Objectives: There are conflicting evidence regarding the relationship of peripheral neuropathy in prediabetes. Our aim was to determine the prevalence of peripheral neuropathy in prediabetes through a systematic literature review and meta-analysis.
Methods: Five electronic databases, namely MEDLINE, EMBASE, PubMed, Web of Science and Cochrane Central Register of Controlled Trials were searched for studies published up to October 2017. Original full studies were included that provided prevalence data for a population with prediabetes, who were over 18 years of age. Additional studies were identified from reference lists and two reviewers independently identified eligible studies on predefined inclusion criteria.
Results: In total, 1314 studies were identified after duplicates were removed and subsequently 1255 were excluded. Of the 59 remaining studies, 23 studies (n=6494) met the inclusion criteria for the meta-analysis. The pooled prevalence estimate of neuropathy in prediabetes was 18% (95% CI: 13-22%) with a marked level of heterogeneity (I2 = 97%). The high level of heterogeneity between studies was partly explained by the method of neuropathy assessment. Subgroup analyses based on the method of neuropathy assessment was evaluated and the prevalence was highly dependent on the method of assessment. The prevalence depending on the type of test used was: quantitative tests: 16% (95% CI: 3-30%, I2 = 95%), physical examination: 24% (95% CI: 7-40%, I2 = 83%), questionnaires: 8% (95% CI: 2 -13%, I2 = 57%) and combination(s) of the three: 18% (95% CI: 13- 24%, I2 = 97%).
Conclusions: There is a higher than expected prevalence of peripheral neuropathy in prediabetes. Future large, population based studies using accurate and quantitative means of identifying neuropathy are required and an internationally agreed definition as to what constitutes prediabetic neuropathy is required.
U. Alam: Speaker's Bureau; Self; Sanofi, Novo Nordisk A/S.