Detection of diabetic polyneuropathy in the family medicine clinics by using monofilament

Introduction. Diabetic polyneuropathy (DPN) is the most common microvascular complication of diabetes mellitus (DM), which may be present at the time of disease detection. Screening for DPN is performed for the patients with type 2 diabetes at the time of diagnosis and for type 1 diabetes 5 years after diagnosis. The primary objective of this study was to determine the prevalence of DNP among family medicine patients with diabetes mellitus aged 18 to 70 years using nylon monofilament. Methods. The cross-sectional study estimated the prevalence of DPN among primary care patients with DM in Banja Luka. Seemes-Weinstein nylon 10g monofilament was used to detect DPN. Age, sex, duration of diabetes, type of therapy, symptoms, glycosylated hemoglobin (HbA1c) and risk factors (hypertension, smoking, dyslipidemia, obesity, physical inactivity) were analyzed. Data collection took place from 01/06/2017 to 31/05/2018. Results. The study included 228 patients, 132 (57.9%) men and 96 (42.1%) women. There was a statistically significant difference in the duration of diabetes and the presence of all symptoms of DPN (tingling, burning, light burning and stinging) with respect to the presence of polyneuropathy (p <0.01). Multivariate logistic regression revealed that patients who had hypertension (OR=26.2; 95% CI: 4.070-168.488; p=0.001), used oral antidiabetic therapy (OR=12.3; 95% CI: 1.300 -116.309; p=0.029 ) had tingling (OR=5.2; 95% CI: 1.431- 18.571 p=0.012;)and a longer duration (OR=4.27; 95% CI: 1.983-9.175; p=0.000) of diabetes were more likely to have DPN. Conclusion. The prevalence of DPN in patients with diabetes is 24.2%. Determinants of DNP are the presence of symptoms of tingling, duration of diabetes, hypertension, dyslipidemia, and the use of oral antidiabetic therapy alone.