Study of clinical patterns of diabetic neuropathy in patients of type 2 diabetes mellitus in a tertiary care hospital

Abstract

Introduction: Diabetic neuropathy manifests with sensory, motor, and autonomic functions. The symptoms of neuropathy are highly unpleasant, affecting the quality of life. The diagnosis of diabetic neuropathy is often delayed, so there remains a substantial need for its early diagnosis for timely management.

Objective: The aim of this study was to describe patterns of diabetic neuropathy, study nerve conduction study (NCS) findings in diabetic patients with symptoms of neuropathy, and find the relationship between clinical patterns of neuropathy and worsening glycemic control.

Methods: This is a hospital-based cross-sectional study of 104 known cases of diabetes mellitus patients with symptoms of neuropathy visiting Sree Gokulam Medical College and undergoing NCS as a part of the investigation. The Fisher’s exact test was used accordingly.

Results: The mean age of the study population was 63.1 ± 6.1 years. The mean body mass index was 27.1 ± 3.2 kg/m2 . Overall, 97.1% patients had HbA1c above 7%. Approximately 54.8% of patients presented with tingling sensation, 42.3% with burning sensation, 31.7% complained of pain, 16.3% presented with numbness, 51% patients had abnormal NCS findings in sural and peroneal nerves, 54.8% in superficial peroneal nerve, 46.2% in tibial nerve, and 31.7% patients had abnormal NCS findings in median nerve. Based on the patterns of neuropathy, 68.2% had sensory motor polyneuropathy, 5.8% had carpal tunnel syndrome, 20.2% had small fiber neuropathy (normal NCS), 2.9% had tibial mononeuropathy, and 2.9% had ulnar mononeuropathy. No association was found between the clinical patterns of neuropathy and glycemic control (HbA1c).

Conclusion: The most common pattern of neuropathy was sensory motor polyneuropathy. The common nerves involved were sural, peroneal, and superficial peroneal nerve, and the most common presenting complaint was tingling sensation, followed by burning sensation. There was no relationship between clinical patterns of neuropathy and worsening glycemic control.