Effective Factors in the Time of Development of Neuropathy in Type II Diabetic Patients

Abstract

Background and Objectives: Neuropathy is a common complication of diabetes that can cause disability in diabetic patients. The aim of this study was to determine of effective factors in the Event Time of neuropathy in type 2 diabetic patients using the Cox proportional hazards model. Methods: This study included 371 patients with type II diabetes without neuropathy who were registered at Fereydunshahr Diabetes Clinic. Subjects were followed up for the development of neuropathy between 2006 until March 2016. The data were analyzed using the R software (ver. 3.2.3). The test was conducted at an error level of 5%. Results: At the end of 10 years of study, the cumulative incidence and prevalence of neuropathy was 30.7% and 41.6%, respectively. The Kaplan-Meier method showed the mean time to detection of neuropathy was 76.6 ± 5 months after the first diagnosis of diabetes (83.8 ± 8 in men and 72.7 ± 6 in women). The semi-parametric Cox regression model revealed the one-year, two-year, five-year, and eight-year disease-free survival was 0.867, 0.819, 0.647, and 0.527, respectively. Also, four variables of duration of diabetes, sex, family history of diabetes, and HbA1c can be considered as strong determinants of the time of development of neuropathy in the semi-parametric model (COX) (P<0.05). Conclusion: Optimal glycemic control and regular evaluation of legs in elderly patients, especially women with a positive family history, decrease the occurrence and progression of neuropathy and improve the quality of life in diabetic patients.

Keywords

• diabetes
• neuropathy
• cox proportional hazards model
• kaplan-meier
• survival analysis