Screening for Peripheral Neuropathy and Peripheral Vascular Disease in Patients With Type 2 Diabetes Mellitus: A Community-Based Cross-Sectional Study From Rural Andhra Pradesh, India

TL;DR

This study examines the high prevalence of peripheral neuropathy and poor foot care among type 2 diabetes patients in rural India, highlighting the need for better education and screening.

Contribution

The study provides new insights into the burden of peripheral complications and foot-care practices in rural type 2 diabetes patients in Andhra Pradesh.

Findings

88.44% of patients experienced loss of hot/cold discrimination, indicating high neuropathy prevalence.

Only 16.8% of patients had undergone HbA1c testing in the last year, showing poor monitoring.

Foot-care practices were suboptimal, with less than 4% using moisturizer or foot inspection tools.

Abstract

Background

Diabetes mellitus continues to rise globally, with complications such as peripheral neuropathy and peripheral vascular disease (PVD) contributing substantially to morbidity, particularly in rural communities where awareness is low and care is inadequate.

Objective

To assess the burden of neuropathic symptoms and evaluate foot-care practices among adults with type 2 diabetes mellitus in rural Andhra Pradesh, India, with peripheral vascular status recorded qualitatively through pulse screening.

Methods

A cross-sectional community-based study was conducted across five villages. A total of 173 known type 2 diabetic patients aged ≥40 years were selected using random sampling. Data collection included interviews and clinical assessments for neuropathy and PVD.

Results

Peripheral neuropathic symptoms were highly prevalent, with 153 patients (88.44%) experiencing loss of hot/cold discrimination. A total of 130 patients (75.1%) had one or more comorbidities. While 164 patients (94.79%) were on treatment for diabetes, only 29 patients (16.8%) had undergone HbA1c testing in the last year. Foot-care practices were suboptimal - only six patients (3.5%) reported applying moisturiser between the toes, and just three patients (1.7%) used a mirror to inspect their feet regularly.

Conclusion

Peripheral complications and poor foot-care practices remain widespread. Strengthening education and early screening in rural settings is essential to curb diabetic foot morbidity.

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