Keywords
diabetic polyneuropathy
diabetic foot
diabetes mellitus
How to Cite
Abstract
Objective: To establish the frequency of diabetic polyneuropathy (DPN) and its possible associated factors in a group of patients hospitalized in an institution in Bogota, Colombia. Methods: Cross-sectional study of 132 hospitalized diabetic patients to whom the Michigan Neuropathy Screening Instrument test and the 10g Semmes-Weinstein monofilament test were applied. For statistical analysis, we employed frequency tables, central tendency and dispersion statistics, odds ratio, and a multiple logistic regression model. Results: The proportion of PND in this study was 60,6 % (95 % CI 0,52-0,68). The main associated factors were loss of vibratory sensitivity (OR: 3,4, 95 % CI 1,1-10,9), loss of the Achilles reflex (OR: 12,4, 95 % CI 1,5-102,9), sensation of numbness in the feet (OR: 2,6, 95 % CI % 1,1-6,2) and nocturnal exacerbation of sensory symptoms (OR: 3,4, 95 % CI 1,3-9,0). Conclusions: The proportion of PND in this study was higher than that reported in the literature. Additional studies are required to determine the prevalence of PND in the community and low-complexity care centers.
1. Callaghan BC, Price RS, Feldman EL. Distal symmetric polyneuropathy. JAMA. 2015;314(20):2172. https://doi.org/10.1001/jama.2015.13611
2. Callaghan BC, Cheng HT, Stables CL, Smith AL, Feldman EL. Diabetic neuropathy: clinical manifestations and current treatments. Lancet Neurol [internet]. 2012;11(6):521-34. Disponible en: https://linkinghub.elsevier.com/retrieve/pii/S1474442212700650
3. Brownlee M, Aiello LP, Cooper ME, Vinik AI, Plutzky J, Boulton AJM. Complications of diabetes mellitus. En: Williams textbook of endocrinology [internet]. Filadelfia: Elsevier; 2016. p. 1484-581. Disponible en: https://linkinghub.elsevier.com/retrieve/pii/B9780323297387000332
4. Figuerola Pino D, Reynals de Blasis E, Vidal-Puig A, Aschner Montoya P. Diabetes mellitus. En: Farreras-Rozman: medicina interna. Filadelfia: Elsevier; 2016. p. 1824-62.
5. Feldman E, Callaghan B, Pop-Busui R. Diabetic neuropathy. Nat Rev Dis Primers [internet]. 2019;5(1):42. Disponible en: https://www.nature.com/articles/s41572-019-0097-9
6. Ticse R, Pimentel R, Mazzeti P, Villena J. Elevada frecuencia de neuropatía periférica en pacientes con diabetes mellitus tipo 2 de un hospital general de Lima-Perú. Rev Med Hered. 2013 [citado 2023 jul 11];24(2):114-21. Disponible en: http://www.scielo.org.pe/pdf/rmh/v24n2/v24n2ao3.pdf
7. Tesfaye S, Stevens LK, Stephenson JM, Fuller JH, Plater M, Ionescu-Tirgoviste C, et al. Prevalence of diabetic peripheral neuropathy and its relation to glycaemic control and potential risk factors: the EURODIAB IDDM Complications Study. Diabetología. 1996;39(11):1377-84. https://doi.org/10.1007/s001250050586
8. ElSayed NA, Aleppo G, Aroda VR, Bannuru RR, Brown FM, Bruemmer D, et al. Retinopathy, neuropathy, and foot care: standards of care in diabetes—2023. Diabetes Care [internet]. 2023;46(Suppl_1):S203-15. Disponible en: https://diabetesjournals.org/care/article/46/Supplement_1/S203/148042/12-Retinopathy-Neuropathy-and-Foot-Care-Standards
9. Feng Y, Schlösser FJ, Sumpio BE. The Semmes Weinstein monofilament examination as a screening tool for diabetic peripheral neuropathy. J Vasc Surg [internet]. 2009;50(3):675-682.e1. Disponible en: https://linkinghub.elsevier.com/retrieve/pii/S0741521409010283
10. Alcivar Alcivar DJ, Alvarado Cruz MS, Merchán Villafuerte KM, Journal of Scientific Research Mqri. Prevalencia de neuropatía periférica en pacientes con diabetes mellitus tipo 2. MQR Investigar [internet]. 2022;6(2):23-41. Disponible en: https://www.investigarmqr.com/ojs/index.php/mqr/article/view/41
11. Yang Z, Chen R, Zhang Y, Huang Y, Hong T, Sun F, et al. Scoring systems to screen for diabetic peripheral neuropathy. Cochrane Database Syst Rev. 2018;2018(7):CE10974. https://doi.org/10.1002/14651858.CD010974.pub2
12. Ibarra CT, Rocha JdeJ, Hernández OR, Nieves RE, Leyva R. Prevalencia de neuropatía periférica en diabéticos tipo 2 en el primer nivel de atención. Rev Med Chil. 2012;140(9):1126-31. https://doi.org/10.4067/S0034-98872012000900004
