Peripheral neuropathy and impaired sensation of feet among patients with type 2 diabetes mellitus: a descriptive cross-sectional study

Abstract

Background: Diabetic peripheral neuropathy (DPN) is the most prevalent consequence of type 2 diabetes mellitus (T2DM). Impaired sensation of feet due to DPN increases the risk of foot injury. Therefore, the objectives of this study were to assess the level of glycemic control, the prevalence of DPN and the impaired sensation of feet among the T2DM patients attending community clinics. Methods: A descriptive cross-sectional study was conducted on 386 T2DM patients attending community clinics in Sri Lanka. The baseline data were collected by an interviewer-administered questionnaire. DPN was diagnosed by Michigan neuropathy screening instrument (MNSI) and monofilament test. Glycemic control was assessed by serum glycated hemoglobin (HbA1c) and fasting blood glucose (FBS). Results: Among 386 T2DM patients, 265 (68.7%) were females, 179 (46.4%) had 1-5 years duration of disease. Poor long-term glycemic control (HbA1c) was observed in 292 (75.6%), while poor short-term glycemic control (FBS) was observed in 202 (52.4%). DPN was diagnosed in 68 (17.6%). Monofilament test assessed the touch sensation in 10 points of each foot. The ninth point (plantar central heel) of each foot was the commonest point with absent sensation. It was observed in 99 (25.6%) right feet and 94 (24.4%) left feet respectively. Conclusions: High prevalence of DPN and impaired sensation in specific sites of foot indicate high risk for foot disease. Most patients with DPN had poor glycemic control. Urgent interventions to attain glycemic control and testing for impaired sensation regularly are essential to decrease progression of DPN and foot disease.