Prevalence and risk factors of clinical diabetic polyneuropathy in a Portuguese primary health care population.
OBJECTIVE
Distal symmetrical polyneuropathy in diabetics (DPN) has a variable prevalence around 30% and increases the risk for foot ulcers and amputations. We aimed at evaluating the prevalence of clinical DPN and associated risk factors in patients followed in primary care centers.


METHODS
101 type 2 diabetics were evaluated and 8 were excluded due to the presence of other causes of neuropathy. The remaining 93 had a mean age of 65.4 +/- 10.1 years and a mean diabetes duration of 10.1 +/- 11.1 years, 60.2% were women and 39.8% men. DPN was defined as the presence of both altered sensitivities and reflexes, regardless of symptoms.


RESULTS
Seventy-two (80%) patients had symptoms of polyneuropathy, but DPN was present only in 29 (32.2%). Calluses (37.8%) and trophic skin (74.4%) and nail (75.6%) changes were found in both feet. There was a significant positive association of DPN with age (69.0 +/- 9.1 vs 63.3 +/- 9.9 years, p=0.01), disease duration (15.7 +/- 13.5 vs 7.2 +/- 8.8 years, p=0.001), feet skin changes (38.8 vs 13.0%, p=0.04) and myocardial infarction/ischemia (14.8 vs 1.7%, p=0.03).


CONCLUSIONS
This sample of diabetic patients cared by family doctors presented a high prevalence of DPN. Aging, disease duration, the presence of feet skin changes and myocardial infarction/ischemia are factors that increase the prevalence of the disease. Primary care doctors awareness of the problem might help to decrease the associated morbidity.
Barbosa
A P
AP
Endocrinology Department, São João Hospital, Porto Medical School, Porto, Portugal.
Medina
J L
JL
Ramos
E P
EP
Barros
H P
HP
D000368:Aged; D000428:Alcohol Drinking; D000671:Amputation, Surgical / Q000706:statistics & numerical data; D015992:Body Mass Index; D003924:Diabetes Mellitus, Type 2 / Q000503:physiopathology*; D017719:Diabetic Foot / Q000453:epidemiology* / Q000601:surgery; D003928:Diabetic Nephropathies / Q000453:epidemiology; D003929:Diabetic Neuropathies / Q000453:epidemiology* / Q000503:physiopathology; D003930:Diabetic Retinopathy / Q000453:epidemiology; D005260:Female; D016523:Foot Ulcer / Q000453:epidemiology*; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009260:Nail Diseases / Q000453:epidemiology; D009460:Neurologic Examination; D018579:Patient Selection; D011174:Portugal / Q000453:epidemiology; D015995:Prevalence; D011320:Primary Health Care; D012307:Risk Factors; D012907:Smoking; D012959:Socioeconomic Factors; D013997:Time Factors