Iranian Journal of

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Introduction: The success of a health system depends on the accessibility and the quality of health services it provides. One major indicator of service quality is peoples satisfaction from the service. In this article, healthcare availability and satisfaction of people in 17th zone of Tehran is investigated.
Methods: Population Research Center has performed a survey in 17th zone of Tehran to investigate people s access to health services and healthcare costs. This face- to-face survey is based on the standard questionnaire of World Health Survey. 1121 households were chosen through cluster sampling. The validity and reliability of the questionnaire are confirmed in previous studies.
Results: The average size of the households is 4.23 and its ratio to the number of rooms in the households is 1.98. Expenses per capita and the insurance coverage and quality have no significant difference in large and small households. The share of health expenditures is significantly smaller in households with a female guardian than those with male guardians. People s overall satisfaction from health services is mediocre, little or very little in 62% of the cases.
Conclusion: Although the level of inequity in coverage and quality of health services is small over the area, the overall health care quality is not enough for customer s satisfaction. Initiatives to improve the quality of health services seem mandatory.

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Cardiovascular disorders are responsible of nearly fifty percent of deaths in industrial and developing countries. However numerous studies have revealed considerable differences in distribution of cardiovascular risk factors at the national, regional and ethnic levels. There is a necessity to elucidate the status of all recognized risk factors in any population to attribute these differences in the incidence of cardiovascular events to the changes in some risk factors or natural history of the disease in that society. The study of cardiovascular risk factors in the 17th zone of Tehran is performed according to the model of MONICA project of WHO. In this project the trend of cardiovascular events and their association with changes in risk factors is monitored in more than twenty countries and 35 centers. In this article we describe some aspects of the statistical design and sampling procedure of our aformentioned study such as sampling framework, sampling methods and its rationale, best size of clusters, sample size and sample selection in each cluster.

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Introduction: Urbanization, establishment of sedentary life style and unhealthy diet in association with environmental stress has led the cardiovascular risk factors to prevail in the metropolitan city of Tehran. Survey of lifestyle related cardiovascular risk factors is one of the priorities of Tehran university population laboratory in the 17th zone of Tehran.
Methods:1573 inhabitants of 17th zone of Tehran were recruited by one stage cluster random sampling according to the model of WHO MONICA project.
Results: 58.6% of men and 64% of women had BMI ≥ 25 kg/m2. 41.7% of men and 37.6% of women had hypertension. 8.9% of men and 12.2% of women had diabetes. 34.4% of men and 44.6% of women had total cholesterol ≥ 200 mg/dl. 34.1% of men and 32.6% of women had triglyceride ≥ 200 mg/dl. 34.7% of men and 4.2% of women were regular smokers. 21% of participants had positive family history of cardiovascular disorders.
Conclusion: The prevalence of hypertension in this region is high, that of dyslipidemia relatively lower than the other studies performed in Iran. The prevalence of Diabetes and overweight /obesity is high and comparable to other Iranian studies. It seems that the population of this zone is at high risk for stroke and then coronary heart disease. This fact must be considered in the future interventional programs to control cardiovascular risk factors in the region.

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Introduction: Hypertension is the most important modifiable cardiovascular risk factor. Hypertension is the leading global risk factor for mortality and as the third leading risk factor for cardiovascular disease burden. This survey has been conducted to determine the prevalence of hypertension among the inhabitants of 25-64 aged in 17th zone of Tehran, selected as Population Lab Region.
Methods: In a population-based cross-sectional survey conducted based on MONICA/WHO project, blood pressure measured with standard sphygmomanometer in sitting position after 10 minutes of resting in 1573 people. Blood samples collected in Venoject tubes for laboratory evaluation. Analysis was performed using the more conservative threshold of SBP ≥ 160 mm Hg and/or DBP≥ 95 mm Hg according to the criteria of the World Health Organization (WHO).
Results: A total of 1573 persons (615 men and 958 women) were evaluated. Hypertension prevalence (SBP≥160 or DBP≥95 or using antihypertensive drugs) was 29% in men and 34.8 in women. There was a significant correlation between systolic and diastolic blood pressure and BMI (p<0/0001). 58% of men and 55.8% of women with hypertension were obese (35>BMI>27).The mean of systolic and diastolic blood pressure had meaningful correlation with cholesterol, LDL, HDL, TG and homocysteine.
Conclusion: These results revealed that the prevalence of hypertension among this population was greater than supposed. The hypertension trend from 1992 is rising. Obesity is one of the most important associated risk factors of hypertension. High prevalence of other cardiovascular risk factors is a matter of concern to this population.

