Prevalence and risk factors for diabetic peripheral neuropathy, neuropathic pain and foot ulceration in the Arabian Gulf Region.

Overview

AIMS/INTRODUCTION: This study determined the prevalence and risk factors for diabetic peripheral neuropathy (DPN), painful DPN and diabetic foot ulceration (DFU) in patients with type 2 diabetes (T2D) in secondary health care (SHC) in Qatar, Kuwait and Kingdom of Saudi Arabia. MATERIALS AND METHODS: Adults 18-85 years old with T2D were randomly enrolled from SHC and underwent clinical, metabolic, DPN using vibration perception threshold (VPT) and DN4 questionnaire, and DFU assessments. RESULTS: 3,021 subjects were recruited between June 2017 and May 2019. The prevalence of DPN was 33.3% of whom 52.2% were at risk of DFU and 53.6% were undiagnosed. The prevalence of painful DPN was 43.3%, of whom 54.3% were undiagnosed. DFU was present in 2.9%. The adjusted odds ratios (AOR) for DPN and painful DPN were higher with increasing diabetes duration, obesity, poor glycemic control, hyperlipidemia, and lower with greater physical activity. The AOR for DFU was higher with the presence of DPN, severe loss of vibration perception, hypertension, and vitamin D deficiency. CONCLUSIONS: This is the largest study to date from the Middle East showing a high prevalence of undiagnosed DPN, painful DPN and those at risk of DFU in patients with T2D, and identifies their respective risk factors.