Prevalence of Diabetes Mellitus and its Association with Diabetic Peripheral Neuropathy, Peripheral Vascular Disorder among Security Personnel in United Arab Emirates

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Methods Data were gathered from a sample of 166 security professionals, aged 25–65 years, with a minimum of 8 hours of daily work and at least 2 years of experience, using an observational, cross-sectional study design. The 10 g Semmes Weinstein monofilament testing, Michigan Neuropathy Screening Instrument, and vibration pressure threshold were used for DPN screening followed by the DN4 questionnaire, and the Ankle Brachial Index (ABI) was used for PVD assessment. Results The study found a prevalence of 9.6% of DM among security personnel in the UAE. A statistically significant and strong positive correlation was observed between DM and DPN (r=0.83; p < 0.001) and a moderate correlation with PVD (r= 0.56; p=0.03). Conclusion The prevalence of DM among securities in UAE is 9.6%, which is significant, as the total DM prevalence in UAE according to the 2021 report is 12.3%. There is a strong correlation between DM and DPN, suggesting that security personnel could be at higher risk of developing “Diabetic Foot Syndrome” due to the nature and demands of the job. In addition, neuropathy and peripheral vascular disease can increase risk and cause associated foot complications. " } { "@context": "http://schema.org", "@type": "BreadcrumbList", "itemListElement": [ { "@type": "ListItem", "position": "1", "item": { "@id": "https://f1000research.com/", "name": "Home" } }, { "@type": "ListItem", "position": "2", "item": { "@id": "https://f1000research.com/browse/articles", "name": "Browse" } }, { "@type": "ListItem", "position": "3", "item": { "@id": "https://f1000research.com/articles/14-190", "name": "Prevalence of Diabetes Mellitus and its Association with Diabetic..." } } ] } Home Browse Prevalence of Diabetes Mellitus and its Association with Diabetic... ALL Metrics - Views Downloads Get PDF Get XML Cite How to cite this article Mohamed MA, Kiriyath SM, Saddik Sheikh HM et al. Prevalence of Diabetes Mellitus and its Association with Diabetic Peripheral Neuropathy, Peripheral Vascular Disorder among Security Personnel in United Arab Emirates [version 2; peer review: 1 approved, 2 approved with reservations, 2 not approved] . F1000Research 2025, 14 :190 ( https://doi.org/10.12688/f1000research.161534.2 ) NOTE: If applicable, it is important to ensure the information in square brackets after the title is included in all citations of this article. Close Copy Citation Details Export Export Citation Sciwheel EndNote Ref. Manager Bibtex ProCite Sente EXPORT Select a format first Track Share ▬ ✚ Research Article Revised Prevalence of Diabetes Mellitus and its Association with Diabetic Peripheral Neuropathy, Peripheral Vascular Disorder among Security Personnel in United Arab Emirates [version 2; peer review: 1 approved, 2 approved with reservations, 2 not approved] Mohamed Anas Mohamed https://orcid.org/0009-0006-4896-0424 1 , Saheema Moila Kiriyath https://orcid.org/0009-0003-3698-4312 1 , Huda Mohamed Saddik Sheikh https://orcid.org/0009-0001-8520-9617 1 , [...] Anjela Davis Panattuparambil https://orcid.org/0009-0005-7423-1375 1 , Shahwar Fatima Ansari https://orcid.org/0009-0006-2272-0078 1 , Praveen Kumar Kandakurti https://orcid.org/0000-0003-2669-4488 1 , Kumaraguruparan Gopal 1 , Animesh Hazari https://orcid.org/0000-0002-3936-5029 1 Mohamed Anas Mohamed https://orcid.org/0009-0006-4896-0424 1 , Saheema Moila Kiriyath https://orcid.org/0009-0003-3698-4312 1 , [...] Huda Mohamed Saddik Sheikh https://orcid.org/0009-0001-8520-9617 1 , Anjela Davis Panattuparambil https://orcid.org/0009-0005-7423-1375 1 , Shahwar Fatima Ansari https://orcid.org/0009-0006-2272-0078 1 , Praveen Kumar Kandakurti https://orcid.org/0000-0003-2669-4488 1 , Kumaraguruparan Gopal 1 , Animesh Hazari https://orcid.org/0000-0002-3936-5029 1 PUBLISHED 29 Aug 2025 Author details Author details 1 COLLEGE OF HEALTH SCIENCES, DEPARTMENT OF PHYSIOTHERAPY, GULF MEDICAL UNIVERSITY, AJMAN, United Arab Emirates Mohamed Anas Mohamed Roles: Data Curation, Formal Analysis, Methodology, Writing – Original Draft Preparation, Writing – Review & Editing Saheema Moila Kiriyath Roles: Data Curation, Formal Analysis, Methodology, Writing – Original Draft Preparation, Writing – Review & Editing Huda Mohamed Saddik Sheikh Roles: Data Curation, Formal Analysis, Methodology, Writing – Original Draft Preparation, Writing – Review & Editing Anjela Davis Panattuparambil Roles: Data Curation, Formal Analysis, Methodology, Writing – Original Draft Preparation, Writing – Review & Editing Shahwar Fatima Ansari Roles: Data Curation, Formal Analysis, Methodology, Writing – Original Draft Preparation, Writing – Review & Editing Praveen Kumar Kandakurti Roles: Conceptualization, Formal Analysis, Methodology, Supervision, Writing – Original Draft Preparation, Writing – Review & Editing Kumaraguruparan Gopal Roles: Methodology, Project Administration, Writing – Original Draft Preparation, Writing – Review & Editing Animesh Hazari Roles: Conceptualization, Formal Analysis, Methodology, Supervision, Writing – Original Draft Preparation, Writing – Review & Editing OPEN PEER REVIEW DETAILS REVIEWER STATUS Abstract Aim This study aimed to investigate the prevalence of Diabetes Mellitus (DM) and its associated complications, such as Diabetic Peripheral Neuropathy (DPN) and Peripheral Vascular Disease (PVD), among security personnel in the United Arab Emirates (UAE). Methods Data were gathered from a sample of 166 security professionals, aged 25–65 years, with a minimum of 8 hours of daily work and at least 2 years of experience, using an observational, cross-sectional study design. The 10 g Semmes Weinstein monofilament testing, Michigan Neuropathy Screening Instrument, and vibration pressure threshold were used for DPN screening followed by the DN4 questionnaire, and the Ankle Brachial Index (ABI) was used for PVD assessment. Results The study found a prevalence of 9.6% of DM among security personnel in the UAE. A statistically significant and strong positive correlation was observed between DM and DPN (r=0.83; p < 0.001) and a moderate correlation with PVD (r= 0.56; p=0.03). Conclusion The prevalence of DM among securities in UAE is 9.6%, which is significant, as the total DM prevalence in UAE according to the 2021 report is 12.3%. There is a strong correlation between DM and DPN, suggesting that security personnel could be at higher risk of developing “Diabetic Foot Syndrome” due to the nature and demands of the job. In addition, neuropathy and peripheral vascular disease can increase risk and cause associated foot complications. READ ALL READ LESS Keywords Diabetes Mellitus, security personnel, Peripheral vascular disease, Diabetic peripheral neuropathy, United Arab Emirates Corresponding Author(s) Praveen Kumar Kandakurti ( [email protected] ) Animesh Hazari ( [email protected] ) Close Corresponding authors: Praveen Kumar Kandakurti, Animesh Hazari Competing interests: No competing interests were disclosed. Grant information: The author(s) declared that no grants were involved in supporting this work. Copyright: © 2025 Mohamed MA et al . This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. How to cite: Mohamed MA, Kiriyath SM, Saddik Sheikh HM et al. Prevalence of Diabetes Mellitus and its Association with Diabetic Peripheral Neuropathy, Peripheral Vascular Disorder among Security Personnel in United Arab Emirates [version 2; peer review: 1 approved, 2 approved with reservations, 2 not approved] . F1000Research 2025, 14 :190 ( https://doi.org/10.12688/f1000research.161534.2 ) First published: 12 Feb 2025, 14 :190 ( https://doi.org/10.12688/f1000research.161534.1 ) Latest published: 29 Aug 2025, 14 :190 ( https://doi.org/10.12688/f1000research.161534.2 ) Revised Amendments from Version 1 This revised version of the manuscript incorporates several significant changes across all sections. The abstract has been made more concise by removing mentions of ethical clearance and statistical tools. The introduction was enhanced by adding a paragraph on the link between security personnel and DM complications, alongside a clearer rationale for the study group's selection. In the results section, we have added an explanation for Figure 1 and updated the descriptions for all figures and tables, including renaming the sample characteristics section. The discussion has been majorly changed to focus more on the security and diabetes connection. The limitations have been updated to acknowledge that a regression analysis was not performed. Lastly, three new references are added (8,9, and 10) to support the selection of this sample group and the relation between DM and security personnel. This revised version of the manuscript incorporates several significant changes across all sections. The abstract has been made more concise by removing mentions of ethical clearance and statistical tools. The introduction was enhanced by adding a paragraph on the link between security personnel and DM complications, alongside a clearer rationale for the study group's selection. In the results section, we have added an explanation for Figure 1 and updated the descriptions for all figures and tables, including renaming the sample characteristics section. The discussion has been majorly changed to focus more on the security and diabetes connection. The limitations have been updated to acknowledge that a regression analysis was not performed. Lastly, three new references are added (8,9, and 10) to support the selection of this sample group and the relation between DM and security personnel. See the authors' detailed response to the review by Kusnandar Anggadiredja See the authors' detailed response to the review by Duygu Aktar Reyhanıoglu READ REVIEWER RESPONSES Introduction Diabetes Mellitus (DM) is a metabolic disease that causes an increase in the blood glucose levels. 1 According to the World Health Organization, DM ranked 9th among the top 10 causes of death in 2020, and 8 th in terms of Disability-Adjusted Life Years (DALYS) in 2019. 2 It consists of numerous categories based on pathogenesis including Type1, Type2, gestational diabetes, along with other disorders (endocrinopathies and steroid use). 3 Fasting plasma glucose (FPG) level >126 g/ml or HbA1C level of >6.5% are considered as the criteria for diagnosis of DM. 4 DM type 2, which is the most common type, is caused by insulin resistance or insufficient production. 5 It is mostly seen in middle-aged and older adults, who have persistent hyperglycemia caused by dietary choices and a poor lifestyle. 3 DM leads to several long-term complications, including both microvasculature diseases, such as diabetic peripheral neuropathy (DPN), and macrovascular diseases, such as peripheral vascular diseases (PVD). 5 DPN causes damage to the peripheral nerves due to poor or uncontrolled blood glucose levels, with symptoms such as loss of sensation, pain, numbness, tingling, and muscle weakness. 6 Peripheral vascular disease is a progressive circulation disorder caused by blockage, spasm, or narrowing of the blood vessels. It has been studied that DM also increases the risk of atherosclerosis, which in turn further raises the risk of PVD. 6 Occupational factors may further increase the likelihood of these complications. Security personnel are tasked with maintaining a safe and secure environment in various sectors such as health, commercial, and residential. This occupational group is frequently exposed to unfavorbale conditions, including prolonged and irregular working hours, extreme weather conditions and night or shift duties. One of the major concerns is that this job often requires them to work in an upright posture for long periods of time, which can be a potential risk to various health conditions. 7 While prolonged standing has primarily been associated with musculoskeletal and cardiovascular outcomes, 8 emerging evidences indicate that it may also possibly impair vascular shear dynamics and postprandial glycemia, which creates an indirect path to diabetic complications. This has been supported by research demonstrating that static standing for prolonged hours reduces endothelial shear rate and elevates post-meal glucose and insulin levels in healthy adults. 9 Furthermore, prolonged postural strain may reduce stability and balance which has been linked to both poorer glycemic control and progression of peripheral neuropathy. 10 According to the International Diabetes Federation (IDF), in 2021, the prevalence of DM in the United Arab Emirates (UAE) was 12.3%. 