13. Asociación Colombiana de Diabetes. Guía de práctica clínica para el diagnóstico y tratamiento de los pacientes con pie diabético complicado [internet]. 2019 [citado 2023 jul 11]. Disponible en: https://asodiabetes.org/wp-content/uploads/2021/04/GuiaPractica-1.pdf?srsltid=AfmBOooE-7RVko4W273qsvrMxkKGtFHDtXE3D2E2ZlC6g0oapEE99yKn
14. Jurado J, Ybarra J, Romeo JH, Pou JM. Clinical screening and diagnosis of diabetic polyneuropathy: the North Catalonia Diabetes Study. Eur J Clin Invest. 2009;39(3):183-9. https://doi.org/10.1111/j.1365-2362.2008.02074.x
15. Didiesdle Herrera A, Sánchez Lozano A, Rodríguez Roque M, Rojas Fuentes J, Verdecia Fraga R, López Arguelles J. Evaluación electrofisiológica en pacientes diabéticos. Rev Finlay [internet]. 2017 sep [citado 2025 ene 26];7(3):187-92. Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S2221-24342017000300005&lng=es
16. Moghtaderi A, Bakhshipour A, Rashidi H. Validation of Michigan neuropathy screening instrument for diabetic peripheral neuropathy. Clin Neurol Neurosurg [internet]. 2006;108(5):477-81. Disponible en: https://doi.org/10.1016/j.clineuro.2005.08.003
17. Perkins BA, Olaleye D, Zinman B, Bril V. Simple screening tests for peripheral neuropathy in the diabetes clinic. Diabetes Care [internet]. 2001;24(2):250-6. Disponible en: https://diabetesjournals.org/care/article/24/2/250/23987/Simple-Screening-Tests-for-Peripheral-Neuropathy
18. Pop-Busui R, Ang L, Boulton A, Feldman E, Marcus R, Mizokami-Stout K, et al. Diagnosis and treatment of painful diabetic peripheral neuropathy. ADA Clin Compend [internet]. 2022 [citado 2023 jul 11];2022(1):1-32. Disponible en: https://diabetesjournals.org/compendia/article/2022/1/1/147001/Diagnosis-and-Treatment-of-Painful-Diabetic
19. Herman WH, Pop‐Busui R, Braffett BH, Martin CL, Cleary PA, Albers JW, et al. Use of the Michigan Neuropathy Screening Instrument as a measure of distal symmetrical peripheral neuropathy in type 1 diabetes: results from the Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications. Diabetic Med. 2012;29(7):937-44. https://doi.org/10.1111/j.1464-5491.2012.03644.x
20. Truini A, Spallone V, Morganti R, Tamburin S, Zanette G, Schenone A, et al. A cross-sectional study investigating frequency and features of definitely diagnosed diabetic painful polyneuropathy. Pain [internet]. 2018;159(12):2658-66. Disponible en: https://journals.lww.com/00006396-201812000-00024
21. Kisozi T, Mutebi E, Kisekka M, Lhatoo S, Sajatovic M, Kaddumukasa M, et al. Prevalence, severity and factors associated with peripheral neuropathy among newly diagnosed diabetic patients attending Mulago hospital: a cross-sectional study. Afr Health Sci [internet]. 2017;17(2):463. Disponible en: https://www.ajol.info/index.php/ahs/article/view/158728
22. Partanen J, Niskanen L, Lehtinen J, Mervaala E, Siitonen O, Uusitupa M. Natural history of peripheral neuropathy in patients with non-insulin-dependent diabetes mellitus. N Engl J Med. 1995;333(2):89-94. https://doi.org/10.1056/NEJM199507133330203
23. Andersen ST, Witte DR, Dalsgaard EM, Andersen H, Nawroth P, Fleming T, et al. Risk factors for incident diabetic polyneuropathy in a cohort with screen-detected type 2 diabetes followed for 13 years: ADDITION-Denmark. Diabetes Care [internet]. 2018;41(5):1068-75. Disponible en: https://diabetesjournals.org/care/article/41/5/1068/36552/Risk-Factors-for-Incident-Diabetic-Polyneuropathy
24. de Macedo GMC, Nunes S, Barreto T. Skin disorders in diabetes mellitus: an epidemiology and physiopathology review. Diabetol Metab Syndr. 2016;8(1):63. https://doi.org/10.1186/s13098-016-0176-y
25. Silva GE, Galeano E, Correa JO. Adherencia al tratamiento: implicaciones de la no-adherencia. Acta Med Colomb [internet]. 2005 [citado 2025 enero 26];30(4):268-73. Disponible en: https://www.actamedicacolombiana.com/ojs/index.php/actamed/article/view/2469
This work is licensed under a Creative Commons Attribution 4.0 International License.
Copyright (c) 2025 Miguel Angel Ruiz-Barrera, Mateo Cifuentes, Maria Alejandra Boada, Juan Mora, Martha C. Bohórquez-Ballén, Marcos Silva