title: Diabetic Peripheral Neuropathy and its Determinants among Patients Attending a Tertiary Health Care Centre in Mangalore, India.
abstract: BACKGROUND
  The burden of diabetes mellitus (DM) is on the rise especially in developing countries like India. Due to its chronic nature DM tends to cause many debilitating complications and diabetic peripheral neuropathy (DPN) is one of them. The aim of this study is to determine the prevalence of DPN among patients attending a tertiary care hospital and to identify the determinants associated with it.
  
  
  METHODS
  A cross sectional study was conducted in Government Wenlock Hospital, Mangalore (India), during January-February 2014. A total of 208 patients with >5 year duration of DM were asked to respond to the patient history version of Michigan Neuropathy Screening Instrument (MNSI) and examinations were conducted after obtaining consent from them. The statistical analysis was done in terms of descriptive statistics and association between variables was tested using logistic regression test.
  
  
  RESULTS
  The prevalence of DPN using the MNSI history version and MNSI examination were found to be 18.3% and 32.2% respectively. The major determinants associated with DPN were found to be male gender (OR: 2.7, CI: 1.4-5.1, P=0.001), smoking (OR: 5.8, CI: 1.9-17.3, P=0.001) and age >40 years (OR: 2.7, CI: 1.2-5.8, P=0.011).
  
  
  CONCLUSIONS
  The burden of undetected DPN was found to be higher among diabetics, with an especially higher prevalence among males, smokers and those with long standing diabetes mellitus. Interventions in the form of early detection through routine screening, smoking cessation and regular follow up examinations would go a long way in reducing the burden of disability among diabetics and improve their quality of life significantly. Significance for public healthThe findings of the current research hold importance since diabetes is one of the leading causes of morbidity and mortality across the world. Due to its chronic nature and effects of hyperglycaemia, diabetes tends to be associated with many comorbidities, like peripheral neuropathy, nephropathy, retinopathy etc. The presence of diabetic peripheral neuropathy leads to a reduced quality of life among diabetic patients due to the trauma and consequent gangrenes andamputation. The concept of secondary prevention can be applied to the prevention of diabetic peripheral neuropathy using easy to apply screening tools and thus help in early diagnosis and treatment to reduce the burden of this debilitating illness.
authors.affiliation: Department of Community Medicine, Kasturba Medical College, Manipal University , Mangalore, India.
authors.forename: Monisha
authors.initials: M
authors.lastname: D'Souza
authors.affiliation: Department of Community Medicine, Kasturba Medical College, Manipal University , Mangalore, India.
authors.forename: Vaman
authors.initials: V
authors.lastname: Kulkarni
authors.affiliation: Department of Community Medicine, Kasturba Medical College, Manipal University , Mangalore, India.
authors.forename: Unnikrishnan
authors.initials: U
authors.lastname: Bhaskaran
authors.affiliation: Department of Community Medicine, Kasturba Medical College, Manipal University , Mangalore, India.
authors.forename: Humam
authors.initials: H
authors.lastname: Ahmed
authors.affiliation: Department of Community Medicine, Kasturba Medical College, Manipal University , Mangalore, India.
authors.forename: Hegde
authors.initials: H
authors.lastname: Naimish
authors.affiliation: Department of Community Medicine, Kasturba Medical College, Manipal University , Mangalore, India.
authors.forename: Anjali
authors.initials: A
authors.lastname: Prakash
authors.affiliation: Department of Community Medicine, Kasturba Medical College, Manipal University , Mangalore, India.
authors.forename: Tabreez
authors.initials: T
authors.lastname: S
authors.affiliation: Department of Community Medicine, Kasturba Medical College, Manipal University , Mangalore, India.
authors.forename: Bhanu
authors.initials: B
authors.lastname: Dahiya
authors.affiliation: Department of Community Medicine, Kasturba Medical College, Manipal University , Mangalore, India.
authors.forename: Rekha
authors.initials: R
authors.lastname: Thapar
authors.affiliation: Department of Community Medicine, Kasturba Medical College, Manipal University , Mangalore, India.
authors.forename: Prasanna
authors.initials: P
authors.lastname: Mithra
authors.affiliation: Department of Community Medicine, Kasturba Medical College, Manipal University , Mangalore, India.
authors.forename: Nithin
authors.initials: N
authors.lastname: Kumar
authors.affiliation: Department of Community Medicine, Kasturba Medical College, Manipal University , Mangalore, India.
authors.forename: Ramesh
authors.initials: R
authors.lastname: Holla
authors.affiliation: Department of Community Medicine, Kasturba Medical College, Manipal University , Mangalore, India.
authors.forename: Darshan
authors.initials: D
authors.lastname: Bb
authors.affiliation: Department of Community Medicine, Kasturba Medical College, Manipal University , Mangalore, India.
authors.forename: Avinash
authors.initials: A
authors.lastname: Kumar
keywords: Diabetic neuropathies; Michigan Neuropathy Screening Instrument; developing countries; prevalence