Burden and geographical variation of peripheral neuropathy in India: insights from a large multi-regional screening study
DOI:
https://doi.org/10.18203/2319-2003.ijbcp20260336Keywords:
Peripheral neuropathy, Prevalence, Diabetes, India, Regional variability, Neuropathy screeningAbstract
Background: Peripheral neuropathy (PN) is a major cause of morbidity in India, yet it's true that community-level burden remains underreported. Understanding the distribution of neuropathy across demographic and regional subgroups is essential for targeted public health interventions. Aim and objectives to determine the prevalence and severity of PN in a large, diverse Indian population and to compare PN patterns across age, gender, diabetes status, and geographic regions.
Methods: This cross-sectional study analysed data from 153,354 adults screened across all four zones of India. The study was designed by Corona Remedies Ltd., and data were collected by them. PN was assessed using a standardized bilateral foot scoring system with a Biothesiometer, and severity was classified as normal, mild, moderate, or severe. Demographic details (age, gender, region) and diabetes status were recorded. Prevalence estimates were calculated using descriptive statistics and stratified by key subgroups.
Results: The overall prevalence of PN was 75.4%, with mild (53.9%) being the most common category, followed by moderate (16.8%) and severe (4.7%). PN prevalence was significantly higher among people with diabetes (90.1%) compared to non-diabetics (65.3%). Gender differences were minimal, with males showing slightly higher prevalence (75.8%). Wide zonal variation was observed, with PN prevalence ranging from 74.3% to 79.3%. The Eastern zone demonstrated the highest neuropathy prevalence at 79.3%, driven by a larger proportion of individuals with moderate (16.8%) and severe neuropathy (20.4%).
Conclusions: Neuropathy is highly prevalent in the Indian population, with a significantly more substantial burden among people with diabetes. These findings highlight the need for early screening and targeted interventions for diabetic individuals to prevent neuropathy-related complications.
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References
Pop-Busui R, Boulton AJ, Feldman EL, Bril V, Freeman R, Malik RA, et al. Diabetic Neuropathy: A Position Statement by the American Diabetes Association. Diabetes Care. 2017;40(1):136-54. DOI: https://doi.org/10.2337/dc16-2042
Darivemula S, Nagoor K, Patan SK, Reddy NB, Deepthi CS, Chittooru CS. Prevalence and Its Associated Determinants of Diabetic Peripheral Neuropathy (DPN) in Individuals Having Type-2 Diabetes Mellitus in Rural South India. Indian J Community Med. 2019;44(2):88-91.
Trivedi S, Pandit A, Ganguly G, Das SK. Epidemiology of Peripheral Neuropathy: An Indian Perspective. Ann Indian Acad Neurol. 2017;20(3):173-84. DOI: https://doi.org/10.4103/aian.AIAN_470_16
Tesfaye S, Boulton AJ, Dyck PJ, Freeman R, Horowitz M, Kempler P, et al. Diabetic neuropathies: update on definitions, diagnostic criteria, severity assessment, and treatments. Diabetes Care. 2010;33(10):2285-93. DOI: https://doi.org/10.2337/dc10-1303
Soni K, Srivastava DK, Kumar S, Bajpai PK, Shukla SK, Prakash S. Prevalence of Diabetic Peripheral Neuropathy among Type 2 Diabetes Mellitus patients and its associated risk factors. Indian J Community Health. 2024;36(2):208-14. DOI: https://doi.org/10.47203/IJCH.2024.v36i02.009
Hanewinckel R, Ikram MA, van Doorn PA. Peripheral neuropathies. Handb Clin Neurol. 2016;138:263-82. DOI: https://doi.org/10.1016/B978-0-12-802973-2.00015-X
Ziegler D, Papanas N, Vinik AI, Shaw JE. Epidemiology of polyneuropathy in diabetes and prediabetes. Handb Clin Neurol. 2014;126:3-22. DOI: https://doi.org/10.1016/B978-0-444-53480-4.00001-1
Abraham A, Barnett C, Katzberg HD, Lovblom LE, Perkins BA, Bril V. Sex differences in neuropathic pain intensity in diabetes. J Neurological Sci. 2018;388:103-6. DOI: https://doi.org/10.1016/j.jns.2018.03.008
Bharucha NE, Bharucha AE, Bharucha EP. Prevalence of peripheral neuropathy in the Parsi community of Bombay. Neurology. 1991;41:1315-7. DOI: https://doi.org/10.1212/WNL.41.8.1315
Saha SP, Bhattacharya S, Das SK, Maity B, Roy T, Raut DK. Epidemiological study of neurological disorders in a rural population of Eastern India. J Indian Med Assoc. 2003;101:299-300.
Gourie-Devi M, Gururaj G, Satishchandra P, Subbakrishna DK. Prevalence of neurological disorders in Bangalore, India: A community-based study with a comparison between urban and rural areas. Neuroepidemiology. 2004;23:261-8. DOI: https://doi.org/10.1159/000080090
Ghosh B, Sengupta S, Bhattacharjee R, Pal S, Saha SP, Ganguly G, et al. Spectrum of peripheral neuropathy in Eastern India. J Indian Med Assoc. 2006;104:168-70.
Bril V, Tomioka S, Buchanan RA, Perkins BA; mTCNS Study Group. Reliability and validity of the modified Toronto Clinical Neuropathy Score in diabetic sensorimotor polyneuropathy. Diabet Med. 2009;26(3):240-6. DOI: https://doi.org/10.1111/j.1464-5491.2009.02667.x
Callaghan BC, Little AA, Feldman EL, Hughes RA. Enhanced glucose control for preventing and treating diabetic neuropathy. Cochrane Database Syst Rev. 2012;2012(6):CD007543. DOI: https://doi.org/10.1002/14651858.CD007543.pub2
Armstrong DG, Boulton AJM, Bus SA. Diabetic Foot Ulcers and Their Recurrence. N Engl J Med. 2017;376(24):2367-75. DOI: https://doi.org/10.1056/NEJMra1615439
England JD, Asbury AK. Peripheral neuropathy. Lancet. 2004;363(9427):2151-61. DOI: https://doi.org/10.1016/S0140-6736(04)16508-2