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Introduction: Hyperlipidemia is a major cardiovascular risk factor. This survey has been performed to determine the prevalence of hyperlipidemia in the 17th zone of Tehran.
Methods: 1573 individuals 25-64 aged were recruited from the inhabitants of the 17th zone of Tehran through one stage cluster sampling. Standard questionnaires were filled out for all of the participants. Lipid profile was categorized according to the NCEP:ATP III criteria.
Results: 59% had ideal cholesterol levels, 27.1% borderline and 13.9% had high cholesterol levels. Hypercholesterolemia was more prevalent in women than men. 55% had ideal LDL-cholesterol level. Prevalence of hyper-LDL (>160mg/dl) was 2.3%. Hyper LDL was more prevalent in women than men (p<0.001). Prevalence of hypo-HDL was 13.8% and it was more common in men than women (p<0.001). 33.4% had high triglyceride levels.
Conclusion: Prevalence of dyslipidemia in this area of Tehran is not as high as that obtained from other urban studies. This fact should be considered in the future interventional programs which focus on noncommunicable disease management.

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Background: Obesity and overweight, as the most common metabolic disorders, are great health problem during recent decades. Obesity takes a role as independent or concordant risk factor for many diseases. So, it has a considerable share in burden of morbidities and mortalities. Urbanization and its consequences in increasing of incomes and per capita energy uptake, besides the notable reduction in physical activities are the main causes of increased rates of obesity in developing countries. This survey has been conducted to evaluate the obesity and overweight status and their pattern among the inhabitants of 25-64 aged in 17th zone of Tehran, selected as Population Lab region.
Methods: This study is a part of the Cardiovascular Risk Factors Survey in the Population Lab region. This survey has been designed and conducted based on MONICA/WHO project. A total of 1573 people have been recruited and assessed on age, weight, height, waist and hip circumferences. Body mass index (BMI), waist circumference (WC) and waist-to-hip ratio (WHR) were determined for comparing between groups.
Results: There was a significant difference in mean BMI between two sexes (26.13 kg/m2 in men vs. 28.86 kg/m2 in women). As well, WC and WHR were diverse between men and women (WC: 91.70 cm vs. 89.15 cm WHR: 0.91 vs. 0.85, respectively). Obesity prevalence was 18.6% among men and 38.3% among women. Prevalence of high WC and abnormal WHR were higher among women than men.
Conclusion: These results revealed that prevalence of obesity among adults was very high. The prevalence in women was more than two times than in men. This finding may be in part because of little physical activity and high proportions of carbohydrates intake instead of protein in daily energy uptake and also because of physiological differences among women. Proper and effective planning to achieve applied strategies for improving the social knowledge and awareness and also improving the life style and nutrition status of the people is highly necessiated.

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Introduction: Metabolic syndrome includes obesity, hypertriglyceridemia, glucose intolerance, hypertension and lipid profile abnormalities. The risk of cardiovascular diseases with this syndrome is higher than every components alone. In view of its burden and high mortality rate, this syndrome should be noted.
Methods: The 25-64 aged individuals in 17th zone of Tehran were studied. It was designed according to the WHO MONICA (Multinational Monitoring of Trends and Determinants in Cardiovascular Disease) project using the ATP III criteria. The parameters have been used for the risk analysis were Waist Circumference (WC), fasting serum triglycerides (TG), high density lipoprotein-cholesterol (HDL-C), blood pressure (BP) and fasting plasma glucose (FPG).
Results: The crude prevalence rate of the metabolic syndrome was 29.9% and the age-adjusted prevalence was 27.5%. The prevalence increased with age. The highest prevalence among different age-groups was seen in women aged 55-64 years. In the whole population, the most metabolic abnormalities were hypertriglyceridemia and hypertension that were present in more than half of the population. The people with metabolic syndrome had higher BMI than rest.
Conclusion: Results demonstrate high metabolic syndrome rate among target population specially in women. In view. of correlation between metabolic syndrome and cardiovascular disease, it must be the priority of interventional preventive measures. Improving the diet, changing the lifestyle and increasing physical activity can be helpful.

