Prevalence of Karapada daha-suptata in Madhumeha with reference to diabetic peripheral neuropathy in type 2 diabetes mellitus patients.
Abstract
Background: Diabetes mellitus is a major health issue in today's world. Main threat is not the disease itself but its complications like nephropathy, retinopathy and neuropathy etc. Diabetic peripheral neurropathy is the leading cause of foot ulcers, their complications like limb amputation and cost associated with it. Madhumeha which has been described as 'Maharogas' i.e. difficult to treat disease has many similarities with Diabetes mellitus can be understood and studied as same disease. Ayurveda has mentioned the causes, pathophysiology and symptoms of Diabetic Peripheral Neuropathy as 'karapada daha -suptata' in purvarupa lakshanas and upadrava lakshanas but inscattered form. It needs depth study to understand the concept of Karapada daha- suptata (DPN).
Objective: To study prevalence of Karapada daha-suptata (Diabetic peripheral neuropathy) and the relation of Karapada daha- suptata (DPN) with age, gender, duration of disease Madhumeha, blood sugar level, alcohol and smoking habit etc in Madhumeha patients.
Method :A cross sectional study was carried out in Tribhuvan University Ayurveda Teaching Hospital,. Madhumeha patients (Type 2 diabetes mellitus) patients were recruited for the study. MNSI (Michigan Neuropathy Screening Instrument) was used to diagnose Karapada daha- suptata (Diabetic peripheral neuropathy).
Result: Among 100 patients 31% patient had Karapada daha- suptata (DPN). Our study showed that the prevalence of Karapada daha-suptata(DPN) increased with increasing age of the study population. Similarly prevalence of Karapada daha -suptata in patients with disease duration of Madhumeha (DM2) for more than 5 years was 61.29% where as patients having Diabetes for less than 5 year was 38.71%. Prevalence of Karapada daha-suptata (DPN) was very high (43.13%) among uncontrolled fasting blood sugar level (>126mg/dl) and (47.5%) among uncontrolled post prandial blood sugar level (>200mg/dl). In this study mean Fasting blood sugar level was 177.0323 mg/dl in the patients with Karapada daha-suptata(DPN) and mean post prandial blood sugar level in patients with diabetic peripheral neuropathy was 239.1613mg/dl.
Conclusion: Our study showed Karapada daha-suptata/DPN is highly prevalent and increasing as the duration of disease Madhumeha increses but its not uncommon in newly disagnosed disease too. This study showed significant relation of Karapada daha suptata with disease duration of Madhumeha, level of blood sugar, and increasing age of the patients.Study showed no significant differences in the prevalence of Kara pada daha- suptata in male and female patients and with the smoking habit of the patients.