11 DM is a major health concern and is regarded as a key area of research interest in the UAE. Despite the growing burden of DM in UAE, there is a lack of literature focusing on specific occupational groups. To our knowledge, this is the first study to access the prevalence of diabetes and its vascular complications specifically among UAE-based security personnel. This population has unique job-related exposures that may place them at increased risk for developing the complications. As PVD and DPN usually do not show many symptoms and go unnoticed, the chances of foot complications are higher. In addition, neglected and unattended PVD and DPN can cause diabetic foot ulcers, which can eventually lead to disability with amputation. By identifying both prevalence and complication rates in this group, our study fills a critical gap in literature and provides a foundation for future preventative and workplace-based interventions. Therefore, this study aimed to screen DM cases among security personnel in the UAE and identify its macro-and microvascular complications, particularly PVD and DPN, under the following objectives: 1. To find the prevalence of Diabetes Mellitus among the security personnel in UAE. 2. To find out the association of Diabetes Mellitus with Diabetic peripheral neuropathy and Peripheral vascular disease among security personnel in UAE. Methods Study design and settings: This cross-sectional study was conducted at the College of Health Sciences, Gulf Medical University (GMU), Ajman, UAE. The sample and data collection were multicentric from different emirates of the UAE. The study was flexible in that it included every sector where securities were available. Security agencies across the UAE, such as universities, schools, and security accommodations, were contacted to cooperate in providing participants (security personnel). The participants who were willing to participate signed an informed consent form before inclusion in the study. The ethical review board of the GMU approved the study protocol (IRB-COHS-STD-59-NOV-2023) on 22 nd November 2023, following which recruitment and data collection were initiated. This study was conducted between November 2023 and June 2024. Inclusion criteria - Age 25-65 years. - Male and female security personnel. - Working for a minimum of 8 hours per day - Minimum 2 years of work experience in the field Exclusion criteria - Diagnosed/Reported cases of peripheral neuropathy due to conditions other than diabetes - Undiagnosed (absence of Lab report) and self-reported cases of diabetes mellitus Sampling method and sample size: The study used non-probability convenience sampling. According to the reported DM prevalence of 12.3% in UAE, 11 the required sample size was calculated to be 166 with a margin of error or absolute precision of ± 5% at 95% confidence using the Scalex SP calculator. 12 Study protocol and procedure: Security personnel were recruited and familiarized with the data-collection procedure. They were provided with a written informed consent form and asked to read it carefully, giving them a chance to inquire and ensure their willingness to participate in the study. Demographic data were collected on age, sex, years of experience in the security field, and diabetes duration. Participants who reported DM were asked to confirm by providing the latest laboratory reports (FPG, Post Prandial Blood sugar (PPBS), and HBA1C). A total of 228 security personnel were screened, 166 of whom met the inclusion criteria for further screening for DM, DPN, and PVD. Before measuring blood pressure, the participants were asked to remain relaxed in a high sitting position for 5 mins to ensure that they were in a resting posture. Brachial systolic blood pressure and ankle systolic blood pressure were recorded bilaterally using an Omron 5450 blood pressure monitor, and the means of both sides were noted to ensure accurate readings and to avoid possible errors. The use of this machine was validated to obtain accurate results. 13 , 14 Ankle Brachial Index (ABI) was calculated as the ratio of ankle systolic pressure to brachial systolic pressure. Following this, the participants were screened for peripheral neuropathy using 10 g Semmes Weinstein monofilament in both feet. To accurately measure the sensory response, a 10 g monofilament was placed perpendicular to the sole, and an even pressure was applied to the great toe and other spots (as shown in Figure 1 ). Participants were considered positive for peripheral neuropathy if they failed to feel the monofilament sensation in more than one spot, and a 7/10 correct response was considered a delayed response. 15 , 16 The Michigan Neuropathy Screening Instrument (MNSI) (score ≥7-part A, score > 2-part B) and Vibration Pressure Threshold (score>20 Volts on Biothesiometer) was also used to confirm the presence of peripheral neuropathy. 16 , 17 Participants who tested positive for peripheral neuropathy were given the Douleur Neuropathique en 4 Questions (DN4) questionnaire to check for the presence, severity, and nature of neuropathy pain if present. Figure 1. Testing points of monofilament test. The filled circles indicate the four standard and required testing sites for the monofilament testing, as recommended in diabetic foot screening guidelines. The empty circles represent additional sites that may be tested at the provider’s discretion to further assess sensory loss. This study used a systematic approach to determine the prevalence of DM among security personnel. All procedures used in this study were standardized, which allowed for accurate findings and analysis and contributed to the reliability and validity of this research. Statistical analysis: SPSS version 29 was used to conduct statistical analyses. Demographic data, such as age, sex, location, presence of diabetes mellitus, and years of work, were analyzed using descriptive statistics. Following the test of normality, the Pearson correlation test was used to determine the association between diabetes, DPN, and PVD ( Table 4 ). The level of significance was set at p<0.05. Results Sample characteristics: This study recruited 166 security personnel across different sectors, such as health, commercial, and residential. The mean age of the participants was 34.95 ± 8.15 years. The demographic and clinical characteristics (including BMI, pulse rate, years of experience, and diabetic status) are presented in Table 1 . The sex proportion of our sample is shown in Figure 2.1 and the locations of the data collection is illustrated in Figure 2.2 . Table 1. Demographic and clinical characteristics of the participants. Variables Mean and standard deviation Age 34.95±8.15 years BMI 23.41±4.97 PRB 79.18±11.68 beats per minute BPSB 131.31±17.83 mmHg PRA 79.59±11.03 beats per minute BPSA 169.67±24.99 mmHg ABI 1.29±0.12 Years of work 6.51±4.97 years Years of DM 6.70±2.73 years FBS (Diabetes cases only) 123±37.89 mg/dL PPBS (Diabetes cases only) 243±75.11 mg/dL HbA1C (Diabetes cases only) 7.10±2.03% Figure 2.1. Sex Distribution of participants. There were 158 males and 8 female security personnel. Figure 2.2. Geographical distribution of data collection sites. Data were collected from three of the seven emirates, Ajman, Dubai, and Ras Al Khaimah. The prevalence of diabetes among the sampled security personnel was found to be 9.6% ( Table 2 ), DPN was assessed among the 16 diabetic participants using multiple screening tools: Semmes-Weinstein monofilament, MNSI, VPT, and DN4 scale. The monofilament test showed positive responses in 10 out of 16 diabetic cases and 3 non-diabetic participants. The MNSI detected DPN in 7 diabetic participants (Part A mean: 9±3; Part B mean: 3.5±2) and the mean VPT score was 26.44±7.38 Volts, indicating moderate sensory loss. The mean DN4 was 3.75±2.05 consistent with mild to moderate neuropathic pain. These findings are presented in Table 3 . The mean ABI value calculated from all participants was 1.29 ± 0.12 which falls within the normal range, indicating no significant arterial insufficiency in this sample. However, subgroup analysis showed relevant associations. Table 2. The prevalence of diabetes among our sample. Frequency Percent Yes 16 people 9.6 No 150 people 90.4 Table 3. Screening of diabetic peripheral neuropathy among the DM cases. Monofilament finding Frequency Percent Positive 10 out of 16 DM cases 62.5 Michigan Neuropathy Screening Instrument (MNSI) PART A (Mean±SD)- 9±3 7 out of 16 DM cases 43.75 PART B (Mean±SD)- 3.5±2 Biothesiometer Vibration Pressure Threshold in Volts (Mean±SD)-26.44±7.38 9 out of 16 DM cases 56.25 DN4 score (Mean±SD) 3.75±2.05 3 out of 16 DM cases 18.75 The association between diabetes and its complications is shown in Table 4 . A moderate correlation was observed between DM and ABI values (r=0.56, p=0.03), suggesting early changes in the vascular status. A strong correlation was found between the presence of DM and DPN (r=0.83, p<0.001). For this correlation, MNSI score was used as the quantitative measure of neuropathy. Among non-diabetics, no statistically significant correlations were observed. Table 4. Association of diabetes mellitus and its complications (DPN and PVD). ABI DPN Diabetics Pearson correlation (r-value) 0.56 0.83 P value 0.03 <0.001 Non-diabetics Pearson correlation (r-value) 0.16 Not applicable P value 0.62 Not applicable Discussion This study aimed to determine the prevalence of diabetes and its complications specifically DPN and PVD among security personnel in the UAE, a profession which is characterized by long standing hours, irregular shifts and exposure to the extremes of environment. The findings revealed a prevalence of 9.6%, which is slightly lower than the national average of 12.3%, as reported by the IDF in 2021. 11 However, this value is still notable considering the relatively younger age a normal average BMI of our sample. 18 Importantly, the findings showed a strong association between DM and DPN (r=0.83, p<0.001), which indicate a considerably high burden of neuropathic complications among diabetic security personnel. This aligns with the previous studies reporting DPN as the second most common complication of Type 2 DM and highlights the necessity for proactive screening within occupational health frameworks. 19 – 21 While the ABI of our sample fell within the normal limits (0.9-1.4), 22 a moderate correlation between ABI and diabetes suggests early signs of vascular compromise in diabetic individuals, which may not yet meet the clinical thresholds for PVD but still indicate increased risk. 15 The mean VP among diabetic individuals is consistent with moderate sensory loss, and the DN4 score suggest the presence of mild-moderate neuropathic pain. 16 , 17 , 23 , 24 These values point toward early and potentially progressive complications that require attention. The occupational context may play a significant role in the observed outcomes. Security personnel are often exposed to extended periods of static standing along with lack of medical monitoring, which has been sure to impair endothelial shear stress and increase postprandial glucose levels. 9 These physiological disturbances can indirectly increase the chances of development of complications in diabetic individuals. At the mechanistic level, micro-and macrovascular complications are closely associated with diabetes, mainly due to the presence of chronic hyperglycemia and insulin resistance, which play major roles in initiating the process of these complications. Various mechanisms can lead to complications such as oxidative stress, inflammation, and increased production of glycation end products (AGEs) and their activation (RAGE). 5 , 25 Despite ongoing researches no definitive prevention for the diabetic neuropathy exists, highlighting the importance of early detection and risk reduction, particularly in high risk occupational groups. 