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Introduction: Nutrition plays an important role in the protection and promotion of health. To plan and implement programs aiming at improving community nutritional status, a knowledge of the existing situation is essential. The aim of this cross-sectional study was to determine food and nutrient intakes of the inhabitants in Tehran University of Medical Sciences population laboratory.
Methods: In a sample of 310 women and 185 men, selected by clustered random sampling, food intake was determined using the 24-hour dietary recall (on two non-consecutive days). Weights and heights were also measured on the first visit. For analysis of data, Dorosti Food Processor, Diet Analysis plus and SPSS software were used.
Results: The average (mean ± SD) intakes of energy, protein, carbohydrate, total fat, saturated fat, cholesterol, vitamin A, B2 ,B6 ,B12, folic acid, zinc, iron, and calcium were 2902±336cal, 88±15gr, 461±69gr, 80±19gr, 27±7gr, 272±112mg, 943±319µgr RE, 1.2±.35mgr, 1.2± .37mg, 2.9±2.67µgr, 294±73.7µgr, 10.48± 2.25mg, 28.90±5.81mg, and 537±123mg in men, and 2226±234cal , 66±11gr, 344±41gr, 70±14gr, 22±6gr , 205±85mgr ,882±291µgr RE, .88±.22mg, 1.14± .24mg, 2.2±2.07µgr, 270±60.7µgr, 8.65±1.62mg, 22.66±4.27mg, and 433±113mg in women, respectively. The average (mean +SD) daily numbers of servings of the food guide pyramid main groups, namely, grains, fruits, vegetables, dairy, and meat were 12.74±3.80 ,1.52±1.44, 4.30±2.74, .97±.72 , and .9±.98 in men, and 9.8±3.3, 2.87±2.06, 2.88±2.40, .82±.60, and .86±.84 in women, respectively. Most of these intakes are under current recommendations. Thirty eight percent of the men and 23% of the women had a daily cholesterol intake of at least 300 mg. In addition, the proportions of the men and women with a daily total fat intake of at least 75 gram was 43% and 35%, respectively.
Conclusion: The findings show that while the intake of most micronutrients is lower than respective RDAs, the intake of fat and cholesterol are higher than the current recommendations. This indicates that the community is undergoing nutrition transition. It is recommended that further studies be conducted to identify more comprehensively nutritional problems of the community in question, so that appropriate programs can be prepared and implemented.

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Introduction: Cigarette smoking is a major modifiable risk factor for cardiovascular disease and it has been identified as the single most important cause of cardiovascular accident related deaths in most countries.
Methods: 1573 people who lives in 17th zone of Tehran (Population Research Center of Tehran University of Medical Sciences) were investigated by a cross- sectional study. A group of trained persons collected data by the standard questionnaire that contained demographic and smoking status characteristics. Furthermore the fasting blood samples were taken for more evaluation. Data were analyzed with SPSS software.
Results: According to this study 37/4% of men and 4/2% of women were smoker. There were relationship between cigarette smoking and serum level of homocysteine, Folic Acid, cholesterol, LDL, HDL, Uric Acid, hypertension and BMI (P<0/05). But it was no significant with vitamin B12 and TG statistically.
Conclusion: There were relationship between cigarette smoking and male gender, age, unmarried status and the level of education. So public education should be accomplished in society specially among families for prevention of cardiovascular risk factors.

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Introduction: Elevated plasma total homocysteine is an independent risk factor for cardiovascular disease and a sensitive marker of vitamin B12 and folate insufficiency. Folate and vitamin B12 have a protective effect on cardiovascular disease. This effect may be partly explained by mechanisms independent of homocysteine. This survey is the first population based study to evaluate the plasma total homocysteine, folic acid and vitamin B12 in 1214 healthy Iranian persons.
Methods: This study which was a part of the Cardiovascular Risk Factors Survey in the Population Lab region, has been designed and conducted based on MONICA/WHO project. A total of 1214 people have been recruited and assessed on serum homocysteine, folic acid and vitamin B12 with interview, questionnaires, examination and blood sampling. Blood samples were gathered in Venoject tubes and analyzed according to standard methods.
Results: The variables were assessed in 1214 participants include 428 men (35.3%) and 786 women (64.7%). Prevalence of hyperhomocysteinemia was 96.4% in men and 83.3% in women (p<0.0001). Geometric mean of serum homocysteine was 19.02 ± 1.46 µmol/l in men and 14.05± 1.45 µmol/l in women (p<0.004) and increased with age. Folic acid deficiency was seen in 527 (98.9% )men and 833 women (98.0%). 161 (30.1%)men and 232(27.2%) women had vitamin B12 deficiency.
Conclusion: These results revealed that the prevalence of hyperhomocysteinemia, folic acid and vitamin B12 deficiency was higher than other communities considerably. Preventive interventions as food fortification with folic acid is necessary.

