View More View Less
  • 1 Jos University Teaching Hospital Department of Medicine PMB 2076 Jos Nigeria
  • 2 University College Hospital Department of Medicine Ibadan Nigeria
  • 3 Jos University Teaching Hospital Department of Pathology Jos Nigeria
Restricted access

Background: Over three hundred million people worldwide were estimated to be become diabetic by year 2025. The rates of both obesity and malnutrition are on the increase worlwide. The goal of this study was to describe the relationship of body mass index (BMI) and diabetic peripheral neuropathy (DPN) in persons with diabetes mellitus. Research design and methods: A cross-sectional analysis of BMI and peripheral neuropathy was conducted among one hundred and twenty diabetic subjects, who were grouped based on presence or absence of DPN. Ninety of the diabetic persons had peripheral neuropathy, while thirty of the diabetic persons had no neuropathy. DPN was determined only by clinical assessment using an aspect of the Michigan Neuropathy Screening Instrument (MNSI). Result: The two groups were not different in BMI, total cholesterol and high density lipoproteins (HDL). The group without peripheral neuropathy had better glycaemic control; HB A1C = 5.9 ± 2.5 (%), shorter mean duration of diabetes = 5.3 ± 3.6 years and younger age. More of those with peripheral neuropathy were underweight (six compared to none ‘0’ of those without neuropathy). Similar result was obtained for morbid obesity ‘class 3’, although BMI had no significant effect on DPN after controlling for age, duration of DM and glycaemic control. Discussion and conclusion: Obesity is an index of insulin resistance which may account for poor glycaemic control and predispose to peripheral neuropathy and other complications. Weight loss depicts severity of type 1 DM which may account for complications. This pattern also depicts the trend in a sub-Saharan African city like ours with uneven distribution of wealth and resources hence the poor result in both the underweight and obese class 3.

  • Spallone, V., Gambardella, S., Maiello, M. R. et al.: Relationship between autonomic neuropathy, 24th blood pressure profile and nephropathy in normotensive IDDM patients. Diabet. Care, 1994, 17 , 578–580.

    Maiello M. R. , 'Relationship between autonomic neuropathy, 24th blood pressure profile and nephropathy in normotensive IDDM patients ' (1994 ) 17 Diabet. Care : 578 -580.

    • Search Google Scholar
  • Garland, H.: Neurological Complications of Diabetes Mellitus: Clinical Aspects. Proc. Roy. Soc. Med., 1960, 53 , 137–141.

    Garland H. , 'Neurological Complications of Diabetes Mellitus: Clinical Aspects ' (1960 ) 53 Proc. Roy. Soc. Med. : 137 -141.

    • Search Google Scholar
  • King, H., Aubert, R. E., Herman, W. H.: Global burden of diabetes, 1995–2025: prevalence, numerical estimates and projections. Diabet. Care, 1998, 22 , 650–651.

    Herman W. H. , 'Global burden of diabetes, 1995–2025: prevalence, numerical estimates and projections ' (1998 ) 22 Diabet. Care : 650 -651.

    • Search Google Scholar
  • Schram, M. T., Chaturvedi, N., Fuller, J. H. et al.: Vascular risk factors and markers of endothelial function as determinants of inflammatory markers in type 1 diabetes. The EURODIAB prospective complications study. Diabet. Care, 2003, 26 , 2165–2173.

    Fuller J. H. , 'Vascular risk factors and markers of endothelial function as determinants of inflammatory markers in type 1 diabetes. The EURODIAB prospective complications study ' (2003 ) 26 Diabet. Care : 2165 -2173.

    • Search Google Scholar
  • Pinzur, M., Freeland, R., Juknelis, D.: The association between body mass index and foot disorders in diabetic patients. Foot Ankle Int., 2005, 26 , 375–377.

    Juknelis D. , 'The association between body mass index and foot disorders in diabetic patients ' (2005 ) 26 Foot Ankle Int. : 375 -377.

    • Search Google Scholar
  • James, P. R., Leach, R., Kalamara, E. et al.: The world wide obesity epidemic. Obes., 2001, 9 , 228–233.

    Kalamara E. , 'The world wide obesity epidemic ' (2001 ) 9 Obes. : 228 -233.

  • Alberti, K. G. M. M., Zimmet, P. Z.: WHO Consultation. Definitions, diagnosis and classification of diabetes mellitus. Provisional report of a WHO consultation. Diabet. Med., 1998, 14 , 539–553.

    Zimmet P. Z. , 'WHO Consultation. Definitions, diagnosis and classification of diabetes mellitus. Provisional report of a WHO consultation ' (1998 ) 14 Diabet. Med. : 539 -553.

    • Search Google Scholar
  • Feldman, E. L., Brown, M. B.: A practical two-step quantitative clinical and electrophysiological assessment for the diagnosis and staging of neuropathy. Diabet. Care, 1994, 17 , 1281–1289.

    Brown M. B. , 'A practical two-step quantitative clinical and electrophysiological assessment for the diagnosis and staging of neuropathy ' (1994 ) 17 Diabet. Care : 1281 -1289.

    • Search Google Scholar
  • Himes, J. H., Dietz, W. H.: Guidelines for overweight in adolescent preventive service. recommendations from an expert committee. The expert committee on clinical Guidelines for overweight in Adolescent preventive Services.; Am. J. Clin. Nutr., 1994, 59 , 307–316.

    Dietz W. H. , 'Guidelines for overweight in adolescent preventive service ' (1994 ) 59 recommendations from an expert committee. The expert committee on clinical Guidelines for overweight in Adolescent preventive Services.; Am. J. Clin. Nutr. : 307 -316.

    • Search Google Scholar
  • Cameron, N. E.: Essential fatty acid diet supplementation. Diabet. Care, 1991, 40 , 532–539.

    Cameron N. E. , 'Essential fatty acid diet supplementation ' (1991 ) 40 Diabet. Care : 532 -539.

    • Search Google Scholar
  • Kahler, W.: Diabetes mellitus. A free radical-associated disease. Result of adjuvant antioxidant supplementation. Z. Gesamte Inn. Med., 1998, 48 , 223–232.

    Kahler W. , 'Diabetes mellitus. A free radical-associated disease. Result of adjuvant antioxidant supplementation ' (1998 ) 48 Z. Gesamte Inn. Med. : 223 -232.

    • Search Google Scholar
  • Ziegler, D.: Treatment of Symptomatic Diabetic Peripheral Neuropathy with the antioxidant alpha-lipoic acid. A 3-week multicentre randomized controlled trial (ALADIN Study). Diabetologia, 1995, 38 , 1425–1433.

    Ziegler D. , 'Treatment of Symptomatic Diabetic Peripheral Neuropathy with the antioxidant alpha-lipoic acid. A 3-week multicentre randomized controlled trial (ALADIN Study) ' (1995 ) 38 Diabetologia : 1425 -1433.

    • Search Google Scholar