26 , 27 Limitations and future recommendations: This study has several limitations. First, the instruments used in this study assess DPN are validated for screening, are not the gold standard diagnostic tool for the provisional diagnosis of the condition. Hence, they only serve as a screening tool for detecting the presence of DPN and these results must be verified with appropriate diagnostic measures such as Nerve Conduction Velocity tests (NCV). However, these are the most widely used measures in community-based studies. Second, the study sample was limited to Ajman, Dubai and Ras al Khaimah; therefore, it is difficult to generalize the data to the entire United Arab Emirates. Third, the sample was predominantly male, which reflects the gender distribution of the profession but introduces gender bias. The blood pressure measurements during our study were taken from both the arms and the ankles, and the mean was obtained; however, the measurement was only taken at once and not a minimum of three readings due to time constraints. In addition, we did not perform regression analysis in this study although it could have provided stronger statistical insight into the associations observed. The study did not account for potential confounding factors such as medications, smoking status, dietary habits, genetic factors, sleep, caffeine intake, and stress levels, which may influence glycemic control and vascular health. Lastly, our study used a cross-sectional design, which limits causal interference. Future longitudinal research is needed to determine whether prolonged occupational exposure among security personnel is a contributing factor in the progression of diabetic complications. Incorporating regression analysis in the future studies would additionally isolate the impact of occupation on the risk of DPN and PVD. Conclusion This study adds to our understanding of the prevalence of diabetes and its associated complications among security personnel in the UAE. It was found that the presence of DM among securities is high, with a prevalence of 9.6%, as compared to 12.3% in the whole of UAE. The results indicate that there was a statistically significant association between diabetes mellitus and its complications PVD and DPN, which underscores the necessity of implementing occupational health measures along with preventive strategies for the targeted population. Addressing and acting on these health conditions will help enhance the overall well-being and productivity of security personnel, resulting in better health outcomes and reduced healthcare costs. Declarations Ethics approval and consent to participate This study was approved by the Institutional Research Board of the College of Health Sciences, Gulf Medical University (Ref. no. IRB-COHS-STD-59-NOV-2023). All participants provided written informed consent. The data collection procedures followed the ethical guidelines of the Declaration of Helsinki. Consent for publication Written informed consent was obtained from all participants for voluntary participation in the study prior to data collection, explaining the possible use of the data for research and publication without revealing their identity. Authors contribution All authors contributed significantly to the manuscript under the specific roles described below. MA - Mohamed Anas Mohamed: Data curation, formal analysis, Methodology, Writing (original draft), review, and editing. SM - Saheema Moila Kiriyath: Data curation, formal analysis, Methodology, Writing (original draft), review, and editing. HD - Huda Mohamed Saddik Sheikh: Data curation, formal analysis, Methodology, Writing – original draft, review, and editing. AD - Anjela Davis Panattuparambil: Data curation, formal analysis, Methodology, Writing – original draft, review, and editing. SF - Shahwar Fatima Ansari: Data curation, formal analysis, Methodology, Writing – original draft, review, and editing. PK - Praveen Kumar Kandakurti: Conceptualization, methodology, supervision, formal analysis, writing – original draft, review and editing, approval of final draft. KG - Kumaraguruparan Gopal: Methodology, Project Administration, Writing – original draft, writing – review and editing. AH - Animesh Hazari: Conceptualization, Methodology, Supervision, Formal Analysis, Writing-original draft, review and editing, approval of final draft. Availability of data and materials The complete dataset is provided in an online repository. Figshare: DPN Security in the UAE https://doi.org/10.6084/m9.figshare.28283828.v1 . 28 The project contains the following underlying data: - [Data Sheet DPN- Security] (Demographics, raw data for analysis) and Informed Consent form, data collection sample sheet, questionnaire. Data are available under the terms of the Creative Commons Attribution 4.0 International license (CC-BY 4.0). References 1. Medical Management of Type 2 Diabetes: Medical Management of Type 2 Diabetes.2020. 2. The top 10 causes of death.[cited 2025 Aug 5]. Reference Source 3. Sapra A, Bhandari P: Diabetes. StatPearls. 2023 Jun 21 [cited 2024 Jun 4]. Reference Source 4. Committee ADAPP: 2. 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Peddie MC, Kessell C, Bergen T, et al. : The effects of prolonged sitting, prolonged standing, and activity breaks on vascular function, and postprandial glucose and insulin responses: A randomised crossover trial.PLoS One [Internet].2021 Jan 1 [cited 2025 Aug 5]; 16 (1 January 2021). PubMed Abstract | Publisher Full Text 10. Sugimoto K, Sozu T, Hoshino T, et al. : Longitudinal effects of one-leg standing time on neuropathy outcomes in association with glycemic control in non-elderly patients with type 2 diabetes. J. Diabetes Investig [Internet]. 2022 Jun 1 [cited 2025 Aug 5]; 13 (6): 1039–1051. PubMed Abstract 11. United Arab Emirates - International Diabetes Federation.[cited 2025 Aug 5]. Reference Source 12. Naing L, Nordin RB, Abdul Rahman H, et al. : Sample size calculation for prevalence studies using Scalex and ScalaR calculators. BMC Med. Res. Methodol. 2022 Jul 30 [cited 2025 Aug 5]; 22 (1): 209. PubMed Abstract | Publisher Full Text | Free Full Text 13. 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Hazari A, Mishra V, Agouris I: Clinical evaluation of painful diabetes peripheral neuropathy in type 2 diabetes patients: Lessons from expatriates in the United Arab Emirates. Diabetes Metab. Syndr. Clin. Res. Rev. 2023 Sep 1 [cited 2025 Aug 5]; 17 (9): 102832. PubMed Abstract | Publisher Full Text 18. Zierle-Ghosh A, Jan A: Physiology, Body Mass Index. StatPearls. 2023 Nov 5 [cited 2025 Aug 5]. Reference Source 19. Al Sabbah H , Alketbi M, Dghaim R: Prevalence of Complications in Type 2 Diabetics in Dubai, UAE: A Cross-sectional Study. Arab Journal of Nutrition and Exercise (AJNE). 2019 Aug 27 [cited 2025 Aug 5]: 52–65 Reference Source 20. Mohamad MN, Ismail LC, Stojanovska L, et al. : The prevalence of diabetes amongst young Emirati female adults in the United Arab Emirates: A cross-sectional study. PLoS One. 2021 Jun 1 [cited 2025 Aug 5]; 16 (6): e0252884. PubMed Abstract | Publisher Full Text | Free Full Text 21. Sulaiman N, Mahmoud I, Hussein A, et al. : Diabetes risk score in the United Arab Emirates: a screening tool for the early detection of type 2 diabetes mellitus. BMJ Open Diabetes Res. Care. 2018 Mar 29 [cited 2025 Aug 5]; 6 (1): e000489. Reference Source 22. Cáceres-Farfán L, Moreno-Loaiza M, Cubas WS: Ankle-brachial index: more than a diagnostic test? Arch. Peru Cardiol. Cir. Cardiovasc. 2021 Dec 31 [cited 2025 Aug 5]; 2 (4): 254–262. PubMed Abstract | Publisher Full Text | Free Full Text 23. Sharma KNS, Kumar HA: Assessment of the diagnostic accuracy of Vibrasense compared to a biothesiometer and nerve conduction study for screening diabetic peripheral neuropathy. J. Foot Ankle Res. 2023 Dec 1 [cited 2025 Aug 5]; 16 (1): 65. PubMed Abstract | Publisher Full Text | Free Full Text 24. Viswanathan V, Ahmed Khan B, Nachimuthu S, et al. : Precision of Michigan Neuropathy Screening Instrument (MNSI) Tool for the Diagnosis of Diabetic Peripheral Neuropathy Among People with Type 2 Diabetes-A Study from South India. Int. J. Low Extrem. Wounds. 2023 [cited 2025 Aug 5]. PubMed Abstract | Publisher Full Text 25. Dewanjee S, Das S, Das AK, et al. : Molecular mechanism of diabetic neuropathy and its pharmacotherapeutic targets. Eur. J. Pharmacol. 2018 Aug 15 [cited 2025 Aug 5]; 833 : 472–523. Publisher Full Text 26. Shieb M, Koruturk S, Srivastava A, et al. : Growth of Diabetes Research in United Arab Emirates: Current and Future Perspectives. Curr. Diabetes Rev. 2020 Feb 1 [cited 2025 Aug 5]; 16 (4): 395–401. Free Full Text 27. Alawadi F, Abusnana Bachar Afandi S, Aldahmani KM, et al. : Guidelines Emirates Diabetes Society Consensus Guidelines for the Management of Type 2 Diabetes Mellitus-2020. Alawadi et al. 2019 [cited 2025 Aug 5]. Reference Source 28. 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Publisher Full Text Comments on this article Comments (0) Version 2 VERSION 2 PUBLISHED 12 Feb 2025 ADD YOUR COMMENT Comment Author details Author details 1 COLLEGE OF HEALTH SCIENCES, DEPARTMENT OF PHYSIOTHERAPY, GULF MEDICAL UNIVERSITY, AJMAN, United Arab Emirates Mohamed Anas Mohamed Roles: Data Curation, Formal Analysis, Methodology, Writing – Original Draft Preparation, Writing – Review & Editing Saheema Moila Kiriyath Roles: Data Curation, Formal Analysis, Methodology, Writing – Original Draft Preparation, Writing – Review & Editing Huda Mohamed Saddik Sheikh Roles: Data Curation, Formal Analysis, Methodology, Writing – Original Draft Preparation, Writing – Review & Editing Anjela Davis Panattuparambil Roles: Data Curation, Formal Analysis, Methodology, Writing – Original Draft Preparation, Writing – Review & Editing Shahwar Fatima Ansari Roles: Data Curation, Formal Analysis, Methodology, Writing – Original Draft Preparation, Writing – Review & Editing Praveen Kumar Kandakurti Roles: Conceptualization, Formal Analysis, Methodology, Supervision, Writing – Original Draft Preparation, Writing – Review & Editing Kumaraguruparan Gopal Roles: Methodology, Project Administration, Writing – Original Draft Preparation, Writing – Review & Editing Animesh Hazari Roles: Conceptualization, Formal Analysis, Methodology, Supervision, Writing – Original Draft Preparation, Writing – Review & Editing Competing interests No competing interests were disclosed. Grant information The author(s) declared that no grants were involved in supporting this work. Article Versions (2) version 2 Revised Published: 29 Aug 2025, 14:190 https://doi.org/10.12688/f1000research.161534.2 version 1 Published: 12 Feb 2025, 14:190 https://doi.org/10.12688/f1000research.161534.1 Copyright © 2025 Mohamed MA et al . This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Download Export To Sciwheel Bibtex EndNote ProCite Ref. Manager (RIS) Sente metrics Views Downloads F1000Research - - PubMed Central info_outline Data from PMC are received and updated monthly. - - Citations open_in_new 0 open_in_new 0 open_in_new SEE MORE DETAILS CITE how to cite this article Mohamed MA, Kiriyath SM, Saddik Sheikh HM et al. Prevalence of Diabetes Mellitus and its Association with Diabetic Peripheral Neuropathy, Peripheral Vascular Disorder among Security Personnel in United Arab Emirates [version 2; peer review: 1 approved, 2 approved with reservations, 2 not approved] . F1000Research 2025, 14 :190 ( https://doi.org/10.12688/f1000research.161534.2 ) NOTE: If applicable, it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS track receive updates on this article Track an article to receive email alerts on any updates to this article. TRACK THIS ARTICLE Share Open Peer Review Current Reviewer Status: ? Key to Reviewer Statuses VIEW HIDE Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions Version 2 VERSION 2 PUBLISHED 29 Aug 2025 Revised Views 0 Cite How to cite this report: Yovera-Aldana M. Reviewer Report For: Prevalence of Diabetes Mellitus and its Association with Diabetic Peripheral Neuropathy, Peripheral Vascular Disorder among Security Personnel in United Arab Emirates [version 2; peer review: 1 approved, 2 approved with reservations, 2 not approved] . F1000Research 2025, 14 :190 ( https://doi.org/10.5256/f1000research.184045.r426401 ) The direct URL for this report is: https://f1000research.com/articles/14-190/v2#referee-response-426401 NOTE: it is important to ensure the information in square brackets after the title is included in this citation. Close Copy Citation Details Reviewer Report 06 May 2026 Marlon Yovera-Aldana , Universidad Cientifica del Sur, Lima, Peru Not Approved VIEWS 0 https://doi.org/10.5256/f1000research.184045.r426401 This manuscript explores the prevalence of diabetes mellitus (DM) and selected complications among security personnel, a population of potential interest in occupational health. However, the current version presents important methodological and analytical limitations that compromise the validity and interpretability of ... Continue reading READ ALL This manuscript explores the prevalence of diabetes mellitus (DM) and selected complications among security personnel, a population of potential interest in occupational health. However, the current version presents important methodological and analytical limitations that compromise the validity and interpretability of the findings. In particular, the study lacks clear operational definitions, consistency in measurement, and an appropriate analytical strategy. As a result, it does not adequately achieve its primary objective of evaluating the association between diabetes and its complications.. Introduction The introduction provides a general overview of diabetes and its complications, particularly DPN and PVD. However, this section largely reiterates well-established relationships and does not sufficiently justify the specific contribution of the study. The rationale for focusing on security personnel remains underdeveloped. Although occupational factors such as prolonged standing, irregular schedules, and shift work are mentioned, these are not integrated into a clear conceptual framework explaining how they may influence glycemic control, neuropathy, or vascular disease. The justification relies primarily on the absence of prior studies rather than on a well-defined hypothesis grounded in occupational or pathophysiological mechanisms. A more focused and hypothesis-driven introduction is needed to support the relevance of the research question. Methods The classification of diabetes mellitus appears to rely on recent laboratory values provided by participants. However, it is unclear how individuals with known diabetes under treatment were handled. This approach may lead to misclassification, particularly in cases of controlled disease, and limits the validity of the exposure definition. The assessment of diabetic peripheral neuropathy is insufficiently defined. Multiple instruments were used (monofilament, MNSI, vibration perception threshold, DN4), but the manuscript does not