Relationship between the duration of diabetes and severity of neuropathy in patients of peripheral neuropathic diabetic foot ulcers


  • Utkarsh Kumar Department of General Surgery, KCGMC, Karnal, Haryana, India
  • Anjali Singh Department of Otorhinolaryngology, KCGMC, Karnal, Haryana, India
  • Deepak Singla Department of General Surgery, KCGMC, Karnal, Haryana, India
  • Nivesh Agrawal Department of General Surgery, KCGMC, Karnal, Haryana, India



Peripheral neuropathy, DFU, Semmes-Weinstein monofilament testing (10-g monofilament), TCSS


Background: Diabetic foot ulcer (DFU) has devastating impact on the social, personal as well as economic life of a diabetic patient. In US, prevalence of peripheral neuropathy in adult diabetics is approximately 28%. The aim of this study is to establish relationship between the duration of diabetes and severity of neuropathy in patients with peripheral neuropathic DFU.

Methods: This is a prospective observational study, including 30 patients, who underwent history, examination and Toronto clinical scoring system (TCSS) was used for diagnosing severity of diabetic peripheral neuropathy (mild, moderate, severe) from a period of October 2015 to June 2017.

Results: In this study, we observed that the mean age of the diabetic foot patients was 53.50±12.03 years ranging from 30 to 75 years. Male-to-female ratio was 1.5:1. The mean duration of diabetes was 6.38±4.57 years. The patients with mild neuropathy had a mean duration of diabetes of 4.77±2.61 years, while, those with moderate and severe neuropathy had mean duration of 7.17±1.48years and 8.48±4.59 years, respectively.

Conclusions: The study concluded that there is a significant association between duration of diabetes and severity of neuropathy, i.e., patients with longer duration of diabetes had severe peripheral neuropathy.


Boulton AJ. Diabetic neuropathy and foot complications. Handb Clin Neurol. 2014;126:97-107.

Pop-Busui R, Boulton AJ, Feldman EL, Bril V, Freeman R, Malik RA et al. Diabetic Neuropathy: A Position Statement by the American Diabetes Association. Diabetes Care. 2017;40(1):136-54.

Hicks CW, Selvin E. Epidemiology of Peripheral Neuropathy and Lower Extremity Disease in Diabetes. Curr Diab Rep. 2019;19(10):86.

Oyibo SO. A comparison of two diabetic foot ulcer classification systems: the Wagner and the University of Texas wound classification systems. Diabetes Care. 2001;24(1):84-8.

Abbott CA, Vileikyte L. Multicenter study of the incidence of and predictive risk factors for diabetic neuropathic foot ulceration. Diabetes Care. 1998;21(7):1071-75.

Kennedy JM, Zochodne DW. Impaired peripheral nerve regeneration in diabetes mellitus. J. Peripher Nerv Syst. 2005;10(2):144-57.

Çakici N, Fakkel TM, van Neck JW, Verhagen AP, Coert JH. Systematic review of treatments for diabetic peripheral neuropathy. Diabet Med. 2016;33(11):1466-76.

Thomas P, Tomlinson DR. Diabetic and hypoglycaemic neuropathy. In "Peripheral Neuropathy" (Dyck PJ, Thomas PK, Griffin JW, Low PA, Poduslo JF, eds.). Saunders, Philadelphia. 1992;1219-50.

Fernyhough P, Gallagher A, Averill SA, Priestley JV, Hounsom L, Patel J et al. Aberrant NF phosphorylation in sensory neurons of rats withdiabetic neuropathy. Diabetes. 1999;48:881-9.

Nisar MU, Asad A, Waqas A, Ali N, Nisar A, Qayyum MA et al. Association of Diabetic Neuropathy with Duration of Type 2 Diabetes and Glycemic Control. Cureus. 2015;7(8):e302.

Oguejiofor OC, Odenigbo CU, Oguejiofor CB. Evaluation of the effect of duration of diabetes mellitus on peripheral neuropathy using the United Kingdom screening test scoring system, bio-thesiometry and aesthesiometry. Niger J Clin Pract. 2010;13:240-7.

Maser RE, Steenkiste AR, Dorman JS, Nielsen VK, Bass EB, Manjoo Q, Drash AL, Becker DJ, Kuller LH, Greene DA Epidemiological correlates of diabetic neuropathy. Report from Pittsburgh Epidemiology of Diabetes Complications Study. Diabetes. 1989;38:1456-61.




How to Cite

Kumar, U., Singh, A., Singla, D., & Agrawal, N. (2023). Relationship between the duration of diabetes and severity of neuropathy in patients of peripheral neuropathic diabetic foot ulcers. International Journal of Research in Medical Sciences, 11(5), 1549–1552.



Original Research Articles