Fatores associados à ocorrência da neuropatia periférica diabética em pessoas com diabetes mellitus tipo 2

Debora Ellen Sousa Costa; Lívia Maia Pascoal; Marcelino Santos Neto; Jairo Domingos de Morais; Yan Torres Andrade; Ana Clara Laundos Oliveira; Barbara dos Santos Limeira

doi:10.36517/2175-6783.20262796220

Authors

Debora Ellen Sousa Costa Federal University of Maranhão https://orcid.org/0000-0003-4205-8801
Lívia Maia Pascoal Federal University of Maranhão https://orcid.org/0000-0003-0876-3996
Marcelino Santos Neto Federal University of Maranhão https://orcid.org/0000-0002-6105-1886
Jairo Domingos de Morais University for International Integration of the Afro-Brazilian Lusophony https://orcid.org/0000-0002-8383-7871
Yan Torres Andrade Federal University of Maranhão https://orcid.org/0009-0001-4627-2816
Ana Clara Laundos Oliveira Federal University of Maranhão https://orcid.org/0009-0001-9123-6822
Barbara dos Santos Limeira Federal University of Maranhão https://orcid.org/0000-0001-8788-8089

DOI:

https://doi.org/10.36517/2175-6783.20262796220

Keywords:

Diabetic Neuropathies; Primary Health Care; Diabetes Mellitus, Type 2; Risk Factors.

Abstract

Objective: to identify factors associated with diabetic peripheral neuropathy in individuals with type 2 diabetes mellitus. Methods: cross-sectional study conducted with 123 users followed up in a Primary Health Care Unit. Multiple Poisson regression with robust variance and Spearman correlation were used to analyze associated factors. Results: the prevalence of diabetic peripheral neuropathy was 44.7%. The occurrence of this complication showed a statistically significant association with marital status—married/stable union (p=0.048) and widowed (p=0.015), incomplete secondary education (p=0.030), presence of neuropathic pain (p=0.001) or indeterminate pain (p=0.001), duration of diabetes diagnosis between five and 10 years (p=0.031), and longer than 10 years (p=0.001). Conclusion: sociodemographic and clinical factors directly influenced the occurrence of diabetic peripheral neuropathy. Contributions to practice: these findings reinforce the relevance of Primary Health Care in screening and managing neuropathy, highlighting the nurse’s role in prevention, health education, clinical surveillance, and continuous follow-up.

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References

1. Eid SA, Rumora AE, Beirowski B, Bennett DL, Hur J, Savelieff MG, et al. New perspectives in diabetic neuropathy. Neuron. 2023;111(17):2623-41. doi: https://doi.org/10.1016/j.neuron.2023.05.003

2. Yang Y, Zhao B, Wang Y, Lan H, Liu X, Hu Y, et al. Diabetic neuropathy: cutting-edge research and future directions. Signal Transduct Target Ther. 2025;10(1):132. doi: https://dx.doi.org/10.1038/s41392-025-02175-1

3. American Diabetes Association (ADA). Microvascular complications and foot care: Standards of Medical Care in Diabetes – 2021. Diabetes Care. 2021;44(Suppl 1):151‑67. doi: https://doi.org/10.2337/dc21-S011

4. Goh LH, Siah CJR, Tam WWS, Tai ES, Young DYL. Effectiveness of the chronic care model for adults with type 2 diabetes in primary care: a systematic review and meta-analysis. Syst Rev. 2022;11(1):273. doi: https://dx.doi.org/10.1186/s13643-022-02117-w

5. Silva A, Stival M, Funghetto S, Volpe C, Funez M, Lima L. Comparison of pain and quality of life between individuals with and without diabetic neuropathy. Rev Enferm UFSM. 2021;11:e62. doi: https://doi.org/10.5902/2179769263722

6. Park E, Choi J, Lee S. A nurse‑led telehealth program for diabetes foot care: feasibility and usability study. JMIR Nursing. 2023;6(1):e40000. doi: https://doi.org/10.2196/40000

7. Lopes CGS, Rocha TAH, Thomaz EBAF, Tonello AS, Rocha NCS, Duarte KMM, et al. Diabetes Mellitus macro-regional inequalities in PHC: comparing the three PMAQ-AB cycles. Saúde Debate. 2022; 133(46):376-91. doi: http://dx.doi.org/10.1590/0103-1104202213309i

8. Farias AL, Silva ASA, Tavares VB, Souza JS, Silva HP, Bastos MSCBO, et al. Amazon amandaba—prevalence, risk factors and self-care perception associated with diabetic peripheral neuropathy in patients with type 2 diabetes: a cross-sectional study. Healthcare (Basel). 2023;11(4):518. doi: https://doi.org/10.3390/healthcare11040518

9. Bertolucci PHF, Brucki SMD, Campacci SR, Juliano Y. O Mini‑Exame do Estado Mental em uma população geral: impacto da escolaridade. Arq Neuro‑Psiquiatr. 1994;52(1):1‑7. doi: https://doi.org/10.1590/S0004-282X1994000100001

10. Ministério da Saúde (BR). Sistema de Informação para a Atenção Primária à Saúde (e-SUS) [Internet]. 2025 [cited Oct 17, 2025]. Available from: https://sisaps.saude.gov.br/sistemas/esusaps/

11. Gonçalves H, Lopes A, Costa A, Calvão J, Fonseca L, Gonçalves J, et al. Rastreio de polineuropatia diabética periférica em doentes internados. Rev Med Interna. 2019;26(4):297‑303. doi: https://doi.org/10.24950/rspmi/O/176/19/4/2019

