Diabetic neuropathy in Mauritius: prevalence and risk factors

The study of diabetic neuropathy has been primarily in Europids, despite th e high prevalence of diabetes in other populations. We set out to ascertain the prevalence of diabetic neuropathy and its risk factors in the island n ation of Mauritius. Population surveys were carried out in 1987 and 1992 in Mauritius to establish the prevalence of Type 2 diabetes. In the second su rvey, vibration perception threshold (VPT) was also measured at the great t oe in 847 subjects with diabetes, 204 subjects with impaired glucose tolera nce and 127 subjects with normal glucose tolerance. Neuropathy was defined as levels of VPT exceeding the mean plus 2 standard deviations defined sepa rately for three age groups of Mauritian non-diabetic subjects. Risk factor s for neuropathy were identified cross sectionally from the 1992 data, and longitudinally from the 1987 data. Neuropathy was detected in 8.3% of the 8 47 diabetic subjects (12.7% of those with known diabetes, and 3.6% of those with newly diagnosed diabetes). Logistic regression identified diabetes du ration (odds ratio [95% CI]; 1.08 [1.04-1.13] per year, P = 0.0002), treatm ent with insulin or oral hypoglycaemic agents (2.63 [1.36-5.09], P = 0.004) and greater height (1.36 [1.19-1.57] per 5 cm, P < 0.001) as risk factors for neuropathy, in the cross sectional analysis. In the longitudinal analys is, diabetes duration (1.11 [1.05-1.18] per year, P = 0.001), fasting gluco se (1.12 [1.03-1.22] per mmol/l, P = 0.01) and height (1.23 [1.03-1.45] per 5 cm, P = 0.02) were associated with neuropathy. A lower 2-h plasma insuli n was also associated with neuropathy in the longitudinal analysis. The pre valence of diabetic neuropathy in Mauritius is the lowest reported for any population, but the risk factors associated with it are similar to those pr eviously found. (C) 1998 Elsevier Science Ireland Ltd. All rights reserved.