UNMASKING THE SILENT EPIDEMIC: EVALUATING BIOTHESIOMETRY FOR EARLY DETECTION OF DIABETIC NEUROPATHY IN INDIA

Abstract

Due to the alarmingly high prevalence of type 2 diabetes mellitus (T2DM), India is experiencing a growing healthcare crisis. Diabetic peripheral neuropathy (DPN), one of the range of T2DM consequences, is particularly concerning, with prevalence rates in India ranging from 8% to 59%. DPN greatly increases the chance of serious side effects such gangrene, amputations, foot infections, and deformities. Factors like poor foot cleanliness, wearing the wrong shoes, and going barefoot all add to the intricacy of this problem.

Methods: This single-centre, hospital-based cross-sectional study spanned 18 months, involving 87 participants with confirmed T2DM. Data collection included anthropometric measurements, blood tests for glucose control and lipid profiles, urine sugar levels, and assessments for peripheral neuropathy using biothesiometry and nerve conduction velocity. Statistical analysis included mean values, percentages, chi-square tests, and t-tests.

Results: The study involved mostly male participants (64.4%) with an average age of 59.6 years and an average T2DM duration of 8.1 years. Notable findings included elevated fasting blood sugar (160.9 mg/dL), postprandial blood sugar (251 mg/dL), and HbA1c levels (7.1%). Approximately 49% of participants had high urine sugar levels, with 35.6% showing 4+ urine sugar. Nerve conduction velocity tests indicated peripheral neuropathy in 90.8% of cases. Biothesiometer assessments of the right foot revealed peripheral neuropathy in 78.2% of individuals, with varying severity. In contrast, left foot assessments indicated that 21.8% had no neuropathy. An association was found between HbA1c levels and neuropathy, and a significant difference existed between biothesiometer and nerve conduction velocity results (p=0.021). When assessing neuropathy based on disease duration, nerve conduction velocity tended to identify more cases than the biothesiometer.

Conclusion: This study underscores the significance of early detection of peripheral neuropathy in T2DM patients. The biothesiometer proves to be a practical, non-invasive, and cost-effective tool for this purpose. Routine biothesiometer use is recommended for early detection of peripheral neuropathy in T2DM patients, providing a valuable contribution to managing this significant healthcare challenge in India