RESUMO
BACKGROUND: Chronic complications of diabetes (DM) are a major cause of mortality and morbidity. Of these, diabetic peripheral neuropathy (DPN) is the most common. Screening using validated tools for DPN is crucial to prevent consequent complications. One of the useful tools for DPN screening in clinical practice is the Michigan Neuropathy Screening Instrument (MNSI). However, there is limited information on DPN in the study area. Hence, the aim of this study was to assess the prevalence of DPN and its determinants among patients with type one DM (T1DM) attending Jimma University Medical Center (JUMC) from January 2 to March 31, 2020. METHODS: An institution based cross-sectional study was conducted and DPN was assessed using MNSI. Data were collected using pretested structured questionnaire and entered into EPI data version 3.1 and exported to SPSS version 20 for analysis. A variable having a p-value of <0.25 in the bivariable logistic regression analysis were subjected to multivariable logistic regression analysis to avoid confounding variable's effect. Adjusted odds ratios (AOR) were calculated at 95% confidence interval (CI) and considered significant with a p-value of ≤0.05 in the final model. RESULTS: A total of 217 study participants with T1DM who met inclusion criteria were recruited consecutively during the study period. Their mean age was 43 ± 15.5 years and the overall prevalence of DPN was 37.3% among study participants. The independent predictors of DPN identified by multivariable logistic regression analysis were increasing age [age of 40-49 years (AOR = 3.80; 95% CI: 1.30, 10.60), age of ≥50 years (AOR = 6.50; 95% CI: 2.50, 16.50)], smoking habit [current smoker (AOR = 3.40, 95% CI: 1.20, 9.50; former smoker (AOR = 2.70; 95% CI: 1.60, 6.80)] and comorbid hypertension (AOR = 2.40; 95% CI: 1, 5.40). CONCLUSION: The magnitude of DPN among DM patients at JUMC was high. Early detection and appropriate management is vital particularly for these with increasing age, comorbid hypertension and smoking habit.
RESUMO
BACKGROUND: Diabetes chronic complications are major causes of morbidity and mortality, among which diabetic peripheral neuropathy (DPN) stands out. One of the tools to screen DPN is the Michigan neuropathy screening instrument. However, there is no data compiled using this tool to assess the prevalence and its determinants in Jimma. So, the aim of this study was to assess the prevalence of DPN and its determinants among patients with diabetes mellitus at Jimma University Medical Center. Methods. A hospital-based cross-sectional study was conducted at Jimma University Medical Center on 366 type 2diabetic patients. Data were collected using pretested structured questionnaire and entered into EpiData 3.1 and exported to SPSS version 20 for analysis. Both bivariate and multivariate binary logistic regressions were employed to identify factors associated with DPN. A variable having a p value of < 0.25 in the bivariate model was subjected to multivariate analysis to avoid confounding variable's effect. Adjusted odds ratios were calculated at 95% confidence interval and considered significant with a p value of ≤ 0.05. RESULTS: The mean age of participants was 50.1 ± 14.28 years. The study finding showed that the prevalence of DPN was 53.6% among study participants. According to the multivariate logistic regression age above 40 years (AOR = 4.57; 95% CI: 1.50, 13.9), above 50 years (AOR = 6.5; 95% CI: 2.24, 18.79), duration of diabetes above 5 years (AOR = 3.06; 95% CI: 1.63, 5.77), duration above 10 years (AOR = 7.1; 95% CI: 2.99, 17.28), physical inactivity (AOR = 2.02; 95% CI: 1.14, 3.55), and smoking (current smoker AOR = 7.96, 95% CI: 3.22, 19.64; former smoker (AOR = 2.65; 95% CI: 1.22, 5.77) were independent predictors of DPN among study participants. CONCLUSION: Almost half of the study participants had DPN. Age above 40 years, diabetes duration of above 5 years, physical inactivity, and smoking were significantly associated with DPN. Early detection and appropriate interventions are important among patients with age above 40 years, physically inactive, smokers, and diabetes duration of above 5 years.