specify how these were integrated into a single diagnostic framework. It is unclear whether a participant was classified as having DPN based on a single abnormal test, a combination of findings, or a predefined threshold. The inclusion of DN4, which evaluates neuropathic pain rather than neuropathy itself, further complicates interpretation if used as a diagnostic criterion. The absence of a clear operational definition introduces a high risk of misclassification. The methodology for ABI measurement also lacks clarity. Although bilateral measurements were obtained and averaged, this approach does not follow standard clinical practice, where ABI is typically interpreted per limb using the highest ankle pressure. The lack of detail regarding arterial sites and calculation procedures limits the interpretability of vascular findings. In addition, it is not consistently specified whether all assessments were applied to both diabetic and non-diabetic participants, which complicates the interpretation of prevalence and subsequent analyses. Finally, the use of convenience sampling and the limited representativeness of the sample introduce potential selection bias and limit generalizability. Statistical analysis The use of Pearson correlation to assess the relationship between diabetes and its complications is not appropriate for the variables involved. Even if the MNSI score is used as a continuous measure for neuropathy, diabetes remains a categorical variable. If a numerical coding (e.g., 0/1) was used, this should be explicitly described and justified, as correlation is not the most suitable method to evaluate such relationships. Correlations are reported separately in diabetic and non-diabetic groups, which renders interpretation unclear. Within each subgroup, the variable “diabetes” is constant, and therefore the reported coefficients cannot meaningfully represent an association with diabetes. It is not evident what variables are being correlated or what the reported values represent. Although regression-based methods would be more appropriate to evaluate associations and account for confounding, the current sample size—particularly the small number of diabetic participants—precludes their reliable application. Any multivariable analysis would be underpowered and unstable, with a high risk of overfitting. This limitation is central: the study is not adequately designed, in terms of both sample size and analytical strategy, to address its primary objective of evaluating associations. At best, the data support descriptive or exploratory analyses, but not inferential conclusions. Results The reported prevalence of DPN and PVD is uncertain due to the lack of a standardized diagnostic definition. The use of multiple screening tools without a clear classification criterion introduces potential misclassification, reducing confidence in these estimates. The interpretation of ABI findings is also problematic. While the mean ABI is within normal range, the manuscript suggests early vascular changes based on statistical associations. Without reporting clinically meaningful categories or abnormal values, this interpretation is not adequately supported. Additionally, neuropathic findings are reported in non-diabetic participants, but their significance is not discussed. This raises concerns regarding the specificity of the instruments used and highlights the need for a clearer diagnostic framework. The small number of diabetic participants further limits the robustness of the findings and increases the likelihood of unstable estimates. Discussion The manuscript interprets correlation coefficients as evidence of meaningful associations and suggests increased risk in this occupational group. However, given the lack of clarity and appropriateness of the analytical approach, these interpretations are not justified. In addition, the discussion occasionally implies causal relationships or disease progression, which cannot be inferred from a cross-sectional design. A more cautious interpretation, aligned with the limitations of the data and methods, is required. Conclusion Given the unclear variable definitions, methodological limitations, and the inability to appropriately evaluate associations, the findings should be considered exploratory. Importantly, the study is not sufficiently powered or methodologically structured to achieve its stated objective. Any statements regarding associations, risk, or implications for occupational health should be tempered accordingly. While the topic is relevant, the manuscript presents fundamental methodological and analytical limitations that preclude a valid interpretation of the main findings. In its current form, the study does not achieve its primary objective Is the work clearly and accurately presented and does it cite the current literature? Partly Is the study design appropriate and is the work technically sound? No Are sufficient details of methods and analysis provided to allow replication by others? Partly If applicable, is the statistical analysis and its interpretation appropriate? No Are all the source data underlying the results available to ensure full reproducibility? Partly Are the conclusions drawn adequately supported by the results? No Competing Interests: No competing interests were disclosed. Reviewer Expertise: Endocrinology, diabetes, clinical epidemiology, and research methodology I confirm that I have read this submission and believe that I have an appropriate level of expertise to state that I do not consider it to be of an acceptable scientific standard, for reasons outlined above. Close READ LESS CITE CITE HOW TO CITE THIS REPORT Yovera-Aldana M. Reviewer Report For: Prevalence of Diabetes Mellitus and its Association with Diabetic Peripheral Neuropathy, Peripheral Vascular Disorder among Security Personnel in United Arab Emirates [version 2; peer review: 1 approved, 2 approved with reservations, 2 not approved] . F1000Research 2025, 14 :190 ( https://doi.org/10.5256/f1000research.184045.r426401 ) The direct URL for this report is: https://f1000research.com/articles/14-190/v2#referee-response-426401 NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS Report a concern Respond or Comment COMMENT ON THIS REPORT Views 0 Cite How to cite this report: Balachandra M. Reviewer Report For: Prevalence of Diabetes Mellitus and its Association with Diabetic Peripheral Neuropathy, Peripheral Vascular Disorder among Security Personnel in United Arab Emirates [version 2; peer review: 1 approved, 2 approved with reservations, 2 not approved] . F1000Research 2025, 14 :190 ( https://doi.org/10.5256/f1000research.184045.r426407 ) The direct URL for this report is: https://f1000research.com/articles/14-190/v2#referee-response-426407 NOTE: it is important to ensure the information in square brackets after the title is included in this citation. Close Copy Citation Details Reviewer Report 22 Nov 2025 Mamatha Balachandra , Manipal Institute of Technology Manipal Academy of Higher Education, Manipal, Karnataka, India Approved with Reservations VIEWS 0 https://doi.org/10.5256/f1000research.184045.r426407 Comments to the Author The statistical analysis and its interpretation require improvement. It would be helpful to include the relevant equations, parameters, and analytical steps to provide a clearer and more rigorous explanation of the statistical ... Continue reading READ ALL Comments to the Author The statistical analysis and its interpretation require improvement. It would be helpful to include the relevant equations, parameters, and analytical steps to provide a clearer and more rigorous explanation of the statistical methods used. In the conclusion, the statement: “The results indicate that there was a statistically significant association between diabetes mellitus and its complications PVD and DPN, which underscores the necessity of implementing occupational health measures along with preventive strategies for the targeted population.” Please provide a clear justification for this statement, preferably with supporting data or references to the results presented. In the methodology section, consider illustrating the process using a block diagram or flowchart. This will enhance readability and help the reader better understand the sequence of steps involved, rather than relying solely on textual description. Is the work clearly and accurately presented and does it cite the current literature? Yes Is the study design appropriate and is the work technically sound? Partly Are sufficient details of methods and analysis provided to allow replication by others? Partly If applicable, is the statistical analysis and its interpretation appropriate? Partly Are all the source data underlying the results available to ensure full reproducibility? Partly Are the conclusions drawn adequately supported by the results? Partly Competing Interests: No competing interests were disclosed. Reviewer Expertise: Wireless Ad hoc Networks, Internet of Things, IoT Security I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard, however I have significant reservations, as outlined above. Close READ LESS CITE CITE HOW TO CITE THIS REPORT Balachandra M. Reviewer Report For: Prevalence of Diabetes Mellitus and its Association with Diabetic Peripheral Neuropathy, Peripheral Vascular Disorder among Security Personnel in United Arab Emirates [version 2; peer review: 1 approved, 2 approved with reservations, 2 not approved] . F1000Research 2025, 14 :190 ( https://doi.org/10.5256/f1000research.184045.r426407 ) The direct URL for this report is: https://f1000research.com/articles/14-190/v2#referee-response-426407 NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS Report a concern Respond or Comment COMMENT ON THIS REPORT Views 0 Cite How to cite this report: Perveen W. Reviewer Report For: Prevalence of Diabetes Mellitus and its Association with Diabetic Peripheral Neuropathy, Peripheral Vascular Disorder among Security Personnel in United Arab Emirates [version 2; peer review: 1 approved, 2 approved with reservations, 2 not approved] . F1000Research 2025, 14 :190 ( https://doi.org/10.5256/f1000research.184045.r424577 ) The direct URL for this report is: https://f1000research.com/articles/14-190/v2#referee-response-424577 NOTE: it is important to ensure the information in square brackets after the title is included in this citation. Close Copy Citation Details Reviewer Report 03 Nov 2025 Wajida Perveen , Combined Military Hospital, Lahore Medical College, Lahore, Pakistan Approved VIEWS 0 https://doi.org/10.5256/f1000research.184045.r424577 the study title is appropriate, self explanatory and can stand alone. the abstract gives sufficient reflection of the full text. the study design is simple and clear. the methodology included all necessary components and it can be replicated. although ... Continue reading READ ALL the study title is appropriate, self explanatory and can stand alone. the abstract gives sufficient reflection of the full text. the study design is simple and clear. the methodology included all necessary components and it can be replicated. although sample size is a bit small, but study results may be generalized to a larger population. Ethical aspects are taken care of well. Results are clearly presented and prepared with reasonable statistical tests. The findings are discussed, compared and contrasted with the identification of limitations and future recommendations Is the work clearly and accurately presented and does it cite the current literature? Yes Is the study design appropriate and is the work technically sound? Yes Are sufficient details of methods and analysis provided to allow replication by others? Yes If applicable, is the statistical analysis and its interpretation appropriate? Yes Are all the source data underlying the results available to ensure full reproducibility? Partly Are the conclusions drawn adequately supported by the results? Yes Competing Interests: No competing interests were disclosed. Reviewer Expertise: Physical therapy, sports, Neuropathy I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard. Close READ LESS CITE CITE HOW TO CITE THIS REPORT Perveen W. Reviewer Report For: Prevalence of Diabetes Mellitus and its Association with Diabetic Peripheral Neuropathy, Peripheral Vascular Disorder among Security Personnel in United Arab Emirates [version 2; peer review: 1 approved, 2 approved with reservations, 2 not approved] . F1000Research 2025, 14 :190 ( https://doi.org/10.5256/f1000research.184045.r424577 ) The direct URL for this report is: https://f1000research.com/articles/14-190/v2#referee-response-424577 NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS Report a concern Respond or Comment COMMENT ON THIS REPORT Version 1 VERSION 1 PUBLISHED 12 Feb 2025 Views 0 Cite How to cite this report: Anggadiredja K. Reviewer Report For: Prevalence of Diabetes Mellitus and its Association with Diabetic Peripheral Neuropathy, Peripheral Vascular Disorder among Security Personnel in United Arab Emirates [version 2; peer review: 1 approved, 2 approved with reservations, 2 not approved] . F1000Research 2025, 14 :190 ( https://doi.org/ ) The direct URL for this report is: