Key result
Clinical and electrophysiological testing detects diabetic neuropathy in ~87% of patients with diabetes or prediabetes.
Why the study?
Previous studies on diabetic neuropathy in sub-Saharan Africa used purely clinical approaches that potentially underestimated disease magnitude, leaving a need for objective measures of small and large fiber function.
Cross-Sectional (n=84)
No
The prevalence of diabetic neuropathy, particularly diabetic sensorimotor polyneuropathy, in this sub-Saharan African cohort was higher than previously reported, highlighting the need for objective electrophysiological assessments.
Supports electrophysiological screening in similar diabetes cohorts; leaves open optimal strategies and generalizability in sub-Saharan populations.
BACKGROUND: Diabetic neuropathy (DN) is the most frequent complication of diabetes mellitus, contributing to increased morbidity and mortality. Previous clinical studies on DN in sub-Saharan Africa (sSA) have used purely clinical approaches, potentially underestimating the true magnitude of this disease. This study was designed to determine the prevalence of definite diabetic neuropathy and describe the different subtypes using objective small and large fiber function measures. METHODS: This was a hospital-based cross-sectional study that included diabetes and prediabetes patients, followed up at Jordan Medical Services, Yaoundé, Cameroon, between March 2022 and February 2023. The "Toronto Clinical Neuropathy Score" and "Douleur Neuropathique en 4" questionnaires were used for clinical evaluation. Autonomic symptoms were equally recorded. Nerve conduction studies and Sudoscan were used for electrophysiological assessments of large and small fibre functions. RESULTS: Eighty-four participants were included; 91.7% had type 2 DM, 2.4% had type 1 DM, and 6% had glucose intolerance. DN was found in 73/84 (86.9%). Diabetic sensorimotor polyneuropathy (DSP) was the most frequent subtype (63.8%), followed by diabetic autonomic neuropathy (40.5%), mononeuropathy (36.9%), asymmetric axonal sensory neuropathy (4.8%) and treatment-induced neuropathy of diabetes (TIND) in 1.2% of patients. The prevalence of large and small fibre neuropathies was 38.1% and 25.0%, respectively. CONCLUSION: The prevalence of DN and specifically DSP in our study was higher than previously described in African literature. We identified subtypes never before reported in sSA, mainly small fibre neuropathy and TIND. This may have management and policy implications.
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Chokote et al. (2025) conducted a cross-sectional in Diabetic neuropathy (n=84). Diabetes and prediabetes was evaluated on Prevalence of definite diabetic neuropathy. Clinical and electrophysiological evaluation identified diabetic neuropathy in 86.9% of patients with diabetes or prediabetes, with sensorimotor polyneuropathy being the most frequent (63.8%).
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