Clinical Study of Prevalence of Peripheral Neuropathy, Its Risk Factors and Its Association with Vitamin D3 Level in Type II Diabetes Patients

Introduction: Diabetes is a major global health crisis, ranking among the leading causes of mortality worldwide, alongside cardiovascular disease, cancer, and respiratory disease. According to the WHO, noncommunicable diseases accounted for 74% of global deaths in 2019, with diabetes contributing to 1.6 million deaths, making it the ninth leading cause of death. By 2035, an estimated 592 million people may die from diabetes. Diabetic peripheral neuropathy (DPN), a common complication of Type 2 Diabetes Mellitus (T2DM), arises from chronic hyperglycemia, leading to peripheral nerve dysfunction. Material and Methods: This prospective, cross-sectional study was conducted over a year at a tertiary care center in Gujarat to evaluate the prevalence of peripheral neuropathy in T2DM patients, identify risk factors, and assess correlations with Vitamin D3 levels. A total of 403 adult T2DM patients, diagnosed for at least one year, were recruited through systematic random sampling. Patients with other causes of peripheral neuropathy were excluded. Data were collected using structured questionnaires capturing demographic and clinical details, neuropathy assessment via the Michigan Neuropathy Screening Instrument (MNSI), and nerve conduction studies. Vitamin D3 levels were categorized as deficient, insufficient, or sufficient using chemiluminescent immunoassay, and glycemic control was assessed via HbA1c. Risk factors like age, BMI, smoking, hypertension, and dyslipidemia were analyzed. Statistical methods, including Pearson correlation and logistic regression, were used to evaluate the association between Vitamin D3 levels and neuropathy severity. Data analysis was conducted using SPSS, with p-values <0.05 considered significant. Results: In our study, the prevalence of diabetic peripheral neuropathy (DPN) was 70% among 403 T2DM patients, primarily affecting those aged 51–60 years (50.4%). Patients with DPN were significantly older (p < 0.001), while gender showed no significant influence (p = 0.836). Hypertension, poor glycemic control (FBS: 265.91 ± 19.42 mg/dL, PPG: 285.60 ± 82.38 mg/dL, HbA1c: 9.67 ± 2.12%; p < 0.001), higher BMI, smoking, and dyslipidemia were strongly associated with DPN. Additionally, abnormal waist circumference was prevalent in 69.4% of DPN patients (p < 0.001). Vitamin D deficiency was common across both groups, though a higher proportion of sufficient Vitamin D levels (38.0%) was observed in DPN patients (p = 0.005), underscoring its potential role in DPN severity. Conclusion: Peripheral neuropathy is a prevalent complication in diabetic patients, particularly those over 50 years of age, with no significant gender predilection. Hypertension, obesity, dyslipidemia, smoking, poor glycemic control, and Vitamin D deficiency are significant risk factors. Routine Vitamin D assessment and supplementation, alongside optimized glycemic and lifestyle management, are crucial for mitigating neuropathy risk and severity.