Prevalence and risk factors for diabetic neuropathy and painful diabetic neuropathy in primary and secondary healthcare in Qatar

Abstract

Aims/Introduction: This study determined the prevalence and risk factors for diabetic peripheral neuropathy (DPN) and painful DPN (pDPN) in patients with type 2 diabetes in primary healthcare (PHC) and secondary healthcare (SHC) in Qatar. Materials and Methods: This was a cross-sectional multicenter study. Adults with type 2 diabetes were randomly enrolled from four PHC centers and two diabetes centers in SHC in Qatar. Participants underwent assessment of clinical and metabolic parameters, DPN and pDPN. Results: A total of 1,386 individuals with type 2 diabetes (297 from PHC and 1,089 from SHC) were recruited. The prevalence of DPN (14.8% vs 23.9%, P = 0.001) and pDPN (18.1% vs 37.5%, P < 0.0001) was significantly lower in PHC compared with SHC, whereas those with DPN at high risk for diabetic foot ulceration (31.8% vs 40.0%, P = 0.3) was comparable. The prevalence of undiagnosed DPN (79.5% vs 82.3%, P = 0.66) was comparably high, but undiagnosed pDPN (24.1% vs 71.5%, P < 0.0001) was lower in PHC compared with SHC. The odds of DPN and pDPN increased with age and diabetes duration, and DPN increased with poor glycemic control, hyperlipidemia and hypertension, whereas pDPN increased with obesity and reduced physical activity. Conclusions: The prevalence of DPN and pDPN in type 2 diabetes is lower in PHC compared with SHC, and is attributed to overall better control of risk factors and referral bias due to patients with poorly managed complications being referred to SHC. However, approximately 80% of patients had not been previously diagnosed with DPN in PHC and SHC. Furthermore, we identified a number of modifiable risk factors for PDN and pDPN.

Correlation Between Hemoglobin Glycosylation Index and Nerve Conduction Velocity in Patients with Type 2 Diabetes Mellitus

“…Late diagnosis of DN can lead to significant morbidity in the form of diabetic foot ulceration and amputation and increased mortality. 5 Therefore, it is recommended that all patients should be screened for DN when T2DM is diagnosed. 6 Peripheral nerve conduction velocity (NCV) detection is the most sensitive, accurate and reliable method for diagnosing DN.…”

Painful Diabetic Peripheral Neuropathy Study of Chinese Outpatients (PDNSCOPE): A Multicentre Cross-Sectional Registry Study of Clinical Characteristics and Treatment in Mainland China

“…Fasting plasma glucose was demonstrated to be an independent factor associated with PDN in a previous study [21]. Some studies have indicated that poor glycaemic control was not associated with PDN [26,37], whereas other studies found that HbA1C and pain severity were associated [14]. An interesting discovery from the SCOPE research is that differences in blood glucose level parameters impact on pain severity between newly diagnosed PDN and participants with a previous diagnosis.…”

Screening, diagnosis and management of diabetic sensorimotor polyneuropathy in clinical practice: International expert consensus recommendations

“…In a German educational initiative, painful and painless DSPN were previously undiagnosed in 57 and 82% of the participants with type 2 diabetes, respectively 17 . Likewise, in cross-sectional studies in Qatar, 80% of type 2 diabetes patients with DSPN reported that they had previously not been diagnosed with or treated for this condition 18,19 . Underdiagnosis and hence underestimation of DSPN was also frequent in South-East Asia, possibly due to a lack of consensus on screening and diagnostic procedures 20 .…”