A clinical and electrodiagnostic study of diabetic neuropathy at Jordan University Hospital

Objectives: To study diabetic neuropathy (DN) at JordanUniversity Hospital (JUH) with the aim of assessingage/gender distribution, risk factors, and other diabeticmicrovascular complications, clinical manifestations,results of nerve conduction studies (NCS), and treatmentmodalities, and to compare these findings with those fromWestern and other Middle/Far Eastern literatures.Methods: Among 562 patients with diabetes mellitus (DM)seen over a 2-year-period from January 2003 to January2005, at the Diabetes center at Jordan University Hospital(JUH), 110 patients (10 DM type 1; 100 DM type 2) werestudied retrospectively.Results: The prevalence of DN was 20%. The mean age was55.4 years (range 23-75), with 62 females and 48 males.The most common risk factors for DN were old age, longduration of DM, mean hemoglobin A1c, and hypertension.Almost 50% of patients had additional retinopathy, renalinvolvement, or both. The most common clinical symptomswere distal numbness/paresthesiae in the limbs (60% ofpatients) and the neurological examination was normal in2/3 of patients (only 20% had stocking hypoesthesia topain and temperature and absent ankle jerks). The NCSshowed an axonal neuropathy mainly affecting the lowerlimbs, especially sensory fibers (abnormal sural sensoryaction potential in 98% of patients). Anticonvulsants(carbamazepine and gabapentin) were used efficiently in50% of patients as symptomatic treatment, while tricyclicantidepressants were used as add-on in only 23 patients, dueto anticholinergic side effects.Conclusion: In comparison with other studies, ours showsa lower prevalence of DN, similar age distribution withhowever, a predominance of females, similar risk factorprofiles, clinical/NCS findings, and treatment modalities.