Prevalence and management of diabetic neuropathy in secondary care in Qatar
Georgios Ponirakis
Weill Cornell Medicine-Qatar, Qatar Foundation, Education City, Doha, Qatar
Faculty of Science and Engineering, Manchester Metropolitan University, Manchester, UK
Search for more papers by this authorTarik Elhadd
National Diabetes Center, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar
National Diabetes Center, Al-Wakra Hospital, Hamad Medical Corporation, Doha, Qatar
Search for more papers by this authorSubitha Chinnaiyan
National Diabetes Center, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar
Search for more papers by this authorZeinab Dabbous
National Diabetes Center, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar
Search for more papers by this authorMashhood Siddiqui
National Diabetes Center, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar
Search for more papers by this authorHamad Al-muhannadi
Weill Cornell Medicine-Qatar, Qatar Foundation, Education City, Doha, Qatar
Search for more papers by this authorIoannis N. Petropoulos
Weill Cornell Medicine-Qatar, Qatar Foundation, Education City, Doha, Qatar
Search for more papers by this authorAdnan Khan
Weill Cornell Medicine-Qatar, Qatar Foundation, Education City, Doha, Qatar
Search for more papers by this authorKhaled A. E. Ashawesh
National Diabetes Center, Al-Wakra Hospital, Hamad Medical Corporation, Doha, Qatar
Search for more papers by this authorKhaled M. O Dukhan
National Diabetes Center, Al-Wakra Hospital, Hamad Medical Corporation, Doha, Qatar
Search for more papers by this authorZiyad R. Mahfoud
Weill Cornell Medicine-Qatar, Qatar Foundation, Education City, Doha, Qatar
Search for more papers by this authorChristopher Murgatroyd
Faculty of Science and Engineering, Manchester Metropolitan University, Manchester, UK
Search for more papers by this authorMark Slevin
Faculty of Science and Engineering, Manchester Metropolitan University, Manchester, UK
Search for more papers by this authorCorresponding Author
Rayaz A. Malik
Weill Cornell Medicine-Qatar, Qatar Foundation, Education City, Doha, Qatar
Faculty of Science and Engineering, Manchester Metropolitan University, Manchester, UK
National Diabetes Center, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar
Institute of Cardiovascular Science, University of Manchester, Manchester, UK
Correspondence
Professor Rayaz A. Malik, Weill Cornell Medicine-Qatar, Qatar Foundation, Education City, PO Box: 24144, Doha, Qatar.
Email: [email protected]
Search for more papers by this authorGeorgios Ponirakis
Weill Cornell Medicine-Qatar, Qatar Foundation, Education City, Doha, Qatar
Faculty of Science and Engineering, Manchester Metropolitan University, Manchester, UK
Search for more papers by this authorTarik Elhadd
National Diabetes Center, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar
National Diabetes Center, Al-Wakra Hospital, Hamad Medical Corporation, Doha, Qatar
Search for more papers by this authorSubitha Chinnaiyan
National Diabetes Center, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar
Search for more papers by this authorZeinab Dabbous
National Diabetes Center, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar
Search for more papers by this authorMashhood Siddiqui
National Diabetes Center, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar
Search for more papers by this authorHamad Al-muhannadi
Weill Cornell Medicine-Qatar, Qatar Foundation, Education City, Doha, Qatar
Search for more papers by this authorIoannis N. Petropoulos
Weill Cornell Medicine-Qatar, Qatar Foundation, Education City, Doha, Qatar
Search for more papers by this authorAdnan Khan
Weill Cornell Medicine-Qatar, Qatar Foundation, Education City, Doha, Qatar
Search for more papers by this authorKhaled A. E. Ashawesh
National Diabetes Center, Al-Wakra Hospital, Hamad Medical Corporation, Doha, Qatar
Search for more papers by this authorKhaled M. O Dukhan
National Diabetes Center, Al-Wakra Hospital, Hamad Medical Corporation, Doha, Qatar
Search for more papers by this authorZiyad R. Mahfoud
Weill Cornell Medicine-Qatar, Qatar Foundation, Education City, Doha, Qatar
Search for more papers by this authorChristopher Murgatroyd
Faculty of Science and Engineering, Manchester Metropolitan University, Manchester, UK
Search for more papers by this authorMark Slevin
Faculty of Science and Engineering, Manchester Metropolitan University, Manchester, UK
Search for more papers by this authorCorresponding Author
Rayaz A. Malik
Weill Cornell Medicine-Qatar, Qatar Foundation, Education City, Doha, Qatar
Faculty of Science and Engineering, Manchester Metropolitan University, Manchester, UK
National Diabetes Center, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar
Institute of Cardiovascular Science, University of Manchester, Manchester, UK
Correspondence
Professor Rayaz A. Malik, Weill Cornell Medicine-Qatar, Qatar Foundation, Education City, PO Box: 24144, Doha, Qatar.
Email: [email protected]
Search for more papers by this authorFunding information: Pfizer Gulf FZ LLC, Grant/Award Number: W1230787; Qatar National Research Fund, Grant/Award Number: BMRP-5726113101
Abstract
Aims
Diabetic neuropathy (DN) is a “Cinderella” complication, particularly in the Middle East. A high prevalence of undiagnosed DN and those at risk of diabetic foot ulceration (DFU) is a major concern. We have determined the prevalence of DN and its risk factors, DFU, and those at risk of DFU in patients with type 2 diabetes mellitus (T2DM) in secondary care in Qatar.
Materials and methods
Adults with T2DM were randomly selected from the two National Diabetes Centers in Qatar. DN was defined by the presence of neuropathic symptoms and a vibration perception threshold (VPT) ≥ 15 V. Participants with a VPT ≥ 25 V were categorized as high risk for DFU. Painful DN was defined by a DN4 score ≥4. Logistic regression analysis was used to identify predictors of DN.
Results
In 1082 adults with T2DM (age 54 ± 11 years, duration of diabetes 10.0 ± 7.7 years, 60.6% males), the prevalence of DN was 23.0% (95% CI, 20.5%-25.5%) of whom 33.7% (95% CI, 27.9%-39.6%) were at high risk of DFU, and 6.3% had DFU; 82.0% of the patients with DN were previously undiagnosed. The prevalence of DN increased with age and duration of diabetes and was associated with poor glycaemic control (HbA1c ≥ 9%) AOR = 2.1 (95% CI, 1.3-3.2), hyperlipidaemia AOR = 2.7 (95% CI, 1.5-5.0), and hypertension AOR = 2.0 (95% CI, 1.2-3.4).
Conclusions
Despite DN affecting 23% of adults with T2DM, 82% had not been previously diagnosed with one-third at high risk for DFU. This argues for annual screening and identification of patients with DN. Furthermore, we identify hyperglycaemia, hyperlipidaemia, and hypertension as predictors of DN.
CONFLICT OF INTEREST
We confirm that the manuscript has been read and approved by all named authors and that there are no other persons who satisfied the criteria for authorship and are not listed. We confirm that the order of authors listed in the manuscript has been approved by all authors. None of the authors have received or anticipate receiving income, goods, or benefit from a company that will influence the design, conduct, or reporting of the study.
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