Results

Prevalence of diabetic neuropathy among type 1 and 2 diabetic patients in Saudi ArabiaBanderi Abduallah M. Ahmad Dalal Hamed A. AlEesa Nuha Ali M. AlHefdhi

Supervisor:Dr. Fahad El EidanIntroductionDiabetes mellitus (DM) is a chronic metabolic disorder which occurs when the pancreas does not produce enough insulin or when the body cannot effectively use the insulin it produces, which leads to hyperglycemia. Saudi Arabia: ranked as the 7th highest country with diabetes mellitus prevalence. (24%)

Types: DM type 1, DM type 2Complications: Macro-vascular: CVS disease, CVD Micro-vascular: DPN, retinopathy, nephropathy.

WHOType 1: diagnosis in childhood and adolescence. Results from defects in insulin secretion from the pancreas. Patients require life-long insulin injections.Type 2: diagnosis in adulthood. Related to obesity, physical activity, and unhealthy diet (sedentary lifestyle). Results from defects in the bodys response to insulin.

Macro-vascular complications: due to damage of large blood vessels.Micro-vascular complication: due to damage of small blood vessels.

2Diabetic Peripheral Neuropathy (DPN)Definition: it is the presence of symptoms and/or signs of peripheral nerve dysfunction in people with DM after the exclusion of other causes.

Prevalence: 22 60 % in low-middle income countries 12 - 50 % in US36.6 in Bahrain

DPN is associated with a wide range of complications and increases the risk for foot ulcer and lower extremity amputations.

25% of DPN patients will develop a foot ulcer. 85% of lower limb amputations are due to a foot ulcer in a diabetic patient.

ADA ADA: American Diabetes AssociationSymptoms: burning, tingling, electrical pain, and numbness. (distal parts of body: commonly the lower limbs).Signs: sensory loss to light touch, vibration, and temperature.

Prevalence varies based on: type of diabetes, 3Objective and rationale This study was designed to determine the prevalence of diabetic peripheral neuropathy in Saudi patients of both types of diabetes, and to investigate other related factors associated with DPN. Rationale: DPN is a common complication of DM, and leads to major complications: foot ulcer and lower limb amputation, which increases the mortality rate. Therefore, the prevalence in Saudi Arabia should be investigated to prevent such events.4ResultsTotal of 293 diabetic subjects54 type 1 239 type 2Mean age is 66 years oldOverall prevalence of DPN is 3.4%Prevalence of DPN in type 1 diabetic 1.3%Prevalence of DPN in type 2 diabetic 4.1%Prevalence of DPN was higher among females (63%) than males Non-DPN N=220(75.1)DPN N=73(24.9)P-valueAge years 0.00660113(51.4)51(69.9)Gender 0.096Male106(48.2)27(37.0)Female114(51.8)46(63.0)Duration of diabetes years 0.045 30(21.6)4(8.3) Non-DPN N=220(75.1)DPN N=73(24.9)P-valueType of DM0.025Type I47(21.4)7(9.6)Type II173(78.6)66(90.4)Type of treatment 0.072Insulin158(72.8)62(86.1)Oral hypoglycemic53(24.4)9(12.5)Diet6(2.8)1(1.4)Median number of comorbidities 0.0001 589 (40.7%)48 (69.9%) Non-DPN DPNp-valueBMI0.063 3071 (39%)32 (50.8%)Smoking status 0.131Yes29 (13.2%)15 (20.5%)No190 (86.8%)58 (79.5%)Alcohol status 0.413Yes2(0.9)0(0.0)No217(99.1)73(100)Fasting blood glucose mmol/L (Median)990.25 7167 (76.3%)50 (69.4%)HbA1C (Median)990.147 6.5180 (90.5%)58 (84.1)Significant co-morbidities Non-DPN DPN p-value Peripheral vascular disease 0.0001Yes 15 (6.9%) 17 (23.3%) No 203 (93.1%) 56 (79.7%) Foot ulcer 0.006Yes 15 (6.9%) 13 (17.8%) No 203 (93.1%) 60 (82.2%) Gangrene 0.001Yes 3 (1.4%) 7 (9.6%) No 215 (98.6)% 66 (90.4%) Lower limb amputation 0.001Yes 7 (3.2%) 10 (13.7%) No 211 (96.8%) 63 (86.3%) DKA 0.003Yes 30 (13.8%) 1 (1.4%) No 188 (86.2%) 72 (98.6%) Hypertension0.005Yes160 (73.1%)65 (89%)No59 (26.9%)8 (11%)Cerebral stroke 0.027Yes32 (14.7%)19 (26%)No186 (85.3%)54 (74%)OR=1 Exposure does not affect odds of outcomeOR>1 Exposure associated with higher odds of outcomeOR