A clinical and electrodiagnostic study of diabetic neuropathy at Jordan University Hospital

OBJECTIVE: To study diabetic neuropathy (DN) at Jordan University Hospital (JUH) with the aim of assessing age/gender distribution, risk factors, and other diabetic microvascular complications, clinical manifestations, results of nerve conduction studies (NCS), and treatment modalities, and to compare these findings with those from Western and other Middle/Far Eastern literatures.

METHODS: Among 562 patients with diabetes mellitus (DM) seen over a 2-year-period from January 2003 to January 2005, at the Diabetes center at Jordan University Hospital (JUH), 110 patients (10 DM type 1; 100 DM type 2) were studied retrospectively.

RESULTS: The prevalence of DN was 20%. The mean age was 55.4 years (range 23-75), with 62 females and 48 males. The most common risk factors for DN were old age, long duration of DM, mean hemoglobin A1c, and hypertension. Almost 50% of patients had additional retinopathy, renal involvement, or both. The most common clinical symptoms were distal numbness/paresthesiae in the limbs (60% of patients) and the neurological examination was normal in 2/3 of patients (only 20% had stocking hypoesthesia to pain and temperature and absent ankle jerks). The NCS showed an axonal neuropathy mainly affecting the lower limbs, especially sensory fibers (abnormal sural sensory action potential in 98% of patients). Anticonvulsants (carbamazepine and gabapentin) were used efficiently in 50% of patients as symptomatic treatment, while tricyclic antidepressants were used as add-on in only 23 patients, due to anticholinergic side effects.

CONCLUSION: In comparison with other studies, ours shows a lower prevalence of DN, similar age distribution with however, a predominance of females, similar risk factor profiles, clinical/NCS findings, and treatment modalities.