TITLE:
Evaluation of Peripheral Neuropathy in Diabetic Adults with and without Foot Ulcers in an African Population
AUTHORS:
Osita Ede, Gabriel O. Eyichukwu, Kenechi A. Madu, Iheuko S. Ogbonnaya, Kelechukwu A. Okoro, Chinonso Basil-Nwachuku, Kelechi A. Nwokocha
KEYWORDS:
Peripheral Neuropathy, African, Diabetic Adults, Foot Ulcers
JOURNAL NAME:
Journal of Biosciences and Medicines,
Vol.6 No.12,
December
14,
2018
ABSTRACT: Background: Foot ulcers frequently precede lower extremity amputations (LEA) in diabetic subjects. Peripheral neuropathy (PN) is a strong risk factor for diabetic foot ulceration. Majority of diabetic patients with PN are asymptomatic; hence foot ulceration may be the first clinical presentation. Early detection of PN can forestall the development of foot ulcers through active preventive strategies. Few studies have been done to assess PN in diabetic individuals in Africa. The study aims to evaluate the incidence and risk factors for PN in diabetic adults with and without foot ulcers in an indigenous African population. Method: This cross-sectional study involved 90 diabetic adults, 45 with foot ulcers and 45 without foot ulcers. Assessment of PN was done with the Michigan Neuropathy Screening Instrument (MNSI), the 10 g Semmes-Weinstein monofilament (SWM) and the 128-Hz vibrating tuning fork (VTF). Demographic data were collected by questionnaire. Associations between PN and risk factors such as age, alcohol consumption, duration of diabetes, cigarette smoking, BMI, height and sex were also investigated. Results: There were 59 males (65.6%) and 31 females (34.4%) in the study. The mean age of the subjects with foot ulcers was 59.62 years (SD = 6.47), while those without ulcers was 57.47 years (SD = 6.94). Forty-two subjects (93.33%) with foot ulcers have PN using the MNSI, while 33 subjects without foot ulcers (73.33%) have PN. Both the SWM and the VTF showed a high positive correlation with themselves and with the MNSI. Advancing age, duration of diabetes, alcohol intake, hyperglycaemia and cigarette smoking showed a significant association with peripheral neuropathy, while BMI, height and sex did not. Conclusion: The incidence of PN is quite high in diabetic adults in Africa. This calls for early screening and aggressive control of risk factors to prevent the development of diabetic foot ulceration.