Analysis of risk factors responsible for neuropathy in patients with type 2 diabetes mellitus with diabetic foot during the COVID-19 pandemic

Background: Neuropathy in diabetic foot is the onset of diabetic foot complications. The COVID-19 pandemic has caused changes in the health service system. The lockdown decision can make it difficult for patients to get medication and consult with health workers due to physical activity restrictions. This research aimed to analyze the factors that contribute to peripheral neuropathy in diabetic foot during the COVID-19 pandemic. Materials and Methods: The research is a cross-sectional study with a sample of 122 patients with type 2 diabetes mellitus who participated in the Chronic Disease Management Program at community health centers in Malang, Indonesia, and was selected using a purposive sampling method. Data were analyzed using multivariate linear regression. Results: Variables that contributed to the development of neuropathy were ankle-brachial index of the right foot (β = 7.35, p = 0.06), irregular exercise (β = 2.01, p = 0.07), glycated hemoglobin A (HbA1c) (β = 0.97, p < 0.001), and Low-Density Lipoprotein (LDL) (β = 0.02, p = 0.06). Meanwhile, the variables that contributed to reducing neuropathy were ankle-brachial index of the left foot (β = -1.62, p = 0.73) and being female (β = -2.62, p = 0.02). The regression model could explain the variation in the scores of neuropathy in diabetic foot during the COVID-19 pandemic (R 2 = 20.10%). Conclusion: The factors that contributed to the incidence of neuropathy in diabetic foot during the COVID-19 pandemic were ankle-brachial index, exercise for diabetes, LDL, HbA1c, and sex.