https://f1000research.com/articles/14-190/v1#referee-response-378917 NOTE: it is important to ensure the information in square brackets after the title is included in this citation. Close Copy Citation Details Reviewer Report 26 May 2025 Kusnandar Anggadiredja , Bandung Institute of Technology, Bandung, Indonesia Approved with Reservations VIEWS 0 https://doi.org/ Major issues The use of term 'such as' (Aim) makes the title of this paper a bit 'uncertain'. Authors need to be firmed on whether DPN is the exact factor being investigated in the present study. ... Continue reading READ ALL Major issues The use of term 'such as' (Aim) makes the title of this paper a bit 'uncertain'. Authors need to be firmed on whether DPN is the exact factor being investigated in the present study. In introduction, authors should consider that the health issues related to prolonged standing position are usually related to musculoskeletal and cardiovascular disorders. Authors need to present references tied to diabetic consequences. For the association results as presented in Table 4, which % of DPN is used to calculate the association?, since there are four related numbers in Table 3 Data presentation need revision: Fig 1: what is the difference between the filled and empty circles? Table 1: this is not descriptive statistics but demographic data Fig 2.1: the title “Gender” is not necessary, it is described in the Fig caption. Fig caption should not be started with a verb, please rephrase the caption. Fig 2.2: the title “AREA” is not necessary, it is described in the Fig caption. Fig caption should not be started with a verb, please rephrase the caption. Table 2 and 3: the symbol % is not necessary Minor issues : consistency be consistent 'security personnel' or 'security guard' '…mentioned in Table 3' is considered inappropriate, better use other term, such as '…presented in Table 3' Is the work clearly and accurately presented and does it cite the current literature? Partly Is the study design appropriate and is the work technically sound? Partly Are sufficient details of methods and analysis provided to allow replication by others? Partly If applicable, is the statistical analysis and its interpretation appropriate? Partly Are all the source data underlying the results available to ensure full reproducibility? No source data required Are the conclusions drawn adequately supported by the results? Partly Competing Interests: No competing interests were disclosed. I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard, however I have significant reservations, as outlined above. Close READ LESS CITE CITE HOW TO CITE THIS REPORT Anggadiredja K. Reviewer Report For: Prevalence of Diabetes Mellitus and its Association with Diabetic Peripheral Neuropathy, Peripheral Vascular Disorder among Security Personnel in United Arab Emirates [version 2; peer review: 1 approved, 2 approved with reservations, 2 not approved] . F1000Research 2025, 14 :190 ( https://doi.org/ ) The direct URL for this report is: https://f1000research.com/articles/14-190/v1#referee-response-378917 NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS Report a concern Author Response 11 Sep 2025 Animesh Hazari , COLLEGE OF HEALTH SCIENCES, DEPARTMENT OF PHYSIOTHERAPY, GULF MEDICAL UNIVERSITY, AJMAN, United Arab Emirates 11 Sep 2025 Author Response The authors would like to express their sincere appreciation to the reviewers for their valuable insights and suggestions. These comments have improved our manuscript in terms of clarity, precision and ... Continue reading The authors would like to express their sincere appreciation to the reviewers for their valuable insights and suggestions. These comments have improved our manuscript in terms of clarity, precision and quality. Below, we have provided a response for each comment along with detailed explanations and indications of where the revisions were made. The responses have been underlined. Reviewer 2 Reviewer Comment Author Response Place of Correction 1. Title and Aim- The use of ‘such as’ makes the aim uncertain The phrase ‘such as’ has now been removed from both title and aim. Title and Abstract 2. Introduction- provide references connecting prolonged standing to diabetic consequences We have included recent studies that support the link between prolonged standing and impaired vascular shear rate, postprandial hyperglycemia and reduced balance and stability, all of which are relevant to the pathogenesis to diabetic peripheral neuropathy and peripheral vascular disorders. Introduction 3. Clarify which percent was used to calculate the association in table 4 The MNSI Score was used as the continuous variable to calculate the correlation between diabetes and diabetic peripheral neuropathy in table 4. This is now explicitly mentioned in the results section Results, final paragraph 4. Figure 1: empty vs filled circles The filled circles represent the standard testing sites and empty represent additional optional sites. A note has been added in figure captions explaining the same. Figure 1 captions 5. Table 1: Demographic data, not descriptive stats Retitled, as suggested Table 1 6. Fig 2.1 and 2.2- Remove internal titles, avoid starting with verbs Incorporated as suggested Figure 2.1 and 2.2 captions 7. Table 2 and 3, remove % symbol Incorporated as suggested Tables 2 and 3 8. Language consistency The term ‘’security personnel’’ is now used consistently throughout the article. Whole article 9. Avoid ‘mentioned in table’ phrasing Incorporated as suggested Results and discussion The authors would like to express their sincere appreciation to the reviewers for their valuable insights and suggestions. These comments have improved our manuscript in terms of clarity, precision and quality. Below, we have provided a response for each comment along with detailed explanations and indications of where the revisions were made. The responses have been underlined. Reviewer 2 Reviewer Comment Author Response Place of Correction 1. Title and Aim- The use of ‘such as’ makes the aim uncertain The phrase ‘such as’ has now been removed from both title and aim. Title and Abstract 2. Introduction- provide references connecting prolonged standing to diabetic consequences We have included recent studies that support the link between prolonged standing and impaired vascular shear rate, postprandial hyperglycemia and reduced balance and stability, all of which are relevant to the pathogenesis to diabetic peripheral neuropathy and peripheral vascular disorders. Introduction 3. Clarify which percent was used to calculate the association in table 4 The MNSI Score was used as the continuous variable to calculate the correlation between diabetes and diabetic peripheral neuropathy in table 4. This is now explicitly mentioned in the results section Results, final paragraph 4. Figure 1: empty vs filled circles The filled circles represent the standard testing sites and empty represent additional optional sites. A note has been added in figure captions explaining the same. Figure 1 captions 5. Table 1: Demographic data, not descriptive stats Retitled, as suggested Table 1 6. Fig 2.1 and 2.2- Remove internal titles, avoid starting with verbs Incorporated as suggested Figure 2.1 and 2.2 captions 7. Table 2 and 3, remove % symbol Incorporated as suggested Tables 2 and 3 8. Language consistency The term ‘’security personnel’’ is now used consistently throughout the article. Whole article 9. Avoid ‘mentioned in table’ phrasing Incorporated as suggested Results and discussion Competing Interests: No competing interests disclosed Close Report a concern Respond or Comment COMMENTS ON THIS REPORT Author Response 11 Sep 2025 Animesh Hazari , COLLEGE OF HEALTH SCIENCES, DEPARTMENT OF PHYSIOTHERAPY, GULF MEDICAL UNIVERSITY, AJMAN, United Arab Emirates 11 Sep 2025 Author Response The authors would like to express their sincere appreciation to the reviewers for their valuable insights and suggestions. These comments have improved our manuscript in terms of clarity, precision and ... Continue reading The authors would like to express their sincere appreciation to the reviewers for their valuable insights and suggestions. These comments have improved our manuscript in terms of clarity, precision and quality. Below, we have provided a response for each comment along with detailed explanations and indications of where the revisions were made. The responses have been underlined. Reviewer 2 Reviewer Comment Author Response Place of Correction 1. Title and Aim- The use of ‘such as’ makes the aim uncertain The phrase ‘such as’ has now been removed from both title and aim. Title and Abstract 2. Introduction- provide references connecting prolonged standing to diabetic consequences We have included recent studies that support the link between prolonged standing and impaired vascular shear rate, postprandial hyperglycemia and reduced balance and stability, all of which are relevant to the pathogenesis to diabetic peripheral neuropathy and peripheral vascular disorders. Introduction 3. Clarify which percent was used to calculate the association in table 4 The MNSI Score was used as the continuous variable to calculate the correlation between diabetes and diabetic peripheral neuropathy in table 4. This is now explicitly mentioned in the results section Results, final paragraph 4. Figure 1: empty vs filled circles The filled circles represent the standard testing sites and empty represent additional optional sites. A note has been added in figure captions explaining the same. Figure 1 captions 5. Table 1: Demographic data, not descriptive stats Retitled, as suggested Table 1 6. Fig 2.1 and 2.2- Remove internal titles, avoid starting with verbs Incorporated as suggested Figure 2.1 and 2.2 captions 7. Table 2 and 3, remove % symbol Incorporated as suggested Tables 2 and 3 8. Language consistency The term ‘’security personnel’’ is now used consistently throughout the article. Whole article 9. Avoid ‘mentioned in table’ phrasing Incorporated as suggested Results and discussion The authors would like to express their sincere appreciation to the reviewers for their valuable insights and suggestions. These comments have improved our manuscript in terms of clarity, precision and quality. Below, we have provided a response for each comment along with detailed explanations and indications of where the revisions were made. The responses have been underlined. Reviewer 2 Reviewer Comment Author Response Place of Correction 1. Title and Aim- The use of ‘such as’ makes the aim uncertain The phrase ‘such as’ has now been removed from both title and aim. Title and Abstract 2. Introduction- provide references connecting prolonged standing to diabetic consequences We have included recent studies that support the link between prolonged standing and impaired vascular shear rate, postprandial hyperglycemia and reduced balance and stability, all of which are relevant to the pathogenesis to diabetic peripheral neuropathy and peripheral vascular disorders. Introduction 3. Clarify which percent was used to calculate the association in table 4 The MNSI Score was used as the continuous variable to calculate the correlation between diabetes and diabetic peripheral neuropathy in table 4. This is now explicitly mentioned in the results section Results, final paragraph 4. Figure 1: empty vs filled circles The filled circles represent the standard testing sites and empty represent additional optional sites. A note has been added in figure captions explaining the same. Figure 1 captions 5. Table 1: Demographic data, not descriptive stats Retitled, as suggested Table 1 6. Fig 2.1 and 2.2- Remove internal titles, avoid starting with verbs Incorporated as suggested Figure 2.1 and 2.2 captions 7. Table 2 and 3, remove % symbol Incorporated as suggested Tables 2 and 3 8. Language consistency The term ‘’security personnel’’ is now used consistently throughout the article. Whole article 9. Avoid ‘mentioned in table’ phrasing Incorporated as suggested Results and discussion Competing Interests: No competing interests disclosed Close Report a concern COMMENT ON THIS REPORT Views 0 Cite How to cite this report: Reyhanıoglu DA. Reviewer Report For: Prevalence of Diabetes Mellitus and its Association with Diabetic Peripheral Neuropathy, Peripheral Vascular Disorder among Security Personnel in United Arab Emirates [version 2; peer review: 1 approved, 2 approved with reservations, 2 not approved] . F1000Research 2025, 14 :190 ( https://doi.org/10.5256/f1000research.177573.r378911 ) The direct URL for this report is: https://f1000research.com/articles/14-190/v1#referee-response-378911 NOTE: it is important to ensure the information in square brackets after the title is included in this citation. Close Copy Citation Details Reviewer Report 26 May 2025 Duygu Aktar Reyhanıoglu , Fenerbahce University, Istanbul, Turkey Not Approved VIEWS 0 https://doi.org/10.5256/f1000research.177573.r378911 · Abstract Section: Information regarding ethics committee approval and informed consent should not be included in the abstract. Such details are more appropriately placed in the methodology section. · Originality and Contribution to the Literature: The study’s