Prevalence of neuropathy in the diabetic foot

OBJECTIVE: To illustrate the prevalence of different types of neuropathy in diabetic patients with diabetic foot.

METHODS: This is a retrospective study of 229 diabetic foot patients treated at Princess Haya Hospital Hyperbaric Department, Aqaba, Jordan from January 1997 to January 2008, who were found to have different types of neuropathy. Neuropathy diagnosis was reached through investigating the patient’s history by presence of pain, and clinical neurological examination, absence of ankle reflexes, and abnormal quantitative sensory testing.

RESULTS: We found that 203 out of 229 (89%) patients had at least one type of neuropathy. One hundred and seventy-one out of 203 (84.2%) patients had symptoms of peripheral neuropathy, 11.8% of patients showed symptoms of different autonomic neuropathy, 2.5% of patients had been diagnosed with proximal neuropathy, and 1.5% had focal neuropathy. The mean age of diabetes in complicated neuropathy was 14.32+/-7.17 years. A stocking sensory loss was the leading symptom of peripheral neuropathy (77%) followed by symptoms of tingling, burning, or prickling sensations in 70% of patients.

CONCLUSION: Symptoms and signs of peripheral neuropathy are considered the most important factors when counseling the diabetic patient, who should be thoroughly informed on the importance of applying ample care to the feet. The physician should consider the patient’s age and chronicity of diabetes, and as they increase, it becomes imperatively important to conduct clinical examinations for early diagnosis of neuropathy.