A MULTICENTER STUDY ON THE PREVALENCE OF DIABETIC NEUROPATHY IN ITALY

OBJECTIVE - The prevalence of neuropathy, a common complication of dia betes, was determined in diabetic patients recruited from 109 outpatie nt diabetes clinics in Italy. RESEARCH DESIGN AND METHODS - Neuropathy was diagnosed using the Diabetic Neuropathy Index (DNI), a standardiz ed examination developed for use in the outpatient setting. A total of 8,757 diabetic patients were studied, 51.2% men and 48.8% women, with average and median ages of 56 and 58 years, respectively. RESULTS - O f the 8,757 patients, 32.3% had neuropathy, defined as a positive scor e of >2 points on the DNI. A total of 2,033 (49.6% men and 50.4% women ) were administered the Diabetic Neuropathy Score (DNS), the second co mponent of the screening program, by a neurologist. This component con sists of a quantitative neurological examination and nerve conduction studies that together provide a summated score. A total of 335 patient s (16.5%) were not neuropathic, and 395 (19.4%) had borderline, 453 (2 2.3%) mild, 592 (29.1%) moderate, and 258 (12.7%) severe neuropathy. T he concordance between a positive score on the DNI and a DNS indicatin g neuropathy was 83.5%. The severity of neuropathy increased with both age and disease duration. Of patients with neuropathy, 64.1% had an a verage age between 58 and 59 years with a disease duration between 12. 4 +/- 8.4 years (mild neuropathy) and 15.6 +/- 9.7 years (severe neuro pathy). CONCLUSIONS - Neuropathy is a common complication of diabetes and, in this study, was present in 32.3% of all patients. An increased awareness of the high prevalence of neuropathy can lead to early ther apeutic intervention and possible prevention of later neuropathic comp lications, such as infection and foot ulcers.