Prevalence and associated factors of peripheral neuropathy in type 2 diabetic patients in Antananarivo: a three-year cross-sectional study

Background: Diabetic peripheral neuropathy (DPN) is common, causing functional disability and impaired quality of life for patients. The aims of this study were to determine the prevalence of DPN and its associated factors in type 2 diabetics seen at the Soavinandriana Hospital Center. Methods: This was a descriptive and analytical cross-sectional study, conducted on a 3-years period. The diagnosis of DPN was made based on a DN4 questionnaire score ≥4 and/or impaired sensitivity to 10 monofilament and/or a reduction or absence of the Achilles reflex. Results: Among the 289 DT2 patients, the prevalence of DPN was 28.7%. Risk factors for DPN were age 60-69 years [OR=1.83 (1.06-3.19), p=0.0139], dyslipidemia [OR=3.31 (1.47-3.49), p=0.0009], microalbuminuria [OR=6.98 (3.85-12.9), p<0.0001], diabetes duration ≥10 years [OR=2.80 (1.42-5.52), p=0.0011], glycated hemoglobin level ≥7% [OR=2.25 (1.03-5.85), p=0.0287], presence of nephropathy [OR=13.2 (6.82-26.2), p<0.0001], retinopathy [OR=2.71 (1.42-5.15), p=0.0009], carotid atherosclerosis [OR=2.73 (1.57-4.79), p=0.0001], lower limb arteriopathy [OR=2.27 (1.21-4.23), p=0.0047] and ischemic heart disease [OR=3.41 (1.72-6.82), p=0.0001]. Conclusions: The frequency of DPN was 28.7%. Associated factors were advanced age, the presence of other cardiovascular risk factors, a long duration of diabetes and its poor control, and the presence of other degenerative diabetes complications. Better control of diabetes and associated cardiovascular risk factors with multidisciplinary care are essentials to avoid or limit their occurrence.