Painful Diabetic Neuropathy as a Cause for Refractory Ear Pain in Type 2 Diabetic Patients

Abstract

ObjectiveTo assess painful diabetic neuropathy (PDN) as a cause for refractory ear pain in type 2 diabetics.DesignAn observational prospective case series study.SettingOtolaryngology departments of tertiary referral hospitals from November 2019 to January 2021.PatientsSixty-eight patients with type 2 diabetes with refractory ear pain of more than 1-month duration not responding to the routine analgesics.InterventionDiagnostic intervention.Main Outcome MeasureThe primary outcome measure was the prevalence of painful diabetic neuropathy among different causes of ear pain in the study sample of type II diabetics with refractory ear pain with an assessment of the response of these cases to routine neuropathic pain treatment with pregabalin.ResultsFifteen out of 68 (22.1%) were diagnosed as having painful diabetic neuropathy based on the “Douleur Neuropathique en 4 Questions” (DN4) questionnaire with its mean value being 6.47±1.19. There was a highly significant improvement of the 10 items of painful diabetic neuropathy scales after 1 month of treatment (p < 0.001 for all). There was a significant positive correlation between the Hemoglobin A1c level and duration of diabetes at one hand and intensity of pain derived from the painful diabetic neuropathy scale at the other hand (p = 0.0002, and p = 0.032 respectively).ConclusionPainful diabetic neuropathy showed a potential correlation with refractory ear pain in type II diabetic patients with significant improvement after painful diabetic neuropathy treatment. Further studies are needed to confirm these findings.