12. Oliveira FB, Botelho KKP, Bezerra AR, Azevedo DIO, Santos-Couto-Paz CC, Fachin-Martins E. Cross-cultural adaptation to Brazilian Portuguese of the Michigan Neuropathy Screening Instrument: MNSI-Brazil. Arq Neuropsiquiatr. 2016;74(8):653-61. doi: http://doi.org/10.1590/0004-282X20160094

13. Rolim LC, Thyssen PJ, Flumignan RLG, Andrade DC, Dib SA. Diagnóstico e tratamento da neuropatia periférica diabética: diretriz oficial da Sociedade Brasileira de Diabetes. 2023. doi: https://doi.org/10.29327/557753.2022-14

14. Freynhagen R, Baron R, Gockel U, Tölle TR. Pain DETECT: a new screening questionnaire to identify neuropathic components in patients with back pain. Curr Med Res Opin. 2006;22(10):1911-20. doi: https://doi.org/10.1185/030079906X132488

15. Yovera-Aldana M, Velásquez-Rimachi V, Huerta-Rosario A, More-Yupanqui MD, Osores-Flores M, Espinoza R, et al. Prevalence and incidence of diabetic peripheral neuropathy in Latin America and the Caribbean: a systematic review and meta-analysis. PLoS One. 2021;16(5):e0251642. doi: https://doi.org/10.1371/journal.pone.0251642

16. Golinelli D, Sanmarchi F, Guarducci G, Palombarini J, Benetti P, Rosa S, et al. Gender differences in healthcare utilization across Europe: evidence from the European Health Interview Survey. Health Policy. 2025;162:105448. doi: https://doi.org/10.1016/j.healthpol.2025.105448

17. Reis IFA, Lima LR, Funez MI, Funghetto SS, Costa MVG, Leite MM, et al. Predictive factors for diabetic neuropathy in older people treated in primary care. Rev Enf Ref. 2021;5(7):e20148. doi: https://doi.org/10.12707/rv20148

18. Hagen KM, Ousman SS. Aging and the immune response in diabetic peripheral neuropathy. J Neuroimmunol. 2021;355:577574. doi: https://doi.org/10.1016/j.jneuroim.2021.577574

19. Hicks C, Wang D, Windham B, Matsushita K, Selvin E. Prevalence of peripheral neuropathy defined by monofilament insensitivity in middle-aged and older adults in two US cohorts. Sci Rep. 2021;11:98565. doi: https://dx.doi.org/10.1038/s41598-021-98565-w

20. Instituto Brasileiro de Geografia e Estatística (IBGE). Censo Demográfico 2022: população e domicílios: primeiros resultados [Internet]. 2022 [cited Nov 10, 2025]. Available from: https://censo2022.ibge.gov.br/

21. Gowtham S, Vm AE, Thozhanenjan I, Cm N, Narayanan K. Prevalence of diabetic peripheral neuropathy and its associated risk factors among patients with type 2 diabetes mellitus in the Chengalpattu district of Tamil Nadu. Cureus. 2025;17(5):e83586. doi: http://doi.org/10.7759/cureus.83586

22. Shiffman D, Louie JZ, Devlin JJ, Rowland CM, Mora S. Concordance of cardiovascular risk factors and behaviors in a multiethnic US nationwide cohort of married couples and domestic partners. JAMA Netw Open. 2020;3(10):e2022119. doi: https://doi.org/10.1001/jamanetworkopen.2020.22119

23. Fagundes CP, Wu EL. Biological mechanisms underlying widowhood’s health consequences: does diet play a role? Compr Psychoneuroendocrinol. 2021;7:100058. doi: https://doi.org/10.1016/j.cpnec.2021.100058

24. Ibrahim IAE, Alshahrani MFS, Alshahrani SNS, Alamri ANS, Alamri AMA, Alshahrani SF. Investigating awareness, risk factors, and management of diabetic peripheral neuropathy: an all-inclusive cross-sectional study in Saudi Arabia. J Pharm Bioallied Sci. 2025;17(Suppl):375-7. doi: https://doi.org/10.4103/jpbs.jpbs_177_25

25. Li C, Wang W, Ji Q, Ran X, Kuang H, Yu X, et al. Prevalence of painful diabetic peripheral neuropathy in type 2 diabetes mellitus and diabetic peripheral neuropathy: a nationwide cross-sectional study in mainland China. Diabetes Res Clin Pract. 2023;198:110602. doi: http://doi.org/10.1016/j.diabres.2023.110602

26. Davalos L, Callaghan BC, Muthukumar L, Thomas S, Reynolds EL, Smith AG, et al. The impact of diabetes and metabolic syndrome burden on pain, neuropathy severity and fiber type. Ann Clin Transl Neurol. 2025;12(7):1408-17. doi: https://doi.org/10.1002/acn3.70072

27. Zhou P, Zhou J, Li J, Qin L, Hu W, Zhang X, et al. Prevalence and risk factors for painful diabetic peripheral neuropathy: a systematic review and meta-analysis. Front Neurol. 2025;16:1564867. doi: https://doi.org/10.3389/fneur.2025.1564867

28. Bell DSH, Goncalves E. Alcohol consumption as a causator and/or an accelerator of neuropathy in people with diabetes is regularly overlooked. Diabetes Ther. 2021;12(10):2631-4. doi: https://doi.org/10.1007/s13300-021-01131-w

29. Fan Z, Liu Y, Xie H, Yang Q, Zhang G, Zhang P, et al. Analysis of risk factors for foot ulcers in diabetes patients with neurovascular complications. BMC Public Health. 2025;25(1):792. doi: https://doi.org/10.1186/s12889-025-21639-1

30. Neves RG, Saes MO, Duro SMS, Flores TR, Tomasi E. Inequalities in care for the people with diabetes in Brazil: a nationwide study, 2019. PLoS One. 2022;17(6):e0270027. doi: https://dx.doi.org/10.1371/journal.pone.0270027