originality and its specific contribution to the existing literature have not been clearly articulated. It is important to explicitly state what new insight this research offers and how it adds value to current knowledge. ... Continue reading READ ALL · Abstract Section: Information regarding ethics committee approval and informed consent should not be included in the abstract. Such details are more appropriately placed in the methodology section. · Originality and Contribution to the Literature: The study’s originality and its specific contribution to the existing literature have not been clearly articulated. It is important to explicitly state what new insight this research offers and how it adds value to current knowledge. · Relationship Between Diabetes, Neuropathy, and Security Personnel: The association between diabetes and neuropathy is well-established in the literature. However, the link between these conditions and being a security officer is not sufficiently clarified. It should be addressed whether being a security officer constitutes a risk factor for diabetic peripheral neuropathy (DPN). Furthermore, the clinical relevance of the reported mean values should be discussed: are they within the expected range, above, or below population norms? · Statistical Methods: Using regression analysis could strengthen the study by better clarifying whether being a security officer is associated with an increased risk of diabetes or DPN. This would enhance the validity and interpretability of the findings. · Discussion Section: The first paragraph of the discussion largely reiterates the results. The mean and standard deviation values presented here should be relocated to the results section. The discussion should instead focus on the most significant findings of the study, interpreting their implications and comparing them with the existing literature. Is the work clearly and accurately presented and does it cite the current literature? Yes Is the study design appropriate and is the work technically sound? No Are sufficient details of methods and analysis provided to allow replication by others? Yes If applicable, is the statistical analysis and its interpretation appropriate? Yes Are all the source data underlying the results available to ensure full reproducibility? Yes Are the conclusions drawn adequately supported by the results? No Competing Interests: No competing interests were disclosed. Reviewer Expertise: Diabetic Neuropathy I confirm that I have read this submission and believe that I have an appropriate level of expertise to state that I do not consider it to be of an acceptable scientific standard, for reasons outlined above. Close READ LESS CITE CITE HOW TO CITE THIS REPORT Reyhanıoglu DA. Reviewer Report For: Prevalence of Diabetes Mellitus and its Association with Diabetic Peripheral Neuropathy, Peripheral Vascular Disorder among Security Personnel in United Arab Emirates [version 2; peer review: 1 approved, 2 approved with reservations, 2 not approved] . F1000Research 2025, 14 :190 ( https://doi.org/10.5256/f1000research.177573.r378911 ) The direct URL for this report is: https://f1000research.com/articles/14-190/v1#referee-response-378911 NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS Report a concern Author Response 11 Sep 2025 Animesh Hazari , COLLEGE OF HEALTH SCIENCES, DEPARTMENT OF PHYSIOTHERAPY, GULF MEDICAL UNIVERSITY, AJMAN, United Arab Emirates 11 Sep 2025 Author Response The authors would like to express their sincere appreciation to the reviewers for their valuable insights and suggestions. These comments have improved our manuscript in terms of clarity, precision and ... Continue reading The authors would like to express their sincere appreciation to the reviewers for their valuable insights and suggestions. These comments have improved our manuscript in terms of clarity, precision and quality. Below, we have provided a response for each comment along with detailed explanations and indications of where the revisions were made. The responses have been underlined. Reviewer 1 Reviewer Comment Author Response Place of Correction 1. Abstract -Information regarding Ethics committee approval and informed consent should not be included in abstract Incorporated as suggested. These details have been removed from abstract. Abstract 2. Originality and Contribution to literature- The study’s originality and specific contribution to existing literature have not been articulated. The introduction has been improvised to clearly state that this is the first study examining prevalence of diabetes and its complications among security personnel in UAE. We have also emphasized the study’s novelty and its value in addressing occupational health gap Introduction, last two paragraphs 3. Relationship between Diabetes, Neuropathy and Security Personnel- The link between them not sufficient As suggested, we have elaborated on how security personnel are exposed to risk factors which can indirectly contribute to poor glycemic control and vascular complications. Introduction and Discussion 4. Statistical Methods- Regression analysis could strengthen the study As part of the graduate student research project, we stuck to the stated research hypothesis and performed the statistical analysis accordingly. The authors agree that Regression analysis would provide a deeper understanding to our topic. However, due to time constraints and lack of access to confounding variable data (e.g.: smoking, medication use, dietary intake), we were unable to perform the analysis. This limitation is now acknowledged in the article. Limitation and future recommendations 5. Discussion- First paragraph reiterates the results. Mean and standard deviation values to be kept in results instead The discussion has been revised to focus on interpretations and implications of the findings in context of existing literature. The mean and S.D values have been located in results. Results and discussion The authors would like to express their sincere appreciation to the reviewers for their valuable insights and suggestions. These comments have improved our manuscript in terms of clarity, precision and quality. Below, we have provided a response for each comment along with detailed explanations and indications of where the revisions were made. The responses have been underlined. Reviewer 1 Reviewer Comment Author Response Place of Correction 1. Abstract -Information regarding Ethics committee approval and informed consent should not be included in abstract Incorporated as suggested. These details have been removed from abstract. Abstract 2. Originality and Contribution to literature- The study’s originality and specific contribution to existing literature have not been articulated. The introduction has been improvised to clearly state that this is the first study examining prevalence of diabetes and its complications among security personnel in UAE. We have also emphasized the study’s novelty and its value in addressing occupational health gap Introduction, last two paragraphs 3. Relationship between Diabetes, Neuropathy and Security Personnel- The link between them not sufficient As suggested, we have elaborated on how security personnel are exposed to risk factors which can indirectly contribute to poor glycemic control and vascular complications. Introduction and Discussion 4. Statistical Methods- Regression analysis could strengthen the study As part of the graduate student research project, we stuck to the stated research hypothesis and performed the statistical analysis accordingly. The authors agree that Regression analysis would provide a deeper understanding to our topic. However, due to time constraints and lack of access to confounding variable data (e.g.: smoking, medication use, dietary intake), we were unable to perform the analysis. This limitation is now acknowledged in the article. Limitation and future recommendations 5. Discussion- First paragraph reiterates the results. Mean and standard deviation values to be kept in results instead The discussion has been revised to focus on interpretations and implications of the findings in context of existing literature. The mean and S.D values have been located in results. Results and discussion Competing Interests: No competing interests disclosed Close Report a concern Respond or Comment COMMENTS ON THIS REPORT Author Response 11 Sep 2025 Animesh Hazari , COLLEGE OF HEALTH SCIENCES, DEPARTMENT OF PHYSIOTHERAPY, GULF MEDICAL UNIVERSITY, AJMAN, United Arab Emirates 11 Sep 2025 Author Response The authors would like to express their sincere appreciation to the reviewers for their valuable insights and suggestions. These comments have improved our manuscript in terms of clarity, precision and ... Continue reading The authors would like to express their sincere appreciation to the reviewers for their valuable insights and suggestions. These comments have improved our manuscript in terms of clarity, precision and quality. Below, we have provided a response for each comment along with detailed explanations and indications of where the revisions were made. The responses have been underlined. Reviewer 1 Reviewer Comment Author Response Place of Correction 1. Abstract -Information regarding Ethics committee approval and informed consent should not be included in abstract Incorporated as suggested. These details have been removed from abstract. Abstract 2. Originality and Contribution to literature- The study’s originality and specific contribution to existing literature have not been articulated. The introduction has been improvised to clearly state that this is the first study examining prevalence of diabetes and its complications among security personnel in UAE. We have also emphasized the study’s novelty and its value in addressing occupational health gap Introduction, last two paragraphs 3. Relationship between Diabetes, Neuropathy and Security Personnel- The link between them not sufficient As suggested, we have elaborated on how security personnel are exposed to risk factors which can indirectly contribute to poor glycemic control and vascular complications. Introduction and Discussion 4. Statistical Methods- Regression analysis could strengthen the study As part of the graduate student research project, we stuck to the stated research hypothesis and performed the statistical analysis accordingly. The authors agree that Regression analysis would provide a deeper understanding to our topic. However, due to time constraints and lack of access to confounding variable data (e.g.: smoking, medication use, dietary intake), we were unable to perform the analysis. This limitation is now acknowledged in the article. Limitation and future recommendations 5. Discussion- First paragraph reiterates the results. Mean and standard deviation values to be kept in results instead The discussion has been revised to focus on interpretations and implications of the findings in context of existing literature. The mean and S.D values have been located in results. Results and discussion The authors would like to express their sincere appreciation to the reviewers for their valuable insights and suggestions. These comments have improved our manuscript in terms of clarity, precision and quality. Below, we have provided a response for each comment along with detailed explanations and indications of where the revisions were made. The responses have been underlined. Reviewer 1 Reviewer Comment Author Response Place of Correction 1. Abstract -Information regarding Ethics committee approval and informed consent should not be included in abstract Incorporated as suggested. These details have been removed from abstract. Abstract 2. Originality and Contribution to literature- The study’s originality and specific contribution to existing literature have not been articulated. The introduction has been improvised to clearly state that this is the first study examining prevalence of diabetes and its complications among security personnel in UAE. We have also emphasized the study’s novelty and its value in addressing occupational health gap Introduction, last two paragraphs 3. Relationship between Diabetes, Neuropathy and Security Personnel- The link between them not sufficient As suggested, we have elaborated on how security personnel are exposed to risk factors which can indirectly contribute to poor glycemic control and vascular complications. Introduction and Discussion 4. Statistical Methods- Regression analysis could strengthen the study As part of the graduate student research project, we stuck to the stated research hypothesis and performed the statistical analysis accordingly. The authors agree that Regression analysis would provide a deeper understanding to our topic. However, due to time constraints and lack of access to confounding variable data (e.g.: smoking, medication use, dietary intake), we were unable to perform the analysis. This limitation is now acknowledged in the article. Limitation and future recommendations 5. Discussion- First paragraph reiterates the results. Mean and standard deviation values to be kept in results instead The discussion has been revised to focus on interpretations and implications of the findings in context of existing literature. The mean and S.D values have been located in results. Results and discussion Competing Interests: No competing interests disclosed Close Report a concern COMMENT ON THIS REPORT Comments on this article Comments (0) Version 2 VERSION 2 PUBLISHED 12 Feb 2025 ADD YOUR COMMENT Comment keyboard_arrow_left keyboard_arrow_right Open Peer Review Reviewer Status info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions Reviewer Reports Invited Reviewers 1 2 3 4 5 Version 2 (revision) 29 Aug 25 read read read Version 1 12 Feb 25 read read Duygu Aktar Reyhanıoglu , Fenerbahce University, Istanbul, Turkey Kusnandar Anggadiredja , Bandung Institute of Technology, Bandung, Indonesia Wajida Perveen , Combined Military Hospital, Lahore Medical College, Lahore, Pakistan Mamatha Balachandra , Manipal Institute of Technology Manipal Academy of Higher Education, Manipal, India Marlon Yovera-Aldana , Universidad Cientifica del Sur, Lima, Peru Comments on this article All Comments (0) Add a comment Sign up for content alerts Sign Up You are now signed up to receive this alert Browse by related subjects keyboard_arrow_left Back to all reports Reviewer Report 0 Views copyright © 2026 Yovera-Aldana M. