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

Abstract

Aims/IntroductionPainful diabetic peripheral neuropathy (PDPN) has a significant impact on the patient's quality of life. The prevalence of PDPN in the Middle East and North Africa region has been reported to be almost double that of populations in the UK. We sought to determine the prevalence of PDPN and its associated factors in type 2 diabetes mellitus patients attending secondary care in Qatar.Materials and MethodsThis was a cross‐sectional study of 1,095 participants with type 2 diabetes mellitus attending Qatar's two national diabetes centers. PDPN and impaired vibration perception on the pulp of the large toes were assessed using the Douleur Neuropathique en 4 questionnaire with a cut‐off ≥4 and the neurothesiometer with a cut‐off ≥15 V, respectively.ResultsThe prevalence of PDPN was 34.5% (95% confidence interval [CI] 31.7–37.3), but 80% of these patients had not previously been diagnosed or treated for this condition. Arabs had a higher prevalence of PDPN compared with South Asians (P < 0.05). PDPN was associated with impaired vibration perception adjusted odds ratio (AOR) 4.42 (95% CI 2.92–6.70), smoking AOR 2.43 (95% CI 1.43–4.15), obesity AOR 1.74 (95% CI 1.13–2.66), being female AOR 1.65 (95% CI: 1.03–2.64) and duration of diabetes AOR 1.08 (95% CI 1.05–1.11). Age, poor glycemic control, hypertension, physical activity and proteinuria showed no association with PDPN.ConclusionsPDPN occurs in one‐third of type 2 diabetes mellitus patients attending secondary care in Qatar, but the majority have not been diagnosed. Arabs are at higher risk for PDPN. Impaired vibration perception, obesity and smoking are associated with PDPN in Qatar.

Prevalence and management of diabetic neuropathy in secondary care in Qatar

“…Previously diagnosed DN was self‐reported. PDN was diagnosed using the Douleur Neuropathique en 4 (DN4) questionnaire as previously described …”

“…Diabetic neuropathy (DN) imposes a significant health and economic burden to both the patient and health care providers . DN leads to painful diabetic neuropathy (PDN) in 18% to 65%, erectile dysfunction in 53% to 73%, and diabetic foot ulcers in 2% to 17% of patients with type 2 diabetes mellitus (T2DM). One in four patients with a diabetic foot ulcer is at risk of amputation .…”

Diagnosing peripheral neuropathy in South‐East Asia: A focus on diabetic neuropathy

“…Alternatively, simple questionnaires, such as the Douleur Neuropathique 4, can be used to differentiate neuropathic pain from nociceptive pain based on seven interview questions, assessment of hypoesthesia to touch and pinprick, and the presence of allodynia 49,50 .…”

Diabetic peripheral neuropathy in people with type 2 diabetes: too little too late

“…In the MONICA/KORA Augsburg cohort from Germany, the prevalence of painful neuropathy in people with diabetes was two to three times that of people without diabetes . In a recent study from Qatar we showed that the prevalence of painful DPN was 34.5%, but 80% of participants had not previously been diagnosed or treated for DPN . Furthermore, the Arab population had the highest prevalence of painful DPN, and it was associated with smoking, obesity and being female.…”