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Background: Diabetes is one of the most common chronic diseases worldwide. The number of diabetic patients in Iran is estimated 1.5 million. This survey has been conducted to evaluate diabetes and impaired fasting glucose status among 25-64 aged inhabitants of 17th zone of Tehran, selected as Population Lab region.
Methods: This study is a part of the Cardiovascular Risk Factors Survey in the Population Lab region. This survey has been designed and conducted based on MONICA/WHO project. A total of 1573 people have been recruited and assessed on age, weight, height, waist and hip circumferences. Body mass index (BMI), waist circumference (WC) and waist-to-hip ratio (WHR) were determined for comparing between groups. The known diabetic cases were found as history of taking antihyperglycemic agents or report of their family physician and new cases were diagnosed as FPG≥126mg/dl according to the ADA 2004criteria.IFG was determined by 100≤FPG≤126.Adjusted prevalences are calculated according to the 1375 census data.
Results: type 2 diabetes prevalence was 10.9% and the prevalence of IFG was 5% in this population. The age adjusted prevalences were 9.3% and 4.5% respectively. prevalences were higher in women than men in all age groups. people with diabetes had higher body mass index, waist, waist to hip ratio, mean systolic and diastolic blood pressure(p<0.05).9/8% of diabetic patients were unaware of their disease.
Conclusion: These results revealed that the prevalence of diabetes among women was higher than men. This finding may be in part because of little physical activity .Proper and effective planning to achieve the applied strategies for improving the social knowledge and awareness and also improving the life style of the people is highly necessiated.

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Celiac disease and typel diabetes mellirus have been linked to the same HLA markers and chromosomal loci, which may account for the concurrence of the two disorders in a significant number of patients. This study was designed to investigate the frequency of anti-gliadin antibodies, a marker for celiac disease, in diabetic patients.
Methods: In this study, 182 diabetic patients (52 with typel and 130 with type2 diabetes) were screened for anti-gliadin IgG by indirect immunofluorescence. Age range was 3-29.5 and 42-65 years for type 1 and type 2 diabetes groups.
Results: Anti-gliadin IgG was found in 1.9% and 1.5% of patients with type land type 2 diabetes. In Tehran, 0.02% of healthy blood donors have been reported to be seropositivitive for anti-gliadin IgG.
Conclusion: The prevalence of anti-gliadin seropositivity in type 1 and type 2 diabetics, was respectively 30 and 24 times higher than the general population of Tehran. This concurs with other reports indicating higher occurrence of celiac disease in diabetic populations. The rather low sensitivity and specificity (both around 80%) of the antigliadin antibody test has made it a suboptimal diagnostic test. However, it is quick and inexpensive and can be suitable for screening programs. We recommend the test in all at-risk populations including diabetics.

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Diabetes mellitus is the commonest endocrine-metabolic disorder during the early years of life. As many as one in five of insulin-dependent diabetics may have thyroid antibodies in their sera, which is 2-20 times higher than the general population.
Methods: Tpo-ab, Tg-ab, TSH and HbAlC were measured in 48 children and adolescents with diabetes and compared with for sex/age-matched controls. Clinical data including sex, age at onset and duration of diabetes, family history and signs and symptoms of thyroid disorders were recorded. Statistical analysis was made using SPSS software.
Results: In diabetic group, twelve patients had positive thyroid autoantibodies Tg-ab was positive in ten and Tp-ab was positive in nine and both were positive in seven patients. The prevalence of thyroid antibodies in our study was 25% and in the control group, nobody had thyroid antibodies (P=0.006). Of the twelve patients with autoimmune thyroid disorders, three had hypothyroidism.
Conclusion: The prevalence of autoimmune thyroid disorders was not influenced by sex, age, duration of diabetes or HbAlc level. On the whole, nearly one-fourth of diabetic patients had thyroid antibodies, and annual thyroid antibodies investigation for these patients is suggested.

