Impact of neuropathy on the adherence to diabetes-related self-care activities: a cross-sectional study

Figures & data

Table 1 Patient’s characteristics, stratified according to the presence of DN

	Without overt neuropathy	Overt neuropathy present	P-value
Male sexa	64 (45.4%)	25 (43.9%)	0.845
Age (years)b	59 (12)	64.5 (10.5)	0.001*
Diabetes duration (years)b	7 (9)	7 (9)	0.867
HbA1c (%)c	8.0±1.8	8.6±1.6	0.620
BMI (kg/m^2)c	29.9±4.3	31.9±3.9	0.030*
PHQ-9 score (points)c	7.2±5.3	12.2±7.9	0.011*
Smokersa	50 (35.5%)	15 (26.3%)	0.215
Hypertensive patientsa	117 (83.0%)	45 (78.9%)	0.505
Chronic kidney diseasea	20 (14.2%)	32 (56.1%)	<0.001*
Retinopathya	31 (22.0%)	31 (54.4%)	<0.001*

Notes:

* Differences are statistically significant at α<0.05 threshold.

a Dichotomous variables. Results are presented as number of individuals (percentage from the subgroup). P-value was calculated using the chi-square test.

b Numerical variables with nonparametric distribution. Results are presented as median (interquartile range). P-value was calculated using the Mann–Whitney U-test.

c Numerical variables with Gaussian distribution. Results are presented as average ± standard deviation. P-value was calculated using the unpaired Student’s t-test.

Abbreviations: DN, diabetic neuropathy; HbA1c, hemoglobin A1c; BMI, body mass index; PHQ-9, Patient Health Questionnaire-9.

Figure 1 SDSCA adherence in patients with vs without DN.

Abbreviations: SDSCA, Summary of Diabetes Self-Care Activities; DN, diabetic neuropathy.

Figure 2 Depression severity in patients with vs without DN.

Abbreviations: DN, diabetic neuropathy; PHQ-9, Patient Health Questionnaire-9.

Table 2 SDSCA adherence and depression’s severity in patients with vs without DN

	Neuropathy absent (n=141)	Neuropathy present (n=57)	P-value
SDSCA global scorea	37 (17)	26 (14)	<0.001*
SDSCA diet scorea	17 (8)	12 (8)	<0.001*
SDSCA exercise scorea	6 (5)	5 (3)	0.002*
SDSCA glycemic monitoring scorea	8 (12)	4 (6)	0.010*
SDSCA foot care scorea	6 (8)	3 (4)	0.003*
PHQ-9 scorea	7 (6)	12 (14)	<0.001*
Minimal or no depressionb	32.6% (46)	22.8% (13)	<0.001*
Mild depressionb	44.7% (63)	17.5% (10)
Moderate depressionb	12.8% (18)	22.8% (13)
Moderately severe depressionb	5.7% (8)	12.3% (7)
Severe depressionb	4.3% (6)	24.6% (14)

Notes:

* Differences are statistically significant at α<0.05 threshold.

a Numerical variables with nonparametric distribution. Results are presented as median (interquartile range). P-value was calculated using the Mann–Whitney U-test.

b Dichotomous variables. Results are presented as number of individuals (percentage from the subgroup). P-value was calculated using the chi-square test.

Abbreviations: DN, diabetic neuropathy; SDSCA, Summary of Diabetes Self-Care Activities; PHQ-9, Patient Health Questionnaire-9.

Figure 3 Correlation between the severity of DN and SDSCA adherence.

Notes: P-value was obtained using the t-distribution test.
Abbreviations: DN, diabetic neuropathy; SDSCA, Summary of Diabetes Self-Care Activities; MNSI, Michigan Neuropathy Screening Instrument.

Table 3 Correlations between DN severity and SDSCA adherence in patients with T2DM

SDSCA component	Global MNSI score	MNSI – questionnaire	MNSI – clinical
Global score	−0.527*	−0.392*	−0.440*
Diet score	−0.507*	−0.389*	−0.365*
Exercise score	−0.380*	−0.314*	−0.267*
Glycemic monitoring score	−0.275*	−0.243*	−0.233*
Foot care score	−0.238*	−0.080	−0.331*
PHQ-9 score	0.495*	0.520*	0.225*

Notes:

* Correlations are significant at α<0.01 threshold. P-value was obtained using the t-distribution test.

Abbreviations: DN, diabetic neuropathy; SDSCA, Summary of Diabetes Self-Care Activities; T2DM, type 2 diabetes mellitus; MNSI, Michigan Neuropathy Screening Instrument; PHQ-9, Patient Health Questionnaire-9.