Neurovascular Diseases of The Lower Extremity and Their Predictors Among Type II Diabetes Mellitus at Jimma University Medical Center, Ethiopia, 2024

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.