Diabetic peripheral neuropathy and associated factors among patients attending Mbarara Regional Referral Hospital, Southwestern Uganda: a cross‑sectional study

Abstract

Background: Diabetic peripheral neuropathy (DPN) is a microvascular complication of diabetes mellitus (DM), that is associated with increased risks of morbidity and disability, especially ulceration and amputation. Timely identification, diagnosis, and management of DPN are crucial to prevent amputations, mitigate disabilities, and enhance the quality of life for persons with diabetes. We determined the prevalence and factors associated with peripheral neuropathy among patients with diabetes at Mbarara Regional Referral Hospital (MRRH), southwestern Uganda. Methods: We conducted a cross-sectional study at the Diabetic Clinic of MRRH from November 2023 to January 2024. We used an interviewer-administered questionnaire to obtain data on socio-demographic and medical characteristics, and used the Toronto Clinical Scoring System (TCSS) tool to determine DPN and its severity. Levels/stages of neuropathy were grouped basing on the score as no neuropathy (0–5), mild neuropathy (6–8), moderate neuropathy (9–11), and severe neuropathy≥12. Modified Poisson regression, with robust standard errors was used to evaluate associations between DPN and independent variables. Results: In total, 355 participants were enrolled with mean age 55.94±13.43 years. Most participants were female (60%). The prevalence of DPN was 38.03% (n = 135; 95% CI 33.11–43.21%). Having high blood pressure of > 138/80 mmHg (adjusted prevalence ratio [aPR] =2.73, 95% CI 1.80–4.13), longer duration of diabetes of ≥6 years (aPR=2.01 95% CI 1.46–2.75), being aged≥60 years (aPR=1.49, 95%CI 1.04–2.13) and having fasting blood sugar>7mmol/l (aPR=1.96 95% CI 1.34–2.90) were independently associated with DPN. Conclusions: Approximately one in three DM patients surveyed had DPN. Hypertension, longer diabetes duration, advanced age, and high fasting blood sugar were associated with DPN. Timely detection and targeted interventions, particularly for individuals with modifiable risk factors like hypertension and poor glucose control, could play a crucial role in preventing or delaying the progression of DPN in this setting.