Diabetic Peripheral Neuropathy in Ambulatory Patients with Type 2 Diabetes in a General Hospital in a Middle Income Country: A Cross-Sectional Study
Identifieur interne : 000867 ( Main/Exploration ); précédent : 000866; suivant : 000868Diabetic Peripheral Neuropathy in Ambulatory Patients with Type 2 Diabetes in a General Hospital in a Middle Income Country: A Cross-Sectional Study
Auteurs : María De Los Angeles Lazo [Pérou] ; Antonio Bernabé-Ortiz [Pérou] ; Miguel E. Pinto [Pérou] ; Ray Ticse [Pérou] ; German Malaga [Pérou] ; Katherine Sacksteder [États-Unis] ; J. Jaime Miranda [Pérou] ; Robert H. Gilman [Pérou, États-Unis]Source :
- PLoS ONE [ 1932-6203 ] ; 2014.
Abstract
We aimed to estimate the morbidity rate and associated factors for diabetic peripheral neuropathy (DPN) in a low-middle income country setting.
Cross-sectional study, data was gathered at Peru's Ministry of Health national specialized hospital for endocrinological conditions through standardized interviews, anthropometric measurements and blood tests for glycated haemoglobin (HbA1c). DPN was evaluated using two techniques: the Semmes-Weinstein monofilament test and the diabetic neuropathy symptom score. Overall prevalence and 95% confidence intervals (95% CI) were calculated. Potential factors related to DPN explored included body mass index, years with disease (<10 vs. ≥10 years), glycaemic control (HbA1c <7% vs. ≥7%), microalbuminuria, retinopathy, and current pharmacological treatment. Multivariable analysis was performed using Poisson analysis to calculate prevalence ratios.
DPN was observed in 73/129 (56.6%) patients. In multivariable analysis adjusted by age and sex, the prevalence ratio of neuropathy was 1.4 times higher (95% CI 1.07–1.88) in patients who took insulin plus metformin compared to patients who used one treatment alone, and 1.4 higher (95% CI 1.02–1.93) in patients with ≥10 years of disease compared to those with a shorter duration of disease. Also we found some characteristics in foot evaluation associated to neuropathy such as deformities (p<0.001), onychomycosis (p = 0.012), abnormal Achilles reflex (p<0.001), pain perception (p<0.001) and vibration perception (p<0.001).
DPN is highly frequent among patients with diabetes in a national specialized facility from Peru. Associated factors to DPN included being a diabetic patient for over ten years, and receiving insulin plus metformin
Url:
DOI: 10.1371/journal.pone.0095403
PubMed: 24789071
PubMed Central: 4006783
Affiliations:
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Pinto</name><affiliation wicri:level="1"><nlm:aff id="aff3"><addr-line>Facultad de Medicina “Alberto Hurtado”, Universidad Peruana Cayetano Heredia, Lima, Peru</addr-line></nlm:aff><country xml:lang="fr">Pérou</country><wicri:regionArea>Facultad de Medicina “Alberto Hurtado”, Universidad Peruana Cayetano Heredia, Lima</wicri:regionArea><wicri:noRegion>Lima</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="aff4"><addr-line>Servicio de Endocrinología, Hospital Nacional Cayetano Heredia, Lima, Peru</addr-line></nlm:aff><country xml:lang="fr">Pérou</country><wicri:regionArea>Servicio de Endocrinología, Hospital Nacional Cayetano Heredia, Lima</wicri:regionArea><wicri:noRegion>Lima</wicri:noRegion></affiliation></author><author><name sortKey="Ticse, Ray" sort="Ticse, Ray" uniqKey="Ticse R" first="Ray" last="Ticse">Ray Ticse</name><affiliation wicri:level="1"><nlm:aff id="aff3"><addr-line>Facultad de Medicina “Alberto Hurtado”, Universidad Peruana Cayetano Heredia, Lima, Peru</addr-line></nlm:aff><country xml:lang="fr">Pérou</country><wicri:regionArea>Facultad de Medicina “Alberto Hurtado”, Universidad Peruana Cayetano Heredia, Lima</wicri:regionArea><wicri:noRegion>Lima</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="aff4"><addr-line>Servicio de Endocrinología, Hospital Nacional Cayetano Heredia, Lima, Peru</addr-line></nlm:aff><country xml:lang="fr">Pérou</country><wicri:regionArea>Servicio de Endocrinología, Hospital Nacional Cayetano Heredia, Lima</wicri:regionArea><wicri:noRegion>Lima</wicri:noRegion></affiliation></author><author><name sortKey="Malaga, German" sort="Malaga, German" uniqKey="Malaga G" first="German" last="Malaga">German Malaga</name><affiliation wicri:level="1"><nlm:aff id="aff1"><addr-line>CRONICAS Centre of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru</addr-line></nlm:aff><country xml:lang="fr">Pérou</country><wicri:regionArea>CRONICAS Centre of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima</wicri:regionArea><wicri:noRegion>Lima</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="aff2"><addr-line>Unidad de Conocimiento y Evidencia, Universidad Peruana Cayetano Heredia, Lima, Peru</addr-line></nlm:aff><country xml:lang="fr">Pérou</country><wicri:regionArea>Unidad de Conocimiento y Evidencia, Universidad Peruana Cayetano Heredia, Lima</wicri:regionArea><wicri:noRegion>Lima</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="aff3"><addr-line>Facultad de Medicina “Alberto Hurtado”, Universidad Peruana Cayetano Heredia, Lima, Peru</addr-line></nlm:aff><country xml:lang="fr">Pérou</country><wicri:regionArea>Facultad de Medicina “Alberto Hurtado”, Universidad Peruana Cayetano Heredia, Lima</wicri:regionArea><wicri:noRegion>Lima</wicri:noRegion></affiliation></author><author><name sortKey="Sacksteder, Katherine" sort="Sacksteder, Katherine" uniqKey="Sacksteder K" first="Katherine" last="Sacksteder">Katherine Sacksteder</name><affiliation wicri:level="2"><nlm:aff