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There are controversies on the effects of diabetes and lifestyle of affected patients on their bone mineral densities (BMDs). This study has investigated the effects of lifestyle of type 2 diabetics on BMD at the lumbar spine and proximal femur in pre and postmenopausal women.
Methods: In a historical cohort study, 20 pre-menopausal type 2 diabetics and 57 non-diabetics and 126 type 2 Diabetics and 315 non-diabetics postmenopausal women, were recruited. BMD measurements were also made to the spine and proximal femur (Neck, Wards, and Shaft) by dual energy X-ray absorptiometry (DXA) technique. Exclusion criteria were endocrine, rheumatologic or chronic diseases. Type 2 diabetic cases and non-diabetics were matched for age and body mass index (BMI) in both pre menopausal or postmenopausal groups.
Results: A total of 146 type 2 Diabetic patients without any other endocrine disorder and 372 non-diabetic women, aged 40-81 years were enrolled. No significant differences were found between diabetics and healthy controls in terms of BMD values of spine and femur regions in the pre‌menopausal women. Postmenopausal diabetics, however, had higher BMD at the lumbar spine compared with the healthy postmenopausal controls. An age-related decrease in BMD values (lumbar and femur) was observable in all groups and a significant correlation between BMI and BMD was found. Adjusting for age and BMI, the effect of lifestyle on BMD at all sites was investigated. Occupation was associated with BMD in postmenopausal, but not in premenopausal women. Among the investigated dietary items, milk, yogurt and cheese were all associated with increased BMD in at least one region in diabetic patients. Smoking was not associated with BMD.
Conclusion: Type 2 Diabetes does not seem to be complicated by bone loss and osteoporosis. Physical activity and milk consumption in postmenopausal diabetic women can be a protective factor against bone loss.

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Diabetes is a common endocrine disease with complications such as retinopathy, nephropathy and neuropathy which has its monitoring through biomarkers desirable. At present, glycosylated hemoglobin (HbAic) is used for monitoring the long term control of glucose levels in diabetic patients. However, absence of a standardized range, has led to investigations that recently have suggested insulin-like growth factor-I (IGF-I) as a good biomarker for monitoring blood glucose levels in diabetics. The aim of this study was to examine the correlation between IGF-I and HbAic in Type 1 diabetes.
Methods: We designed a cross-sectional case-control study. The study composed of 26 newly diagnosed patients with Type 1 diabetes (15 male and 11 female mean age, 23.7±9.1 years) and 26 healthy controls (9 male and 17 female mean age, 24.1±4.4 years). Levels of fasting plasma glucose (FPG), HbA]C) IGF-I and IGF-binding protein-3 (IGFBP-3) were measured in both groups. FPG was measured by enzymatic glucose oxidase method and the colorimetric method was used to measure HbAlc. Determination of total serum levels of IGF-I and IGFBP-3 were done using immunoassay methods. P-value<0.05 was considered as statistically significant.
Results: The mean value of IGF-I concentrations in type 1 diabetics was significantly lower than controls (p< 0.05). A reverse correlation was observed between IGF-I and HbAic. Conclusion: The study indicates that in poorly controlled diabetics, levels of FPG and HbAic rise concurrent with a drop in levels of IGF-I decreases. Our study also showed a significant correlation between IGF-I and HbAie. Therefore, IGF-I could be indirectly used as a biomarker for controlling glucose levels in diabetics.

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Diabetes mellitus (DM) is the commonest cause of renal failure, blindness and non traumatic amputation. According to ADA, prevention of DM complications is possible through monitoring and control of blood glucose levels.
Methods: The Betachek strip, produced in Australia, is able to determine biood glucose level with no need for electronic glucometer devices.
Results: In this study, we compared venous and capillary blood glucose levels as determined by lest strips with measurements of enzymatic method (the standard laboratory kit). The mean capillary and venous blood glucose measured by the strip test was 21.85 mg/dl (P< 0.0001) and 17.9 mg/dl (P< 0.002) respectively that was 11.13% more than the standard method.
Conclusion: In this study, standard method had higher correlation with venous samples glucose level, than capillary samples (as measured by Betachek) (0.84 vs. 0.824). This difference was statistically significant (P< 0.0001).
Good correlation between the Betachek strip and the standard enzymatic method of blood glucose measurements, advocate its usage in home setting.

