Detection of diabetic polyneuropathy in a family medicine clinic by using monofilament
Military Medical Academy
Background/Aim. Diabetic polyneuropathy (DPN) is the most common microvascular complication of diabetes melli-tus (DM), which may be present at the time of disease detec-tion. Screening for DPN is performed for the patients with type 2 diabetes at the time of diagnosis and for type 1 diabe-tes 5 years after diagnosis. The primary aim of this study was to determine the prevalence of DNP among family medicine patients with DM aged 18 to 70 years using nylon monofila-ment. Methods. The cross-sectional study estimated the prevalence of DPN among primary care patients with DM in Banja Luka, Republic of Srpska, Bosnia and Herzegovina. Semmes-Weinstein nylon 10 g monofilament was used to de-tect DPN. Age, gender, duration of DM, type of therapy, symptoms, glycosylated hemoglobin (HbA1c), and risk fac-tors (hypertension, smoking, dyslipidemia, obesity, physical inactivity) were analyzed. Data collection took place from June 1st, 2017 to May 31st, 2018. Results. The study includ-ed 228 patients, 132 (57.9%) men and 96 (42.1%) women. There was a statistically significant difference in the presence of all symptoms of DPN (tingling, burning, light burning, and stinging) among patients with different duration of DM (p < 0.01). Multivariate logistic regression revealed that patients who had hypertension [odds ratio (OR) = 26.2; 95% confi-dence interval (CI): 4.070–168.488; p = 0.001], used oral anti-diabetic therapy (OR = 12.3; 95% CI: 1.300–116.309; p = 0.029), had tingling (OR = 5.2; 95% CI: 1.431–18.571; p = 0.012) and a longer duration of diabetes (OR = 4.27; 95% CI: 1.983–9.175; p = 0.000) were more likely to have DPN. Con-clusion. The prevalence of DPN in family medicine patients with DM using nylon monofilament was 24.2%. Determi-nants of DNP were the presence of symptoms of tingling, duration of diabetes, hypertension, and the use of oral antidi-abetic therapy alone.
bosnia and herzegovina; diabetes mellitus, type 2; diabetic neuropathies; prevalence; primary health care; risk factors