title: Insufficient early detection of peripheral neurovasculopathy and associated factors in rural diabetes residents of Taiwan: a cross-sectional study.
abstract: BACKGROUND
  Diabetic peripheral neuropathy (PN) and peripheral vasculopathy (PV) are major causes of foot ulcers in patients with diabetes. The early detection of PN/PV with appropriate health counseling is the best strategy for preventing foot lesions. The objective of this study is to examine the prevalence and associated risk factors of PN/PV among rural community residents with type 2 diabetes mellitus (T2DM).
  
  
  METHODS
  This cross-sectional descriptive study was conducted in Taiwan from February to October 2012. Type 2 diabetes mellitus and health promotion scale, Michigan neuropathy screening instrument, and ankle-brachial pressure index values were measured.
  
  
  RESULTS
  A total of 404 (55% women) participated in and completed the program. The overall prevalence of PN and PV was 34.5 and 17.1%, respectively. The majority of the participants (90%) did not receive early PN/PV detection by health care providers. After adjustment for the potential confounding factors, multivariate analysis indicated that the factors determining PN/PV were age (P <0.001), living around sea coastal regions (P <0.001), high HbA1C level (P <0.01), and fewer regular health-promoting behaviors (P <0.01).
  
  
  CONCLUSIONS
  There was a high prevalence of PN/PV among rural T2DM residents who received insufficient early detection. The early detection of PN/PV and provision of health education with customized health-promoting behaviors of people with diabetes in the rural community are important issues.
authors.forename: Chia-Mou
authors.initials: CM
authors.lastname: Lee
authors.forename: Chang-Cheng
authors.initials: CC
authors.lastname: Chang
authors.forename: Mei-Yu
authors.initials: MY
authors.lastname: Pan
authors.forename: Chyong-Fang
authors.initials: CF
authors.lastname: Chang
authors.affiliation: College of Nursing, Chang Gung University of Science and Technology, No, 2, Chia-pu Rd, West Sec, Putz City, Chiayi County 61363, Taiwan. meiyen@mail.cgust.edu.tw.
authors.forename: Mei-Yen
authors.initials: MY
authors.lastname: Chen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000554:Ambulatory Care Facilities; D055109:Ankle Brachial Index; D003430:Cross-Sectional Studies; D017719:Diabetic Foot / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology; D037001:Directive Counseling; D042241:Early Diagnosis; D004522:Educational Status; D005260:Female; D006266:Health Education; D007722:Health Knowledge, Attitudes, Practice; D006293:Health Promotion; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications / Q000453:epidemiology*; D010523:Peripheral Nervous System Diseases / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology; D015995:Prevalence; D012307:Risk Factors; D012424:Rural Population; D012907:Smoking / Q000009:adverse effects / Q000453:epidemiology*; D013624:Taiwan / Q000453:epidemiology