scholarly journals Prevalence, Patterns, and Factors Associated with Peripheral Neuropathies among Diabetic Patients at Tertiary Hospital in the Kilimanjaro Region: Descriptive Cross-Sectional Study from North-Eastern Tanzania

2019 ◽  
Vol 2019 ◽  
pp. 1-7 ◽  
Author(s):  
Ahlam A. Amour ◽  
Nyasatu Chamba ◽  
Johnstone Kayandabila ◽  
Isaack A. Lyaruu ◽  
Dekker Marieke ◽  
...  

Objective. Diabetic peripheral neuropathy (DPN) is a common microvascular complication of diabetes mellitus (DM) and may progress to diabetic foot, which frequently leads to amputation and/or disability and death. Data is scanty on the burden of diabetic peripheral neuropathy in Tanzania. The aim of this study was to assess the burden of peripheral neuropathy, its severity, and the associated factors. Methods. The study was a cross-sectional hospital-based study and was carried out from October 2017 to March 2018 among adolescent and adult patients attending Kilimanjaro Christian Medical Center (KCMC) diabetes clinic. Results. A total of 327 diabetic patients, females n=215 (65.7%) and males n=121 (34.3%), were included in the study. The mean age was 57.2 yrs. A total of 238 (72%) had type 2 and 89 (27.2%) had type1 DM. The prevalence of peripheral neuropathy was 72.2% of whom 55% were severe, 19% were moderate, and 26% were mild. The severity of neuropathy increased with the increase in age >40 years (p < 0.001) and increase in body mass index (p<0.001) and duration of diabetes; duration >7 years (p <0.006). The main associated factors were age >40 years, OR 2.8 (1.0-7.7), >60 years, OR 6.4 (2.3-18.2), obesity, OR 6.7 (0.9-27.7), and hypertension, OR 4.3 (2.2-8.2). Conclusion. More than half of the patients included in this study were found to have neuropathy, nearly half of whom presented with the severe form. The main risk factors were increasing age, increasing duration of diabetes, obesity, and hypertension. Diabetic peripheral neuropathy is underdiagnosed in northern Tanzania where screening for neuropathy is not routinely done.

2019 ◽  
Vol 2019 ◽  
pp. 1-6 ◽  
Author(s):  
Zahra D. Khan ◽  
Janet Lutale ◽  
Sibtain M. Moledina

Despite adequate treatment for diabetes, it is estimated that 15%- 20% of people with diabetes are struggling with a moderate to severe form of depression daily. Little is known about depression in diabetes in East Africa, particularly in Tanzania. The study is aimed at determining the prevalence of depression and associated factors among patients with diabetes. A descriptive cross-sectional study was carried out at the diabetes clinic of Muhimbili National Hospital. The 9-item Patient Health Questionnaire (PHQ 9) scale was used to assess presence of depressive symptoms among diabetes patients at the clinic. In addition, patient’s sociodemographic and clinical characteristics were obtained and analysed for their association with depression. A total of 353 participants were recruited, of whom 229 (64.9%) patients were female and 156 (44.2%) were aged between 41 and 60 years. The overall prevalence of depression among diabetes patients at the diabetes clinic was 87%. Most (56.7%) had minimal depression, 22.1% had mild depression, and 8.2% had moderate depression. None had severe depression. Factors independently associated with a diagnosis of mild to moderate depression were being on insulin therapy and being a current smoker. There was a high prevalence of depression in this diabetic population. Majority of patients had minimal depression but about 30% had either mild or moderate depression. A holistic approach that focuses on the identification and management of depression among patients with diabetes is recommended.


1970 ◽  
Vol 28 (5) ◽  
Author(s):  
Belete Biadgo ◽  
Tadele Melak ◽  
Sintayehu Ambachew ◽  
Habtamu Wondifraw Baynes ◽  
Miteku Andualem Limenih ◽  
...  

BACKGROUND: Metabolic syndrome is a cluster of risk factors that is responsible for the risk of coronary heart disease and stroke. Therefore, the aim of this study was to assess the prevalence of MetS and its components among T2DM patients.METHODS: A cross-sectional study was conducted at the Diabetes Clinic of the Hospital, from June to July, 2015. Data were entered into EPI INFO software and exported to SPSS 20 for analysis. MetS prevalence was estimated using NCEP ATPIII and IDF criteria. Anthropometric measurements, investigations of serum glucose and lipid profiles were done. Logistic regression analysis was used to evaluate associated factors. A P-value ≤ 0.05 wasconsidered statistically significant.RESULT: A total of 159 participants were included in the study; 119 (59.7%) were females with mean (±SD) age of (49.8±8.7) year. The prevalence of MetS was 66.7% in NCEP-ATP III and 53.5% in IDF definitions. The most prevalent component of MetS was elevated triglyceride (56.6% in ATPIII and 62.3% in IDF criteria), followed by abdominal obesity (61%) IDF and elevated blood pressure (55.4%) NCEP-ATPIII criteria. The regression analysis showed that increased age, being female, high BMI, having diabetes for over 5 years and poor glycemic control were significantly associated with metabolic syndrome.CONCLUSION: The prevalence of MetS and its components among T2DM patients were high, suggesting that diabetic patients are at increased risk of CVD and other complications. Efforts should be geared towards addressing these abnormalities through lifestyle modification, health awareness and medications in order to reduce this complication. 


