Characterizing distal peripheral neuropathy in type 2 diabetes mellitus in a semi-urban community setting in Peru

Background Distal peripheral neuropathy (DPN) is a devastating complication of type 2 diabetes that is causing medical and economic burden worldwide, especially in developing nations like Peru. Hospital prevalence of DPN has been determined in Peru, but information characterizing DPN in the community is scarce. This study characterized DPN among individuals with Type 2 diabetes using a population-based survey in Peru. Methods Cross-sectional, population-based study conducted in Tumbes, Peru. Participants were categorized by glycemic status measured by an oral glucose tolerance test. Neuropathic status was measured by biothesiometry. Result A total of 1,607 participants were included, mean age 48.2 (standard deviation (SD)=0.3), and 810 (50.3%) women. A total of 176 (11.0%, 95% confidence interval (CI)=9.5–12.6%) persons had type 2 diabetes and 272 (17%; 95% CI=15.1–18.8%) had dysglycemia. Among those with type 2 diabetes, 105 (59.7%) were aware of their diagnosis, with 94 (89.5%) on treatment, and only 30 (28.6%) with appropriate control. DPN prevalence was 44.3% among those with type 2 diabetes and 19.8% among those with dysglycemia. In multivariable model, type 2 diabetes, but not dysglycemia, was associated with a 1.28-increased (95% CI=1.13–1.45) prevalence of DPN compared to normal controls. Conclusions There is a high prevalence of DPN at community level. The high prevalence of DPN and high amount of undiagnosed and uncontrolled cases of type 2 diabetes demonstrate a need for earlier detection, stricter glycemic control, and improved screening, especially in resource-constrained settings like Peru.