Abstract 99: Prevalence and its associated determinants of Diabetic Peripheral Neuropathy (DPN) in individuals having type-2 diabetes mellitus in rural South India/ Indian journal of Community Medicine

Background: International Diabetes federation 2021 states that approximately 537 million adults are living with DM and is expected to rise to 643 million by 20301. It also states that among 88 million people having diabetes in southeast Asia, 77 million belong to India, making India as diabetic capital of world1. DMis associated with severe microvascular and macrovascular complications leading to major implications on public health. DPN (Diabetic peripheral neuropathy) is one of the most common, earliest and serious complication of DM. However, limited data is available on prevalence of DPN in central part of the country, thus our study is focused on the prevalence of DPN in this part of country, where we mostly have rural population. Methods: An observational study was conducted in T2DM patients presenting to tertiary care center in Jabalpur, MP. Sample size of 150 was calculated using formula n = z2pq/d2 with prevalence of DPN as 20%. T2DM patients presenting in OPD/IPD were examined using preformed questionnaire based on various signs and symptoms and confirmed by nerve conduction study (NCS) recorded using RMS Aleron 201 electromyography machine. NCS was recorded single handedly and reported by single neurologist to avoid bias. Results: Among 150 patients, 102 (68%) developed DPN. Age of the patient is not found to be significant risk factor for DPN in our study (p value > 0.05). Patients presented with sensation of burn (25.33%) followed by numbness (18%), tingling (11.33%), pricking (2%), diabetic foot (2.6%). Surprisingly, 20% were asymptomatic even at the time of presentation. Significant correlation of DPN is found with duration of DM (p value < 0.05). As the duration of diabetes increases to >10 years' prevalence of DPN increases to as high as 87.1%. Surprisingly, we also found that 54.5% patients already had neuropathy at the time of diagnosis. In our study, HbA1c is found to be a significant risk factor for DPN (p value < 0.0001) with prevalence of neuropathy to be as high as 90% where HbA1c > 10%. Discussion: Indian Journal of community medicine estimates prevalence of DPN in India vary widely from 9.6% to 78% in different populations2 ranging from 29.2% in north India to 47% in south India whereas studies lack in central India. Though, our study was conducted in tertiary care center but included mainly referred rural population. Due to poor glycemic control and negligence of rural patients, our study shows prevalence of DPN to be as high as 68%. Most common symptom was found to be burn sensation while around 20% were asymptomatic at the time of presentation. Significant correlation of DPN is found with duration of DM and HbA1c. Thus, better glycemic control and early diagnosis of T2DM will reduce DPN related complications like foot ulcerations and amputations, gait disturbances.