Prevalence and risk factors of clinical diabetic polyneuropathy in a Portuguese primary health care population

Objective: Distal symmetrical polyneuropathy in dia. betics (DPN) has a var iable prevalence around 30% and increases the risk for foot ulcers and ampu tations. We aimed at evaluating the prevalence of clinical DPN and associat ed risk factors in patients followed in primary care centers. Material and methods: 101 type 2 diabetics were evaluated and 8 were exclud ed due to the presence of other causes of neuropathy. The remaining 93 had a mean age of 65.4 +/- 10.1 years and a mean diabetes duration of 10.1 +/- 11.1 years, 60.2% were women and 39.8% men. DPN was defined as the presence of both altered sensitivities and reflexes, regardless of symptoms. Results: Seventy-two (80%) patients had symptoms of polyneuropathy, but DPN was present only in 29 (32.2%). Calluses (37.8%) and trophic skin (74.4%) and nail (75.6%) changes were found in both feet. There was a significant p ositive association of DPN with age (69.0 +/- 9.1 vs 63.3 +/- 9.9 years, p = 0.01), disease duration (15.7 +/- 13.5 vs 7.2 +/- 8.8 years, p = 0.001), feet skin changes (38.8 vs 13.0%, p 0.04) and myocardial infarction/ischemi a (14.8 vs 1.7%, p = 0.03). Conclusions: This sample of diabetic patients cared by family doctors prese nted a high prevalence of DPN. Aging, disease duration, the presence of fee t skin changes and myocardial infarction/ischemia are factors that increase the prevalence of the disease. Primary care doctors awareness of the probl em might help to decrease the associated morbidity.