2020 ◽  
Vol 2020 ◽  
pp. 1-6 ◽  
Author(s):  
Daba Abdissa ◽  
Tesfaye Adugna ◽  
Urge Gerema ◽  
Diriba Dereje

Background. Diabetic foot ulceration is a devastating complication of diabetes mellitus and is a major source of morbidity and mortality. So far, there are few published data on diabetic foot ulcers and its determinants among diabetic patients on follow-up at Jimma Medical Center. Hence, the aim of this study was to assess the prevalence of diabetic foot ulcer and its determinants among patients with diabetes mellitus at Jimma Medical Center. Methods. A hospital-based cross-sectional study was conducted from June 1 to August 30, 2019, and systematic random sampling technique was applied. The total number of study subjects who participated in the study was 277. Data were collected using an interview-administered structured questionnaire. Data were entered into EpiData version 3.1 and exported to SPSS version 20 software for analysis. Analysis was done using descriptive statistics and logistic regression. A variable having a p value of <0.25 in the bivariate model was subjected to multivariate analysis to avoid confounding the variable’s effect. Adjusted odds ratios (AOR) were calculated at 95% confidence interval and considered significant with a p value of ≤0.05. Result. The mean of age of participants was 50.1±14.19 years. More than three-fourths of participants (82.7%) were type 2 DM. The mean duration of diabetic patients was 6.00±5.07 years. The prevalence of diabetic foot ulcer was 11.6% among study participants. According to multivariate logistic regression analysis, previous history of ulceration (AOR=5.77; 95% CI: 2.37, 14.0) and peripheral neuropathy (AOR=11.2; 95% CI: 2.8, 44.4) were independent predictors of diabetic foot ulcer. Conclusion. The prevalence of diabetic foot ulcer was 11.6%. Previous history of ulceration and peripheral neuropathy were associated with diabetic foot ulcer. The health care providers are recommended to thoroughly give emphasis during follow-up of patients who had previous history of ulceration and peripheral neuropathy in order to decrease the occurrence of diabetic foot ulcer.


2018 ◽  
Vol 10 (1) ◽  
pp. 72-76
Author(s):  
Dipesh Karki ◽  
Amar Nagila ◽  
Niraj Dhakal ◽  
Sumit Chhetri

Background: Diabetic peripheral neuropathy (DPN) is a most common micro vascular complication of diabetes posing significant morbidity and mortality with early and insidious onset. Studies has variably pointed that older age, gender, duration of diabetes, dyslipidemia, are linked with development of DPN. Aims and Objectives: To determine the prevalence of neuropathy in diabetic patients and see its link with age, gender, duration of diabetes, therapy and ethnicity. Materials and Methods: This is a cross-sectional study involving 110 clinically diagnosed diabetic patients, meeting the inclusion criteria. Basic demographic data were taken during clinical examination. Presence of degree of neuropathy was screened by measuring vibration perception threshold using Biothesiometer. Data was entered on SPSS and were categorized, necessary non parametric statistical tests were applied to these categorical variables as needed. The level of significance was set at p value less than 0.05. Results: Presence of neuropathy was measured in 110 diabetic patients. The overall prevalence of DPN was 45.45%. Frequency of neuropathy was higher with increase in age with 72.7% in more than 60 years of age and 23.5% in less than or equal to 40 years of age group (p=0.007). Similarly, the increasing trend of DPN with increase in duration of DM was evident in this study with DPN present in more than 55% of patients with more than 5 years of diabetes(p=0.004). Conclusion: The prevalence rate of DPN in diabetes was observed to be higher (45.45%). Our result suggested that DPN is associated with old age and the duration of diabetes mellitus. Asian Journal of Medical Sciences Vol.10(1) 2019 72-76


2019 ◽  
Vol 7 (1) ◽  
pp. 103-106 ◽  
Author(s):  
Eva Decroli ◽  
Asman Manaf ◽  
Syafril Syahbuddin ◽  
Yuliarni Syafrita ◽  
Dwisari Dillasamola

