Conference abstract

Prevalence, substitute diagnostic tool, risk factors of diabetic polyneuropathy and foot care awareness in diabetic patients in a semi urban setting- Cameroon

Pan African Medical Journal - Conference Proceedings. 2017:2(50).25 Dec 2017.
doi: 10.11604/pamj-cp.2017.2.50.95

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Keywords: Diabetic polyneuropathy, foot care awareness, Cameroon
Oral presentation

Prevalence, substitute diagnostic tool, risk factors of diabetic polyneuropathy and foot care awareness in diabetic patients in a semi urban setting- Cameroon

Nvaleu Tadfor1,&, Yacouba Njankouo2, Yannick Djieka3, Rene Mouliom2, Simeon Pierre Choukem4

1Health and Human Research Development (2HD), Douala, Cameroon, 2Hopital General de Douala, Faculty of Health and Biomedical Sciences University of Douala, Cameroon, 3Limbe Regional Hospital, Limbe, Cameroon, 4Faculty of Health Sciences University of Buea, Hopital General de Douala, Cameroon

&Corresponding author
Nvaleu Tadfor, Health and Human Research Development (2HD), Douala, Cameroon

Abstract

Introduction: the world is facing an epidemic of Diabetes. Polyneuropathy is a length dependent symmetric sensorimotor type of neuropathy a main risk factor of diabetic foot ulcers. The diabetic neurological examination (DNE) score and yearly foot examinations have been recommended for clinical diagnosis of Diabetic polyneuropathy (DPN). The DNE score is lengthy. Other simple tools for accurate diagnosis exist. Risk factors for DPN are not known in our setting. The objectives were to determine the prevalence of Diabetic Polyneuropathy; To compare the Vibratory Perception Threshold (VPT), Monofilament score (MS) and Diabetic Neurological Symptom Score to the DNE score. Identify risk factors of DPN; To estimate Clinician and patient awareness of foot care.

Methods: we conducted a cross sectional analytic study of diabetic patients in the Buea and Limbe regional hospitals during 4 months. Co-founders of diabetic polyneuropathy, alcoholics and HIV patients were excluded.

Results: 360 patients with mean age of 56 years. 236(65.6%) women and 348(9.67%) T2DM were recruited. The prevalence of DPN was 30.6% (110) using the DNE score. VPT was most specific (96%), sensitive (94.6% and correlated (0.59) to the DNE score. The monofilament and DNS had sensitivities, specificities and correlations of (95.8%, 79.5%, r = 0.48) and (62.2%, 83.5%, r = 0.16) respectively. Determinants of DPN were age > 60 years (p10 (p = 0.003), treatment with insulin and oral hypoglycaemics (p = 0.005), history of foot ulcer (p = 0.03), hypertension (p=0.04). During the preceding year, 264(73%) patientsí feet were not examined, 272(80%) did not check their foot wear before wearing, 255(71%) used razor to trim their nails, 144(40%) walked barefeet, and 72(21%) wore tight shoes.

Conclusion: the prevalence of DPN is high. VPT is a recommended simple tool for diagnosing DPN. Old age, long duration from diagnosis, treatment with both insulin and oral hypoglycemic drugs, a history of foot ulcer and hypertension are risk factors of DPN. Patients and clinicians ten years afterwards are still unaware of the correct foot care practices.