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 06 May 2026 | for Version 2 Marlon Yovera-Aldana , Universidad Cientifica del Sur, Lima, Peru 0 Views copyright © 2026 Yovera-Aldana M. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. format_quote Cite this report speaker_notes Responses (0) Not Approved info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions This manuscript explores the prevalence of diabetes mellitus (DM) and selected complications among security personnel, a population of potential interest in occupational health. However, the current version presents important methodological and analytical limitations that compromise the validity and interpretability of the findings. In particular, the study lacks clear operational definitions, consistency in measurement, and an appropriate analytical strategy. As a result, it does not adequately achieve its primary objective of evaluating the association between diabetes and its complications.. Introduction The introduction provides a general overview of diabetes and its complications, particularly DPN and PVD. However, this section largely reiterates well-established relationships and does not sufficiently justify the specific contribution of the study. The rationale for focusing on security personnel remains underdeveloped. Although occupational factors such as prolonged standing, irregular schedules, and shift work are mentioned, these are not integrated into a clear conceptual framework explaining how they may influence glycemic control, neuropathy, or vascular disease. The justification relies primarily on the absence of prior studies rather than on a well-defined hypothesis grounded in occupational or pathophysiological mechanisms. A more focused and hypothesis-driven introduction is needed to support the relevance of the research question. Methods The classification of diabetes mellitus appears to rely on recent laboratory values provided by participants. However, it is unclear how individuals with known diabetes under treatment were handled. This approach may lead to misclassification, particularly in cases of controlled disease, and limits the validity of the exposure definition. The assessment of diabetic peripheral neuropathy is insufficiently defined. Multiple instruments were used (monofilament, MNSI, vibration perception threshold, DN4), but the manuscript does not specify how these were integrated into a single diagnostic framework. It is unclear whether a participant was classified as having DPN based on a single abnormal test, a combination of findings, or a predefined threshold. The inclusion of DN4, which evaluates neuropathic pain rather than neuropathy itself, further complicates interpretation if used as a diagnostic criterion. The absence of a clear operational definition introduces a high risk of misclassification. The methodology for ABI measurement also lacks clarity. Although bilateral measurements were obtained and averaged, this approach does not follow standard clinical practice, where ABI is typically interpreted per limb using the highest ankle pressure. The lack of detail regarding arterial sites and calculation procedures limits the interpretability of vascular findings. In addition, it is not consistently specified whether all assessments were applied to both diabetic and non-diabetic participants, which complicates the interpretation of prevalence and subsequent analyses. Finally, the use of convenience sampling and the limited representativeness of the sample introduce potential selection bias and limit generalizability. Statistical analysis The use of Pearson correlation to assess the relationship between diabetes and its complications is not appropriate for the variables involved. Even if the MNSI score is used as a continuous measure for neuropathy, diabetes remains a categorical variable. If a numerical coding (e.g., 0/1) was used, this should be explicitly described and justified, as correlation is not the most suitable method to evaluate such relationships. Correlations are reported separately in diabetic and non-diabetic groups, which renders interpretation unclear. Within each subgroup, the variable “diabetes” is constant, and therefore the reported coefficients cannot meaningfully represent an association with diabetes. It is not evident what variables are being correlated or what the reported values represent. Although regression-based methods would be more appropriate to evaluate associations and account for confounding, the current sample size—particularly the small number of diabetic participants—precludes their reliable application. Any multivariable analysis would be underpowered and unstable, with a high risk of overfitting. This limitation is central: the study is not adequately designed, in terms of both sample size and analytical strategy, to address its primary objective of evaluating associations. At best, the data support descriptive or exploratory analyses, but not inferential conclusions. Results The reported prevalence of DPN and PVD is uncertain due to the lack of a standardized diagnostic definition. The use of multiple screening tools without a clear classification criterion introduces potential misclassification, reducing confidence in these estimates. The interpretation of ABI findings is also problematic. While the mean ABI is within normal range, the manuscript suggests early vascular changes based on statistical associations. Without reporting clinically meaningful categories or abnormal values, this interpretation is not adequately supported. Additionally, neuropathic findings are reported in non-diabetic participants, but their significance is not discussed. This raises concerns regarding the specificity of the instruments used and highlights the need for a clearer diagnostic framework. The small number of diabetic participants further limits the robustness of the findings and increases the likelihood of unstable estimates. Discussion The manuscript interprets correlation coefficients as evidence of meaningful associations and suggests increased risk in this occupational group. However, given the lack of clarity and appropriateness of the analytical approach, these interpretations are not justified. In addition, the discussion occasionally implies causal relationships or disease progression, which cannot be inferred from a cross-sectional design. A more cautious interpretation, aligned with the limitations of the data and methods, is required. Conclusion Given the unclear variable definitions, methodological limitations, and the inability to appropriately evaluate associations, the findings should be considered exploratory. Importantly, the study is not sufficiently powered or methodologically structured to achieve its stated objective. Any statements regarding associations, risk, or implications for occupational health should be tempered accordingly. While the topic is relevant, the manuscript presents fundamental methodological and analytical limitations that preclude a valid interpretation of the main findings. In its current form, the study does not achieve its primary objective Is the work clearly and accurately presented and does it cite the current literature? Partly Is the study design appropriate and is the work technically sound? No Are sufficient details of methods and analysis provided to allow replication by others? Partly If applicable, is the statistical analysis and its interpretation appropriate? No Are all the source data underlying the results available to ensure full reproducibility? Partly Are the conclusions drawn adequately supported by the results? No Competing Interests No competing interests were disclosed. Reviewer Expertise Endocrinology, diabetes, clinical epidemiology, and research methodology I confirm that I have read this submission and believe that I have an appropriate level of expertise to state that I do not consider it to be of an acceptable scientific standard, for reasons outlined above. reply Respond to this report Responses (0) Yovera-Aldana M. Peer Review Report For: Prevalence of Diabetes Mellitus and its Association with Diabetic Peripheral Neuropathy, Peripheral Vascular Disorder among Security Personnel in United Arab Emirates [version 2; peer review: 1 approved, 2 approved with reservations, 2 not approved] . F1000Research 2025, 14 :190 ( https://doi.org/10.5256/f1000research.184045.r426401) NOTE: it is important to ensure the information in square brackets after the title is included in this citation. The direct URL for this report is: https://f1000research.com/articles/14-190/v2#referee-response-426401 keyboard_arrow_left Back to all reports Reviewer Report 0 Views copyright © 2025 Balachandra M. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 22 Nov 2025 | for Version 2 Mamatha Balachandra , Manipal Institute of Technology Manipal Academy of Higher Education, Manipal, Karnataka, India 0 Views copyright © 2025 Balachandra M. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. format_quote Cite this report speaker_notes Responses (0) Approved With Reservations info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions Comments to the Author The statistical analysis and its interpretation require improvement. It would be helpful to include the relevant equations, parameters, and analytical steps to provide a clearer and more rigorous explanation of the statistical methods used. In the conclusion, the statement: “The results indicate that there was a statistically significant association between diabetes mellitus and its complications PVD and DPN, which underscores the necessity of implementing occupational health measures along with preventive strategies for the targeted population.” Please provide a clear justification for this statement, preferably with supporting data or references to the results presented. In the methodology section, consider illustrating the process using a block diagram or flowchart. This will enhance readability and help the reader better understand the sequence of steps involved, rather than relying solely on textual description. Is the work clearly and accurately presented and does it cite the current literature? Yes Is the study design appropriate and is the work technically sound? Partly Are sufficient details of methods and analysis provided to allow replication by others? Partly If applicable, is the statistical analysis and its interpretation appropriate? Partly Are all the source data underlying the results available to ensure full reproducibility? Partly Are the conclusions drawn adequately supported by the results? Partly Competing Interests No competing interests were disclosed. Reviewer Expertise Wireless Ad hoc Networks, Internet of Things, IoT Security I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard, however I have significant reservations, as outlined above. reply Respond to this report Responses (0) Balachandra M. Peer Review Report For: Prevalence of Diabetes Mellitus and its Association with Diabetic Peripheral Neuropathy, Peripheral Vascular Disorder among Security Personnel in United Arab Emirates [version 2; peer review: 1 approved, 2 approved with reservations, 2 not approved] . F1000Research 2025, 14 :190 ( https://doi.org/10.5256/f1000research.184045.r426407) NOTE: it is important to ensure the information in square brackets after the title is included in this citation. The direct URL for this report is: https://f1000research.com/articles/14-190/v2#referee-response-426407 keyboard_arrow_left Back to all reports Reviewer Report 0 Views copyright © 2025 Perveen W. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 03 Nov 2025 | for Version 2 Wajida Perveen , Combined Military Hospital, Lahore Medical College, Lahore, Pakistan 0 Views copyright © 2025 Perveen W. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. format_quote Cite this report speaker_notes Responses (0) Approved info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions the study title is appropriate, self explanatory and can stand alone. the abstract gives sufficient reflection of the full text. the study design is simple and clear. the methodology included all necessary components and it can be replicated. although sample size is a bit small, but study results may be generalized to a larger population. Ethical aspects are taken care of well. Results are clearly presented and prepared with reasonable statistical tests. The findings are discussed, compared and contrasted with the identification of limitations and future recommendations Is the work clearly and accurately presented and does it cite the current literature? Yes Is the study design appropriate and is the work technically sound? Yes Are sufficient details of methods and analysis provided to allow replication by others? Yes If applicable, is the statistical analysis and its interpretation appropriate? Yes Are all the source data underlying the results available to ensure full reproducibility? Partly Are the conclusions drawn adequately supported by the results? Yes Competing Interests No competing interests were disclosed. Reviewer Expertise Physical therapy, sports, Neuropathy I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard. reply Respond to this report Responses (0) Perveen W. Peer Review Report For: Prevalence of Diabetes Mellitus and its Association with Diabetic Peripheral Neuropathy, Peripheral Vascular Disorder among Security Personnel in United Arab Emirates [version 2; peer review: 1 approved, 2 approved with reservations, 2 not approved] . F1000Research 2025, 14 :190 ( https://doi.org/10.5256/f1000research.184045.r424577) NOTE: it is important to ensure the information in square brackets after the title is included in this citation. The direct URL for this report is: https://f1000research.com/articles/14-190/v2#referee-response-424577 keyboard_arrow_left Back to all reports Reviewer Report 0 Views copyright © 2025 Anggadiredja K. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 26 May 2025 | for Version 1 Kusnandar Anggadiredja , Bandung Institute of Technology, Bandung, Indonesia 0 Views copyright © 2025 Anggadiredja K. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. format_quote Cite this report speaker_notes Responses (1) Approved With Reservations info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions Major issues The use of term 'such as' (Aim) makes the title of this paper a bit 'uncertain'. Authors need to be firmed on whether DPN is the exact factor being investigated in the present study. In introduction, authors should consider that the health issues related to prolonged standing position are usually related to musculoskeletal and cardiovascular disorders. Authors need to present references tied to diabetic consequences. For the association results as presented in Table 4, which % of DPN is used to calculate the association?, since there are four related numbers in Table 3 Data presentation need revision: Fig 1: what is the difference between the filled and empty circles? Table 1: this is not descriptive statistics but demographic data Fig 2.1: the title “Gender” is not necessary, it is described in the Fig caption. Fig caption should not be started with a verb, please rephrase the caption. Fig 2.2: the title “AREA” is not necessary, it is described in the Fig caption. Fig caption should not be started with a verb, please rephrase the caption. Table 2 and 3: the symbol % is not necessary Minor issues : consistency be consistent 'security personnel' or 'security guard' '…mentioned in Table 3' is considered inappropriate, better use other term, such as '…presented in Table 3' Is the work clearly and accurately presented and does it cite the current literature? Partly Is the study design appropriate and is the work technically sound? Partly Are sufficient details of methods and analysis provided to allow replication by others? Partly If applicable, is the statistical analysis and its interpretation appropriate? Partly Are all the source data underlying the results available to ensure full reproducibility? No source data required Are the conclusions drawn adequately supported by the results? Partly Competing Interests No competing interests were disclosed. I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard, however I have significant reservations, as outlined above. reply Respond to this report Responses (1) Author Response 11 Sep 2025 Animesh Hazari, COLLEGE OF HEALTH SCIENCES, DEPARTMENT OF PHYSIOTHERAPY, GULF MEDICAL UNIVERSITY, AJMAN, United Arab Emirates The authors would like to express their sincere appreciation to the reviewers for their valuable insights and suggestions. These comments have improved our manuscript in terms of clarity, precision and quality. Below, we have provided a response for each comment along with detailed explanations and indications of where the revisions were made. The responses have been underlined. Reviewer 2 Reviewer Comment Author Response Place of Correction 1. Title and Aim- The use of ‘such as’ makes the aim uncertain The phrase ‘such as’ has now been removed from both title and aim. Title and Abstract 2. Introduction- provide references connecting prolonged standing to diabetic consequences We have included recent studies that support the link between prolonged standing and impaired vascular shear rate, postprandial hyperglycemia and reduced balance and stability, all of which are relevant to the pathogenesis to diabetic peripheral neuropathy and peripheral vascular disorders. Introduction 3. Clarify which percent was used to calculate the association in table 4 The MNSI Score was used as the continuous variable to calculate the correlation between diabetes and diabetic peripheral neuropathy in table 4. This is now explicitly mentioned in the results section Results, final paragraph 4. Figure 1: empty vs filled circles The filled circles represent the standard testing sites and empty represent additional optional sites. A note has been added in figure captions explaining the same. Figure 1 captions 5. Table 1: Demographic data, not descriptive stats Retitled, as suggested Table 1 6. Fig 2.1 and 2.2- Remove internal titles, avoid starting with verbs Incorporated as suggested Figure 2.1 and 2.2 captions 7. Table 2 and 3, remove % symbol Incorporated as suggested Tables 2 and 3 8. Language consistency The term ‘’security personnel’’ is now used consistently throughout the article. Whole article 9. Avoid ‘mentioned in table’ phrasing Incorporated as suggested Results and discussion View more View less Competing Interests No competing interests disclosed reply Respond Report a concern Anggadiredja K. Peer Review Report For: Prevalence of Diabetes Mellitus and its Association with Diabetic Peripheral Neuropathy, Peripheral Vascular Disorder among Security Personnel in United Arab Emirates [version 2; peer review: 1 approved, 2 approved with reservations, 2 not approved] . F1000Research 2025, 14 :190 ( https://doi.org/) NOTE: it is important to ensure the information in square brackets after the title is included in this citation. The direct URL for this report is: https://f1000research.com/articles/14-190/v1#referee-response-378917 keyboard_arrow_left Back to all reports Reviewer Report 0 Views copyright © 2025 Reyhanıoglu D. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 26 May 2025 | for Version 1 Duygu Aktar Reyhanıoglu , Fenerbahce University, Istanbul, Turkey 0 Views copyright © 2025 Reyhanıoglu D. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. format_quote Cite this report speaker_notes Responses (1) Not Approved info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions · Abstract Section: Information regarding ethics committee approval and informed consent should not be included in the abstract. Such details are more appropriately placed in the methodology section. · Originality and Contribution to the Literature: The study’s originality and its specific contribution to the existing literature have not been clearly articulated. It is important to explicitly state what new insight this research offers and how it adds value to current knowledge. · Relationship Between Diabetes, Neuropathy, and Security Personnel: The association between diabetes and neuropathy is well-established in the literature. However, the link between these conditions and being a security officer is not sufficiently clarified. It should be addressed whether being a security officer constitutes a risk factor for diabetic peripheral neuropathy (DPN). Furthermore, the clinical relevance of the reported mean values should be discussed: are they within the expected range, above, or below population norms? · Statistical Methods: Using regression analysis could strengthen the study by better clarifying whether being a security officer is associated with an increased risk of diabetes or DPN. This would enhance the validity and interpretability of the findings. · Discussion Section: The first paragraph of the discussion largely reiterates the results. The mean and standard deviation values presented here should be relocated to the results section. The discussion should instead focus on the most significant findings of the study, interpreting their implications and comparing them with the existing literature. Is the work clearly and accurately presented and does it cite the current literature? Yes Is the study design appropriate and is the work technically sound? No Are sufficient details of methods and analysis provided to allow replication by others? Yes If applicable, is the statistical analysis and its interpretation appropriate? Yes Are all the source data underlying the results available to ensure full reproducibility? Yes Are the conclusions drawn adequately supported by the results? No Competing Interests No competing interests were disclosed. Reviewer Expertise Diabetic Neuropathy I confirm that I have read this submission and believe that I have an appropriate level of expertise to state that I do not consider it to be of an acceptable scientific standard, for reasons outlined above. reply Respond to this report Responses (1) Author Response 11 Sep 2025 Animesh Hazari, COLLEGE OF HEALTH SCIENCES, DEPARTMENT OF PHYSIOTHERAPY, GULF MEDICAL UNIVERSITY, AJMAN, United Arab Emirates The authors would like to express their sincere appreciation to the reviewers for their valuable insights and suggestions. These comments have improved our manuscript in terms of clarity, precision and quality. Below, we have provided a response for each comment along with detailed explanations and indications of where the revisions were made. The responses have been underlined. Reviewer 1 Reviewer Comment Author Response Place of Correction 1. Abstract -Information regarding Ethics committee approval and informed consent should not be included in abstract Incorporated as suggested. These details have been removed from abstract. Abstract 2. Originality and Contribution to literature- The study’s originality and specific contribution to existing literature have not been articulated. The introduction has been improvised to clearly state that this is the first study examining prevalence of diabetes and its complications among security personnel in UAE. We have also emphasized the study’s novelty and its value in addressing occupational health gap Introduction, last two paragraphs 3. Relationship between Diabetes, Neuropathy and Security Personnel- The link between them not sufficient As suggested, we have elaborated on how security personnel are exposed to risk factors which can indirectly contribute to poor glycemic control and vascular complications. Introduction and Discussion 4. Statistical Methods- Regression analysis could strengthen the study As part of the graduate student research project, we stuck to the stated research hypothesis and performed the statistical analysis accordingly. The authors agree that Regression analysis would provide a deeper understanding to our topic. However, due to time constraints and lack of access to confounding variable data (e.g.: smoking, medication use, dietary intake), we were unable to perform the analysis. This limitation is now acknowledged in the article. Limitation and future recommendations 5. Discussion- First paragraph reiterates the results. Mean and standard deviation values to be kept in results instead The discussion has been revised to focus on interpretations and implications of the findings in context of existing literature. The mean and S.D values have been located in results. Results and discussion View more View less Competing Interests No competing interests disclosed reply Respond Report a concern Reyhanıoglu DA. Peer Review Report For: Prevalence of Diabetes Mellitus and its Association with Diabetic Peripheral Neuropathy, Peripheral Vascular Disorder among Security Personnel in United Arab Emirates [version 2; peer review: 1 approved, 2 approved with reservations, 2 not approved] . F1000Research 2025, 14 :190 ( https://doi.org/10.5256/f1000research.177573.r378911) NOTE: it is important to ensure the information in square brackets after the title is included in this citation. 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