AIM: This study was conducted to identify malondialdehyde (MDA) serum level, nerve growth factor (NGF) serum level, diabetic peripheral neuropathy score and the correlation between MDA and NGF serum level with diabetic peripheral neuropathy score. METHODS: A cross-sectional study was conducted to observe diabetic patients in the internal medicine department in Dr M. Djamil Hospital, Padang, Indonesia. The MDA serum level was measured using Beuge method with thiobarbituric acid. The NGF serum level was analysed using ELISA method. Diabetic peripheral neuropathy score was defined when history score in Michigan Neuropathy Screening Instrument (MNSI) ≥ 7 and physical assessment score in MNSI > 2. RESULTS: Thirty subjects with diabetes has diabetic peripheral neuropathy score 3.53 (± 0.91), MDA serum level 2.16 (± 2.89) nmol/ml, and NGF serum level 10.56 (± 2.89) pg/dl. There were significant correlations between the MDA serum level and the diabetic peripheral neuropathy score (r = 0.364, p = 0.048), and between the NGF serum level with the diabetic peripheral neuropathy score (r = -0.59, p = 0.001). CONCLUSION: There are high MDA serum level and low NGF serum level in patients with diabetic peripheral neuropathy. Low NGF serum level plays a bigger role than high MDA serum level in diabetic peripheral neuropathy.


2017 ◽  
Vol 2017 ◽  
pp. 1-7 ◽  
Author(s):  
P. F. Felisaz ◽  
G. Maugeri ◽  
V. Busi ◽  
R. Vitale ◽  
F. Balducci ◽  
...  

The aim of this study was to assess with MRI morphometric ultrastructural changes in nerves affected by diabetic peripheral neuropathy (DPN). We used an MR micro-neurography imaging protocol and a semiautomated technique of tissue segmentation to visualize and measure the volume of internal nerve components, such as the epineurium and nerve fascicles. The tibial nerves of 16 patients affected by DPN and of 15 healthy volunteers were imaged. Nerves volume (NV), fascicles volume (FV), fascicles to nerve ratio (FNR), and nerves cross-sectional areas (CSA) were obtained. In patients with DPN the NV was increased and the FNR was decreased, as a result of an increase of the epineurium (FNR in diabetic neuropathy 0,665; in controls 0,699, p=0,040). CSA was increased in subjects with DPN (12,84 mm2 versus 10,22 mm2, p=0,003). The FV was increased in patients with moderate to severe DPN. We have demonstrated structural changes occurring in nerves affected by DPN, which otherwise are assessable only with an invasive biopsy. MR micro-neurography appears to be suitable for the study of microscopic changes in tibial nerves of diabetic patients.


2020 ◽  
Author(s):  
MD Abu Bashar

Abstract Background Diabetic peripheral neuropathy (DPN), a common and troublesome complication in patients with type 2 diabetes mellitus (T2DM), contributes to a higher risk of diabetic foot ulcer and lower limb amputation. These situations can negatively impact the quality of life of affected individuals.Objectives The study aimed to assess prevalence of DPN in patients of type 2 DM from rural North India and associated risk factors. Methods A facility based cross sectional study was carried out among type 2 diabetic patients attending NCD clinic of a secondary care hospital in rural North India. A questionnaire which included socio-demographic details, clinical and laboratory parameters, and the Michigan Neuropathy Screening Instrument (MNSI) for detecting peripheral neuropathy, was administered to 100 consecutive patients. Statistical Package for Social Sciences (SPSS) version 25.0 was used for entering and analyzing data. Bivariate analysis was performed for determining the factors significantly associated with presence of DPN. Results The prevalence of DPN was 42.0%. Male gender, advancing age(≥60 years), longer duration of diabetes (>10 years ), smoking, physical inactivity, obesity, uncontrolled blood pressure, poor A glycaemic control and altered lipid profile were found to be significantly associated with the presence of DPN. Conclusion Prevalence of DPN among type 2 diabetics from rural north India is alarmingly high. There is need of essential screening of all diabetic patients by their primary care provider for early detection of DPN particularly in rural India.


2020 ◽  
Vol 13 (1) ◽  
pp. 240-245
Author(s):  
Abdisa D. Hurisa ◽  
Getandale Z. Negera

Background: Erectile Dysfunction (ED) is defined as the persistent inability to achieve and/or maintain penile erection sufficient for satisfactory sexual performance. Few studies have examined the prevalence of ED among men diabetic patients in Ethiopia. The aim of this study was to determine the prevalence and predictors of ED among diabetic patients in a tertiary hospital of Southwest Ethiopia. Methods: A hospital-based cross-sectional study was conducted on male diabetic patients on follow-up at the diabetic clinic of Jimma Medical Center (JMC), Southwest Ethiopia. Results: 350 male diabetic patients were enrolled in the study. The mean (+SD) age of the study participants was 47.9 (+12.2) years. The majority, 212 (60.4%) of the diabetic patients had varying degrees of ED and almost all, 207 (97.6%) of the patients were not treated for ED. Independent predictors of ED were older age (AOR: 4.6; 95%CI: [2.84, 7.55]; p<0.001) and longer duration of diabetes (AOR: 3.5; 95%CI: [2.12, 5.70]; p<0.001). Conclusion: This study confirmed a high prevalence of ED in diabetic male patients in Jimma Medical Center (JMC). Periodic assessment and management of ED should be a routine part of the diabetic care, particularly for those aged above 40 years and living with diabetes mellitus for many years.


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