of neuropathy in diabetic patients in Germany in 2002–results from the Diabetic Microvascular Complications (DIMICO) study. Diabetes Res ClinPract 2008;81: 223–230.
7. American Diabetes Association. Standards of medical care in diabetes‑2006. Diabetes Care 2006;29:S4‑42
8. Monisha D’Souza, Vaman Kulkarni, Unnikrishnan Bhaskaran, Humam Ahmed, HegdeNaimish, Anjali Prakash et al. Diabetic peripheral neuropathy and its determinants among patients attending a tertiary health care centre in Mangalore, India. Journal of Public Health Research 2015; 4:450
9. George H, Rakesh PS, Krishna M, Alex R, Abraham VJ, George K, et al. Foot care knowledge and practices and the prevalence of peripheral neuropathy among people with diabetes attending a secondary care rural hospital in southern India. J Fam Med Primary Care 2013; 2:27-32.
10. Ashok S, Ramu M, Deepa R, Mohan V. Prevalence of neuropathy in type 2 diabetic patients attending a diabetes centre in South India.J Assoc Physicians India 2002; 50:546-50
11. Moghtaderi A, Bakhshipour A, Rashidi H. Validation of Michigan neuropathy screening instrument for diabetic peripheral neuropathy. ClinNeurolNeurosurg 2006; 108:477-81.
12. University of Michigan. How to Use the Michigan Neuropathy Screening Instrument[Internet]. Michigan. Available from:http://www.med.umich.edu/mdrtc/profs/documents/svi/MNSI_howto.pdf.
13. Sreelatha M, Kumar VS, Shekar GC, Shekar VC. Study of Thyroid Profile in Patients with Type 2 Diabetes Mellitus. 2017;5(2):211–20
14. Tabatabaei-Malazy O, Mohajeri-Tehrani M, Madani S, et al. The prevalence of diabetic peripheral neuropathy and related factors. AIran J Public Health 2011;40:55-62
15. Cabezas-Cerrato J. The prevalence of clinical diabetic polyneuropathy in Spain: a study in primary care and hospital clinic groups. Diabetologia1998; 41:1263-9.
16. Al-Geffari M. Comparison of different screening tests for diagnosis of diabetic peripheral neuropathy in Primary Health Care setting. Int J Health Sci. 2012; 6:127–34. https://doi.org/10.12816/0005988.
17. Börü UT, Alp R, Sargin H, et al. Prevalence of peripheral neuropathy in type 2 diabetic patients attending a diabetes center in Turkey. Endocr J 2004; 51:563-7.
18. Al-Sarihin K, Althwabia I, Khaled MB, Haddad F. Prevalence of peripheral neuropathy among patients with diabetes mellitus at King Hussein Hospital, Amman, Jordan. RMJ. 2013; 38:92–6.
19. Ashok S, Ramu M, Deepa R, Mohan V. Prevalence of neuropathy among type 2 diabetes mellitus patients attending a diabetes centre in South India. Journal Association Physicians India 2002; 50:546-550
20. Bansal D, Gudala K, Muthyala H, Prasad HE, Nayakallu R, Bhansali A. Prevalence and risk factors of development of peripheral diabetic neuropathy in type 2 diabetes mellitus in a tertiary care setting. Journal of Diabetes Investigation2014; 5: 714–721
21. Khawaja N, Abu‑Shennar J, Saleh M, Dahbour S, Khader Y and Ajlouni K. The prevalence and risk factors of peripheral neuropathy among patients with type 2 diabetes mellitus; the case of Jordan. DiabetolMetabSyndr (2018); 10:43. doi: 10.1186/s13098-018-0336-3
22. Rani PK, Raman R, Rachapalli SR, et al. Prevalence and risk factors for severity of diabetic neuropathy in type 2 diabetes mellitus. Indian J Med Sci 2010; 64: 51–57.
23. Morkrid K, Ali L, Hussain A. Risk factors and prevalence of diabetic peripheral neuropathy: a study of type 2 diabetic outpatients in Bangladesh. Int J Diabetes Dev Ctries 2010;30: 11–17
24. Kasim K, Amar M, Sadek AAE, et al. Peripheral neuropathy in type-II diabetic patients attending diabetic clinics in Al-Azhar University Hospitals, Egypt. Int J Diabetes Mellitus 2009; 2: 20–23.
25. Aaberg ML, Burch DM, Hud ZR, et al. Gender differences in the onset of diabetic neuropathy. J Diabetes Complications 2008; 22: 83–87.
26. Kamenov ZA, Parapunova RA, Georgieva RT. Earlier development of diabetic neuropathy in men than in women with type 2 diabetes mellitus. Gend Med 2010;7: 600–615.
27. Barbosa AP, Medina JL, Ramos EP, Barros HP. Prevalence and risk factors of clinical diabetic polyneuropathy in a Portuguese primary health care population. Diabetes Metab 2001;27:496-502
28. Janghorbani M, Rezvanian H, Kachooei A, Ghorbani A, Chitsaz A, Izadi F, et al. Peripheral neuropathy in type 2 diabetes mellitus in Isfahan, Iran: Prevalence and risk factors. ActaNeurolScand a 2006;114:384-91
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