Peripheral neuropathy, hypertension, foot ulcers and amputations among Saudi Arabian patients with type 2 diabetes

Three hundred and seventy-five Saudi Arabian patients with type 2 diabetes were consecutively examined for peripheral neuropathy, foot ulcers, amputations and hypertension. All the 46-69-year-old patients (n = 212) were compared to a corresponding Swedish group seen by the same physician using identical approach and definitions. Vibration sensitivity was examined using a tuning fork. Pin prick sensitivity using a needle on the plantar and dorsal aspects of the foot. Distal neuropathy was defined as complete absence of vibration and/or pin prick sensitivity in an extremity. With a diabetes duration of 10 or more years the prevalence of neuropathy among the 375 Saudi Arabians was 38% (95% confidence intervals 30-45); hypertension 19% (13-25) current and past ulcers 4.7% (1.3-8); amputations below ankle 3.4% (0.5-6). In the selected 46-69-year-old group prevalence of hypertension (17%), ulcers (2.3%) and amputation (1%) was significantly lower in the Saudi Arabian than in the Swedish patients. The frequencies reported here are the first from the Arab Peninsula. The Saudi Arabian patients with type 2 diabetes have the same prevalence of distal neuropathy as other ethnic groups. A low prevalence of hypertension is consistent with findings in expatriate and indigenous Arab groups with type 2 diabetes. The low occurrence of ulcers and amputations may be explained by different styles of footwear.