Prevalence and factors associated with Peripheral Neuropathy among adolescents and young adults with diabetes mellitus at Mulago National Referral Hospital

Abstract

Introduction Adolescents and young adults have poor adherence to diabetes treatment and recommendations which predispose them to diabetic complications. Peripheral neuropathy is a common complication which can progress to lower limb weakness, loss of reflexes and diabetic foot. There is still paucity of data on the prevalence and factors associated with peripheral neuropathy among adolescents and young adults with diabetes mellitus because there is currently no policy in Uganda as regards routine screening of diabetic peripheral neuropathy. Study Objective; To determine the prevalence and factors associated with peripheral neuropathy among adolescents and young adults with diabetes mellitus attending Mulago National Referral hospital. Methods; The study was a cross sectional study design and 202 participants were recruited through consecutive sampling. An interviewer administered questionnaire was used to collect data on prevalence and factors associated with peripheral neuropathy. Peripheral neuropathy was measured as a binary outcome as either present or absent. Logistic regression was used to estimate the association of the independent factors with peripheral neuropathy. Results: The prevalence of diabetic peripheral neuropathy was 10.8% (95% CI 6.6-15.2). The factors that were associated with a higher likelihood of DPN were; being overweight (aOR 3.3, 95% CI 1.0-10.9, p-value 0.049) and age between 20 to 30 years (aOR 3.9, 95% CI 1.3-9.5, p-value 0.014). The factors that were associated with a lower likelihood of DPN were; having adequate physical activity (aOR 0.28, 95% CI 0.12-0.96, p-value 0.042), and a vegetable and grain based diet (aOR 0.43, 95% CI 0.09-0.93, p-value 0.005 for 1-3 times a week and aOR 0.33, xiv 95% CI 0.1000.91, p-value 0.032 for more than 3 times a week). HbA1c was a confounder of the relationship between BMI and presence of DPN. Conclusion: The prevalence of diabetes peripheral neuropathy was found to be high in adolescents and young adults with DM. Being overweight, having adequate physical activity, age between 20 to 30 years and a vegetable and grain based diet were independent factors associated with DPN. Routine screening and diabetes education should be strengthened to allow for primary prevention and early diagnosis of DPN.