India has become 'World Capital' of diabetes and coupled with the fact that Indians are genetically weak against metabolic disorders, prevention and management of diabetes pose a formidable challenge.A cross sectional study was conducted to determine the extent of diabetic neuropathy & associated factors as well as its association with other long term complications of diabetes in patients attending diabetes clinic of tertiary care rural teaching hospital in Gujarat, India. Out of 307 consecutive patients attending diabetes clinic from April 2006 to Dec 2007, 287 patients were included in the study. 'Diabetic Neuropathy' was identified when there was loss of vibration sense using 128 MHz tuning fork. Diabetic retinopathy and nephropathy were identified using standard methods. Of the 287 diabetic patients assessed (169 Males, 118 Females, mean age(SD) 57.8(11.1)), Neuropathy was seen in 128(44.6%) patients. Retinopathy [18% vs.6.4%, Odds Ratio(OR) 3.2, 95% Confidence Interval (1.6, 7.0)] and Nephropathy [10.9% vs. 1.9%., Odds Ratio(OR) 6.3, 95% Confidence Interval (1.8, 22.3)] were more common in patients with Neuropathy as compared to patients without Neuropathy. A multi-variable logistic regression analysis revealed that Duration of diabetes, poor glycemic control and presence of nephropathy are significantly associated with Diabetic neuropathy [Adjusted OR (95% CI) are 1.06 (1.02, 1.1), 1.9(1.1, 3.3) and 6.1(1.3, 28.5)] respectively. This study indicates high prevalence of diabetic neuropathy. Further studies to find out the hurdles and possible solutions in maintaining good glycemic control are due as it is the only modifiable factor coupled with the fact that diabetic neuropathy is irreversible.
