Abstract:
Background: Poorly controlled diabetic mellitus has a devastating impact on peripheral nerves
and blood vessels and even with good management options, complete prevention remains an
ongoing challenge, particularly in T2DM. Thus, researchers need to evaluate the occurrence of
neurovascular diseases and predictors of peripheral neuropathy and peripheral arterial in T2DM.
Objective: To determine the prevalence of neurovascular diseases of the lower extremity and
their predictors among T2DM at Jimma University Medical Center, 2024.
Materials and Methods: A cross-sectional design with sequential sampling was utilized. the
Michigan Neuropathy Screening Index for diagnosing peripheral neuropathy as well as the
Edinburgh Claudication Questionnaires in conjunction with the ankle-brachial index to screen
peripheral arterial disease. Data were collected via structured face-to-face interviews,
anthropometric measurements, and immuno-hematological parameters using the Kobo Toolbox.
The descriptive study was followed by bivariate and multivariate regression adjustments, with a
95% confidence interval, and at P-values < 0.25 and <0.05 respectively, utilizing SPSS v27.
Results: The study included 336 T2DM with response rates of 95.8% (322). The majority were
male 187(57.9%), females 135(41.8%), and their mean age was (49±16 years). The prevalence of
Peripheral neuropathy, Peripheral arterial disease, and Neurovascular disease of the lower
extremity was 57.6%, 55.1%, and 76.1%, respectively. Older age (40-49 years, OR:5.43; >50
years, OR:5.52), longer duration of T2DM (5-10 years, OR:4.65; >10, OR:7.72), lower high-
density lipoprotein (OR:10.16), increased fasting blood sugar (OR=5.79), elevated glycated
hemoglobin (OR:1.55), poor self-care (OR:19.51), and elevated Neutrophil-to-lymphocyte ratio
(OR=2.33) were associated to peripheral neuropathy. whereas, urban dwellers (OR:2.00), longer
duration of T2DM(5–10years, OR:2.31;>10 years, OR:2.72), elevated glycated hemoglobin (AO:
1.94),Lower high-density lipoprotein (OR:2.90), poor self-care (OR:3.37), elevated platelets-to-
lymphocyte ratio(OR:1.17), and increased waist circumference (OR:1.19) were identified risks
of Peripheral arterial disease.
Conclusion and Recommendations: The prevalence of diabetes-induced neurovascular diseases
of the lower extremity among T2DM was high. Older age, urban residents, prolonged duration,
hyperglycemia, dyslipidemia, central obesity, poor self-care, and low-grade inflammation were
significant risk factors. Therefore, healthcare professionals should prioritize regular screening for
peripheral neuropathy and peripheral arterial disease, early risk factors identification, and
implementing interventions such as diabetes self-care educations, frequent monitoring, and early
treatment initiation accordingly.
