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J Clin Transl Endocrinol. 2016 Jul 20;5:26-31. doi: 10.1016/j.jcte.2016.07.001. eCollection 2016 Sep.

Peripheral sensory neuropathy in type 2 diabetes patients: A case control study in Accra, Ghana.

Journal of clinical & translational endocrinology

Kwame Yeboah, Peter Puplampu, Vincent Boima, Daniel A Antwi, Ben Gyan, Albert G B Amoah

Affiliations

  1. Department of Physiology, School of Biomedical & Allied Health Sciences, University of Ghana, Accra, Ghana.
  2. Department of Medicine & Therapeutics, School of Medicine & Dentistry, University of Ghana, Accra, Ghana.
  3. Department of Immunology, Noguchi Memorial Institute of Medical Research, University of Ghana, Accra, Ghana.
  4. National Diabetes Management & Research Centre, Korle-Bu Teaching Hospital, Accra, Ghana.

PMID: 29067231 PMCID: PMC5644439 DOI: 10.1016/j.jcte.2016.07.001

Abstract

OBJECTIVE: Peripheral sensory neuropathy (PSN) is a common cause of ulceration and amputation in diabetes (DM) patients. The prevalence of PSN in DM patients is largely undetermined in sub-Saharan African population. We studied the burden of PSN in DM patients using a validated questionnaire and quantitative sensory test.

METHODS: In a case-control design, PSN was measured in 491 DM patients and 330 non-DM controls using Michigan neuropathy screening instrument (MNSI) and vibration perception threshold (VPT). PSN was defined as MNSI symptom score ≥7, MNSI examination score ≥2 or VPT ≥25V.

RESULTS: The prevalence of PSN screened by MNSI symptom score, MNSI examination score and VPT was 7.1%, 51.5% and 24.5% in DM patients; and 1.5%, 24.5% and 8.5% in non-DM participants respectively. The major determinants of PSN screened by MNSI examination score were diabetes status [OR (95% CI): 4.31 (2.94-6.31), p < 0.001], age [1.03 (1.01-1.05), p < 0.001], previous [4.55 (2.11-9.82), p < 0.001] and current [8.16 (3.77-17.68), p < 0.001] smoking status. The major determinants of PSN screened by VPT were diabetes status [1.04 (1.02-1.06), p < 0.001], age [1.02 (1.01-1.03), p = 0.047], heart rate [1.78 (1.08-2.92), p = 0.023], second-hand smoking [3.66 (2.26-5.95), p < 0.001] and body height [3.28 (1.65-8.42), p = 0.015].

CONCLUSION: Our study has shown high burden of PSN in DM patients in Ghana using simple, accurate, and non-invasive screening tools like MNSI and neurothesiometer.

Keywords: DM, diabetes mellitus; Diabetes; Ghana; MNSI, Michigan neuropathy screening instrument; PSN, peripheral sensory neuropathy; Peripheral sensory neuropathy; VPT, vibration perception threshold; Vibration perception threshold

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