id="aff5"><addr-line>Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America</addr-line></nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland</wicri:regionArea><placeName><region type="state">Maryland</region></placeName></affiliation></author><author><name sortKey="Miranda, J Jaime" sort="Miranda, J Jaime" uniqKey="Miranda J" first="J. Jaime" last="Miranda">J. Jaime Miranda</name><affiliation wicri:level="1"><nlm:aff id="aff1"><addr-line>CRONICAS Centre of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru</addr-line></nlm:aff><country xml:lang="fr">Pérou</country><wicri:regionArea>CRONICAS Centre of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima</wicri:regionArea><wicri:noRegion>Lima</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="aff3"><addr-line>Facultad de Medicina “Alberto Hurtado”, Universidad Peruana Cayetano Heredia, Lima, Peru</addr-line></nlm:aff><country xml:lang="fr">Pérou</country><wicri:regionArea>Facultad de Medicina “Alberto Hurtado”, Universidad Peruana Cayetano Heredia, Lima</wicri:regionArea><wicri:noRegion>Lima</wicri:noRegion></affiliation></author><author><name sortKey="Gilman, Robert H" sort="Gilman, Robert H" uniqKey="Gilman R" first="Robert H." last="Gilman">Robert H. Gilman</name><affiliation wicri:level="1"><nlm:aff id="aff1"><addr-line>CRONICAS Centre of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru</addr-line></nlm:aff><country xml:lang="fr">Pérou</country><wicri:regionArea>CRONICAS Centre of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima</wicri:regionArea><wicri:noRegion>Lima</wicri:noRegion></affiliation><affiliation wicri:level="2"><nlm:aff id="aff5"><addr-line>Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America</addr-line></nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland</wicri:regionArea><placeName><region type="state">Maryland</region></placeName></affiliation></author></analytic><series><title level="j">PLoS ONE</title><idno type="eISSN">1932-6203</idno><imprint><date when="2014">2014</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Aim</title><p>We aimed to estimate the morbidity rate and associated factors for diabetic peripheral neuropathy (DPN) in a low-middle income country setting.</p></sec><sec><title>Methods</title><p>Cross-sectional study, data was gathered at Peru's Ministry of Health national specialized hospital for endocrinological conditions through standardized interviews, anthropometric measurements and blood tests for glycated haemoglobin (HbA1c). DPN was evaluated using two techniques: the Semmes-Weinstein monofilament test and the diabetic neuropathy symptom score. Overall prevalence and 95% confidence intervals (95% CI) were calculated. Potential factors related to DPN explored included body mass index, years with disease (<10 vs. ≥10 years), glycaemic control (HbA1c <7% vs. ≥7%), microalbuminuria, retinopathy, and current pharmacological treatment. Multivariable analysis was performed using Poisson analysis to calculate prevalence ratios.</p></sec><sec><title>Results</title><p>DPN was observed in 73/129 (56.6%) patients. In multivariable analysis adjusted by age and sex, the prevalence ratio of neuropathy was 1.4 times higher (95% CI 1.07–1.88) in patients who took insulin plus metformin compared to patients who used one treatment alone, and 1.4 higher (95% CI 1.02–1.93) in patients with ≥10 years of disease compared to those with a shorter duration of disease. Also we found some characteristics in foot evaluation associated to neuropathy such as deformities (p<0.001), onychomycosis (p = 0.012), abnormal Achilles reflex (p<0.001), pain perception (p<0.001) and vibration perception (p<0.001).</p></sec><sec><title>Conclusion</title><p>DPN is highly frequent among patients with diabetes in a national specialized facility from Peru. Associated factors to DPN included being a diabetic patient for over ten years, and receiving insulin plus metformin</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Chan, Jc" uniqKey="Chan J">JC Chan</name></author><author><name sortKey="Gagliardino, Jj" uniqKey="Gagliardino J">JJ Gagliardino</name></author><author><name sortKey="Baik, Sh" uniqKey="Baik S">SH Baik</name></author><author><name sortKey="Chantelot, Jm" uniqKey="Chantelot J">JM Chantelot</name></author><author><name sortKey="Ferreira, Sr" uniqKey="Ferreira S">SR Ferreira</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Tres, Gs" uniqKey="Tres G">GS Tres</name></author><author><name sortKey="Lisboa, Hr" uniqKey="Lisboa H">HR Lisbôa</name></author><author><name sortKey="Syllos, R" uniqKey="Syllos R">R Syllos</name></author><author><name sortKey="Canani, Lh" uniqKey="Canani L">LH Canani</name></author><author><name sortKey="Gross, 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Pinto</name><name sortKey="Pinto, Miguel E" sort="Pinto, Miguel E" uniqKey="Pinto M" first="Miguel E." last="Pinto">Miguel E. Pinto</name><name sortKey="Ticse, Ray" sort="Ticse, Ray" uniqKey="Ticse R" first="Ray" last="Ticse">Ray Ticse</name><name sortKey="Ticse, Ray" sort="Ticse, Ray" uniqKey="Ticse R" first="Ray" last="Ticse">Ray Ticse</name></country><country name="États-Unis"><region name="Maryland"><name sortKey="Sacksteder, Katherine" sort="Sacksteder, Katherine" uniqKey="Sacksteder K" first="Katherine" last="Sacksteder">Katherine Sacksteder</name></region><name sortKey="Gilman, Robert H" sort="Gilman, Robert H" uniqKey="Gilman R" first="Robert H." last="Gilman">Robert H. Gilman</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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