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Increased prevalence of Helicobacter Pylori (HP) infection is a common feature in diabetics, which is attributable to the presence of diverse predisposing factors. In this study, the prevalence of HP infection has been investigated in type 1 diabetic children.
Methods: In a cross-sectional study, anti-HP antibody (IgG) was measured in 75 type 1 diabetics (aged 2-18 years) and the results were compared with 75 healthy children who were matched for age, sex and socio-economic status. In seropositive diabetic patients with gastrointestinal (GI) symptoms, gastroduodenoscopy was performed to establish the diagnosis.
Results: Sera were positive for anti-HP in 22.7% of diabetics versus 17.3% in controls (P>0.05). No significant difference was observable between seropositive and seronegative diabetic groups as regard to age, sex, age at onset of diabetes, number of outpatient visits during the last 6 months, HbAlc and insulin requirements. Gastrointestinal symptoms were more common in diabetics than the healthy controls the prevalence of these symptoms, however, did not differ significantly between seropositive and seronegative diabetics.
Conclusion: The study indicated that type 1 diabetes is not associated with increased risk of HP infection. Further studies are required to investigate the impact of HP infection treatment on the glycemic control in diabetic children.

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At least 2 million people are affected by type II diabetes mellitus in Iran. Neuropathy is one of the commonest complications of diabetes affecting the quality of life of patients and can result in foot ulcer and amputation. The current study aimed to examine possible factors that could alter development of diabetic neuropathy.
Methods: In this case-control study, 110 diabetic patients were selected from Shariati hospital diabetes clinic. Michigan Neuropathic Diabetic Scoring (MNDS) was used to distinguish cases from controls. The neuropathic status of patients was confirmed with EMG-NCV. Multiple factors were compared between the two groups including ACE-I consumption, blood pressure, serum lipid level, sex, smoking, method of diabetes control and its quality.
Results: Statistically significant relations were found between neuropathy and age, gender, quality of glycemic control and duration of diabetes (P values: 0.04, 0.04, 0.000 and 0.005, respectively). No correlation existed between atherosclerotic risk factors (high BP, hyperlipidemia, cigarette smoking) and diabetic neuropathy.
Conclusion: In this study, hyperglycemia was the only modifiable risk factor for diabetic neuropathy. Glycemic control can decrease the incidence of neuropathy and delay its progression leading to improvement in the quality of life in diabetics. Aged and male diabetic patients and those with poor diabetes control are groups in most need of regular foot exam and more practical educations.

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Diabetes is one of the most common metabolic diseases. The prevalence of diabetes, which is around 4.5 - 6% in Iran, reaches as high as 14.2% in population of age 30 years and over in Yazd. Microalbuminuria is diagnosable before development of nephropathy and could be detected at an early stage when effective therapy can still be carried out. In this stage near normalization of blood glucose, strict blood pressure control and administration of ACE inhibitors can prevent nephropathic complications.
This study was aimed to determine the correlation among microalbuminuria, age, duration of diabetes, body mass Index, serum triglyceride, serum cholesterol and blood pressure in type 2 diabetic inhabitants of Yazd diabetes research center.
Methods: This cross-sectional study was carried out during November 2002-July 2003 to investigate the correlation between microalbuminuria and assumed risk factors. Two hundred and eighty eight type 2 diabetic patients (141 males and 147 females) were selected through consecutive sampling. Results: Overall prevalence of microalbuminuria was 14.2%. Chi-square analysis revealed the association between microalbuminuria and high diastolic blood pressure (P-value=0.003) and duration of diabetes (P-value = 0.001). No statistically significant correlation was found between microalbuminuria and body mass index, serum triglyceride, serum cholesterol and systolic blood pressure.
Conclusion: Determination of urine albumin/creatinin ratio is an easy method for screening microalbuminuria which is recommended for all diabetics especially those with hypertension and a long term history of diabetes.

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Neuropathy is a common complication of diabetes mellitus. Meticulous neurological examination and electrodiagnosis are valuable tools in early diagnosis of neuropathy and prevention of its sequels.
Methods: A hundred and three randomly selected diabetic patients were recruited from the endocrine clinic. Mean age of patients was 52.6 ±14 years. 29.4% had type 1 and 70.6% had type 2 diabetes.
Medical history was taken from patients and neurological examination was done. Electroneurographic examination included nerve conduction velocity, action potential amplitude, distal latency and H reflex measurements.
Results: Neuropathy was found in 79.4% of patients. The prevalence of neuropathy had a direct relation with duration of the disease. The most common complaints were tingling and numbness of extremities (72%) and burning sensation of the feet (36%). The most common physical findings were abnormal ankle jerk (92%), and decreased vibration perception (76%) in feet. Abnormal H reflex
(92.5%) and decreased amplitude of action potentials (79%) were the most common electroneurographic findings. There was a strong correlation between clinical and electroneurographic findings.
Conclusion: Neuropathy was quite common in diabetic patients. Neurologic examination is, therefore, recommended to prevent unnecessary workups and prevent complications.