A cross-sectional study to estimate the point prevalence of painful diabetic neuropathy in Eastern Libya

Abstract

BackgroundPainful Diabetic Neuropathy (PDN) is a complication that affects up to one third of people living with diabetes. There is limited data on the prevalence of PDN from countries in the Middle East and North Africa. The aim of this study was to estimate the point prevalence of PDN in adults in Eastern Libya using the self-report Leeds Assessment of Neuropathic Symptoms and Signs (S-LANSS) pain scale.MethodsWe invited patients attending the Benghazi Diabetes Centre who had diabetes for ≥ 5 years to take part in the study. Patients provided consent and completed the Arabic S-LANSS. Anthropometrics, marital status, socioeconomic and education information was recoded and fasting plasma glucose concentration determined.ResultsFour hundred and fifty participants completed the study (age = 19 to 87 years, BMI = 17.6 to 44.2 kg/m2, 224 women). One hundred and ninety five participants (43.3%) reported pain in their lower limbs in the previous 6 months and 190/195 participants (97.4%) reported a S-LANSS score of ≥ 12 suggesting they had neuropathic pain characteristics. Thus, 42.2% (190/450) of participants with diabetes were categorised as experiencing pain with neuropathic characteristics. Mean ± SD duration of diabetes for participants with PDN (20.4 ± 6.5 years) was significantly higher compared with those without PDN (11.1 ± 4.6 years). Participants with PDN smoked tobacco for more years than those without pain (7.9 ± 12.3 years versus 1.1 ± 3.9 years respectively); had significantly higher fasting plasma glucose concentration (143.6 ± 29.3 mg/dl versus 120.0 ± 17.3 mg/dl) and had a significantly higher levels of education and employment status. The most significant predictors of PDN were duration of diabetes (OR = 25.85, 95% CI = 13.56–49.31), followed by smoking for men (OR = 8.28, 95% CI = 3.53–9.42), obesity (OR = 3.96, 95% CI = 2.25–6.96) and high fasting plasma glucose concentration (OR = 3.51, 95% CI = 1.99–6.21).ConclusionThe prevalence of PDN in people with diabetes in Eastern Libya was 42.2%. Risk factors for developing PDN were high fasting plasma glucose concentration, long duration of diabetes, and higher level of educational and employment status.Electronic supplementary materialThe online version of this article (10.1186/s12889-018-6374-9) contains supplementary material, which is available to authorized users.

A Study on Peripheral Neuropathy and Its Related Risk Factors Associated With hba1c Levels

“…In a research by Van Acker et al (2009) in Belgium, 14% of the patients had lower limb neuropathic pain. In another report, 42.2% of diabetics in Eastern Libya had PDN, with age being a risk factor (Garoushi et al 2019). In Saudi Arabia, 65.3% of people have PDN (Halawa et al 2010).…”

Prevalence of painful diabetic peripheral neuropathy and its impact on quality of life among diabetic patients in Western region, Saudi Arabia

“…They ranged between 13.7% in Iran,[ 16 ] 32.2% in Kuwait,[ 17 ] 23% in Turkey,[ 18 ] and 53.7% among Egyptian, Lebanese and Jordanian patients,[ 19 ] and 42.2% in Libya. [ 20 ] Similar picture in terms of PDNP point prevalence emerged among international surveys. Proportion of DM patients who developed PDPN was 44.5% in Nigeria[ 21 ] and 30.6% in Taiwan[ 22 ] for instance.…”

“…Our results tally well with regional and international studies as the longer duration of diabetes increase PDNP susceptibility. [ 8 20 31 32 33 34 35 ]…”

A randomized control trial of duloxetine and gabapentin in painful diabetic neuropathy

“…PDN is a common diabetes complication; as many as one third of diabetic individuals are affected around the world. 14 Evidence-based guidelines recommend pregabalin, gabapentin, and duloxetine for management of pain in PDN as first-line treatment. 15 The current study evaluated the clinical effectiveness of gabapentin with duloxetine in PDN patients.…”