Avaliação da perda de sensibilidade nos pés e fatores associados em pacientes com diabetes acompanhados ambulatorialmente – um estudo transversal

Abstract

Background: Diabetes mellitus (DM) is a chronic metabolic disease characterized by vascular and nerve involvement, including diabetic foot complications. Protective sensory loss in the feet of diabetic patients is a critical predictor of severe complications, such as ulcers and amputations. Regular assessment of this condition is essential to prevent unfavorable outcomes. Objective: To determine the prevalence of protective sensory loss in DM patients at a university hospital and identify clinical and sociodemographic factors associated with this condition. Methods: This cross-sectional study was conducted with diabetic patients attending specialized outpatient clinics. Data were collected through patient interviews and chart reviews, along with the monofilament test to assess protective sensory loss in the feet. Statistical analysis included descriptive and exploratory tests, as well as bivariate and multivariate analyses to identify factors associated with sensory loss (p < 0.05). Results: A total of 184 patients were interviewed, with a median age of 61 years; the majority were female (72%), self-identified as mixed-race (54%), and diagnosed with type 2 diabetes mellitus (87%). The prevalence of protective sensory loss was 20%. Factors such as longer DM duration (95% CI: 1.01–1.09, p = 0.022), presence of target organ damage (95% CI: 1.25–6.84, p = 0.015), and increased body weight (OR = 1.04; 95% CI: 1.01–1.07, p = 0.007) were significantly associated with sensory loss. However, systemic arterial hypertension (SAH), although initially associated in the bivariate analysis, was not significantly associated after adjusting for other variables. Conclusions: The significant prevalence of protective sensory loss and lack of awareness about the monofilament test among many patients reinforce the need to expand neuropathy screening and health education in diabetes management.