Ibrahim Gul, Muhammad Faraz Siddique, Tahir Ghaffar.
Risk Factors Associated with Diabetic Peripheral Neuropathy in Non-insulin Dependent Diabetes Mellitus at a Tertiary Care Hospital in Peshawar, Pakistan; an Analytical Cross Sectional Study.
Pak J Med Res Jan ;61(2):68-73.

Objective: To identify the risk factors associated with diabetic peripheral neuropathy (DPN) in patients with non-insulin dependent diabetes mellitus (NIDDM) at a tertiary care hospital of an underdeveloped country. Study type, settings & duration: This cross sectional analytical study was conducted over a period of one year at Khyber Teaching Hospital, Peshawar from January to December 2013.   Methodology: Participants with diabetes mellitus (DM) satisfying the inclusion criteria were enrolled in the study and categorized into two groups, one having DPN(n=110) and the other having no DPN(n=110) based on modified Neuropathy Disability Score (mNDS). Socio-demographic characteristics and disease profile of the participants were taken with structured interview questionnaire and analysed using STATA SE 13. Results: The overall response rate was 92.4% (n=220) and mean age was 54.5+8.8 years with equal male to female ratio. Participants with DPN had significantly higher disease duration (>10 years: 60% v 18.2%, p<0.001), poorer glycaemic control (HbA1c 8.0-10.0 = 36.4% v 26.4%, HbA1c>10.0 = 28.2% v 10.0%, p<0.001),raised uric acid (14.5% v 4.6%, p <0.02) hypertension (69.1% v 53.6%, p=0.02), central obesity (72.7% v 47.3%, p <0.001) and overweight/obese status (BMI 25.0-29.9=52.7% v 29.1%, BMI >30.0= 22.7% v 8.2%, p <0.001).Also the combination of insulin and oral hypoglycaemic drugs were significantly associated with DPN as against to oral hypoglycaemic drugs alone. There was no difference in the two groups with respect to age, sex, monthly income, smoking status, alcohol use or the presence of dyslipidaemia. Conclusion: Amongst the various risk factors, higher duration of DM, poor glycaemic control and raised BMI are strongly associated with DPN

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