Magnitude of distal symmetrical polyneuropathy using Michigan neuropathy screening instrument and biothesiometer among diabetic patient following at Tikur Anbessa Specialized hospital, Addis Ababa Ethiopia, Institutional based cross sectional study
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Date
2023-08
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Addis Ababa University
Abstract
Background:Diabetic neuropathy is most common complication in diabetic patients affecting 50-75 % of diabetic patient.
In around 50% of patient distal symmetrical polyneuropathy is asymptomatic and result in increased risk of
limb loss and hospitalization, which affect the quality of life of patient. Once it occur there is no
reversibility, hence early picking of the problem will help in management of diabetic patient .The finding
from this Study will help ,in our set up ,which tool to use to detect early distal symmetrical polyneuropathy.
Objective:The study is designed to assess Magnitude of distal symmetrical polyneuropathy using Michigan
neuropathy scoring instrument and Biothesiometer among Diabetic patient attending Tikur Anbessa
Specialized Hospital.
Method:An institution-based cross-sectional study was conducted at Tikur Anbessa Hospital on 290 diabetic and
pre-diabetic individuals. Study subjects were recruited from the diabetic clinic using systematic random
sampling methods, every other clinic schedule. Data were collected using Kobotoolbox which was fed with
a well-structured questionnaire, which was then cleaned exported to Stata version 19 for Analysis. Both
bivariate and multivariate binary logistic regressions were employed to identify factors associated with
DSPN. A variable having a p value of <0.25 in the bivariate model was subjected to avoid
confounding variable’s effect. After checking for model-fitting information (Hosmer and Lemeshow test
p=0.523) the adjusted odds ratio with a 95% confidence interval and a p-value <0.05 was used to determine
statistical significance
Result:This study showed DSPN prevalence of 43.8% using MNSI and 85.2 % using biothesiometer. After
multivariate analysis Smoking history, duration of diabetes, LDL value above 70 mg /dl and obesity have
significant association with the occurrence of DSPN. Patient with smoking history had 2.5 times likely to
develop DSPN as compared to non-smoke (AOR =2.5 95 % CI (1.16, 5.63),P-value of 0.02). Duration of
diabetes longer than 10 years was 2 times associated with DSPN as compared to duration of below five year
(AOR=2.03 95 CI(1.01,4.09) ,P-value 0.047).Patients who had LDL value above 70 mg /dl were likely to
have DSPN 1.9 times DSPN ( AOR=1.9 95% CI (1.05,3.45) ,P – value =0.035.Obese individuals were 2.7
times likely to have DSPN as compared to normal weight ( AOR= 2.7, CI95% (1.28-5.72),P-value =0.009
Conclusion:Most of the study participant had DSPN using biothesiometer DSPN. Long duration of diabetes, smoking
history, obesity and high low density lipoprotein were independent risk factor for DSPN .Biothesiometer
peak 79.1% of participant with no clinical symptom based on MNSI symptom .Symptomatic participant has
sever DSPN biothesiometer .Thus our finding suggest prevalence of DSPN is high and can use
biothesiometer for early detection of DSPN.
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Keywords
Diabetic Neuropathy