title: Prevalence and risk factors for severity of diabetic neuropathy in type 2 diabetes mellitus.
abstract: OBJECTIVE
  To estimate the prevalence of diabetic neuropathy (severity wise) and associated risk factors in a population having type 2 diabetes mellitus.
  
  
  METHODS
  A population-based sample of 1401 persons with diabetes (identified as per the WHO criteria) underwent comprehensive eye examination including stereoscopic digital photography (45° four field) for diabetic retinopathy grading. Vibration perception threshold (VPT) measurements were done to assess neuropathy (cut off ≥ 20 V). Severity of neuropathy was graded into three groups based on VPT score as mild (20-24.99 V), moderate (25-38.99 V), and severe (≥39 V). Univariate and multivariate analyses were done to find out the independent risk factors for severity of diabetic neuropathy.
  
  
  RESULTS
  In the overall group, the prevalence of diabetic neuropathy was 18.84% (95% CI: 16.79-20.88). The prevalence of mild diabetic neuropathy was 5.9% (95% CI: 4.68-7.15), moderate diabetic neuropathy was 7.9% (95% CI: 6.50-9.33), and severe diabetic neuropathy was 5% (95% CI: 3.86-6.14). Increasing age per year (P < 0.0001) was a statistically significant risk factor for all - mild, moderate, and severe - types of diabetic neuropathy. For severe diabetic neuropathy, other significant risk factors were duration of diabetes mellitus (P = 0.027), macroalbuminuria (P = 0.001), and presence of diabetic retinopathy (P = 0.020).
  
  
  CONCLUSIONS
  The results suggested that every fifth individual in a population of type 2 diabetes is likely to have diabetic neuropathy. Nearly 13% had neuropathy of moderate and severe category, making this group vulnerable for complications such as foot ulceration or lower limb amputation.
authors.affiliation: Shri Bhagwan Mahavir Vitreoretinal Services, Sankara Nethralaya, Chennai, Tamil Nadu, India.
authors.forename: Padmaja Kumari
authors.initials: PK
authors.lastname: Rani
authors.forename: Rajiv
authors.initials: R
authors.lastname: Raman
authors.forename: Sudhir R
authors.initials: SR
authors.lastname: Rachapalli
authors.forename: Swakshyar Saumya
authors.initials: SS
authors.lastname: Pal
authors.forename: Vaitheeswaran
authors.initials: V
authors.lastname: Kulothungan
authors.forename: Tarun
authors.initials: T
authors.lastname: Sharma
mesh_terms: D000368:Aged; D000419:Albuminuria / Q000453:epidemiology; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology*; D003929:Diabetic Neuropathies / Q000453:epidemiology*; D003930:Diabetic Retinopathy / Q000453:epidemiology; D005260:Female; D006801:Humans; D007194:India / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D012720:Severity of Illness Index