Abstract

Background: Diabetic Peripheral Neuropathy (DPN) is a common complication of type 2 diabetes mellitus (T2DM), and is closely linked to poor glycemic control. However, little is known about how environmental and lifestyle differences between urban and rural settings affect the risk of DPN.Purpose: This study aimed to identify and compare the risk factors of DPN among T2DM patients living in rural and urban areas.Methods: A comparative cross-sectional design with convenience sampling was used to recruit 156 T2DM patients from both urban (Surabaya) and rural (Lamongan) areas of East Java, Indonesia. Data were collected using the Vascular Quality of Life-6 (VQ-6), Diabetic Neuropathy Symptom (DNS), Diabetic Neuropathy Examination (DNE), and Ankle-Brachial Index (ABI). Logistic regression was performed for analysis, with a significance level set at p<0.05.Results: The mean age of rural participants was 55.86 (SD=8.4) years, slightly younger than that of urban participants at 57.27 (SD=9.3) years. Urban residents had higher education levels (37.7%), but engaged less in regular physical activity (51.9%). The risks of DPN were significantly higher in rural areas (p<0.05), with key contributing factors including higher ABI (OR=17.07), more diabetic neuropathic symptoms (OR=3.35), multiple diabetes medications (OR=10.27), lower physical activity (OR=0.24), and lower education level (OR=0.25). Of these, ABI was the strongest predictor of DPN risks.Conclusion: Rural T2DM patients are at greater risk of DPN due to vascular and neuropathic complications combined with sociodemographic disadvantages. These findings highlight the importance of early detection and tailored education programs for rural communities to prevent and manage DPN.

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