The Dos and Don'ts of Painful Diabetic Peripheral Neuropathy : Primary Care Guidelines for the Middle East and North Africa

Abstract

Background: Diabetes mellitus (DM) is becoming increasingly common in developing countries and is of major concern in the Middle East and North Africa (MENA). Since at least 30% of diabetic patients may develop painful diabetic peripheral neuropathy (pDPN) within their lifetime, there is an urgent need to increase awareness of the condition among physicians in the region.Objectives: To increase awareness of physicians in the Middle East and North Africa of the increasing prevalence of DM and pDPN and to provide practical consensus recommendations to facilitate the diagnosis and management of pDPN.Methods: A panel of family medicine physicians was convened in Dubai to discuss current awareness of pDPN in the region and to develop consensus statements based on a review of meta-analyses, systematic reviews, and evidence-based guidelines on the screening, diagnosis and management of pDPN.Recommendations: The panel recommends that all patients with diabetes be screened at least annually for symptoms of neuropathic pain using screening tools such as the Doleur Neuropathique en 4 Questions (DN4) as well as thorough examination of the patient's feet. Treatment should aim to achieve a clinically meaningful reduction in pain using first-line agents including pregabalin, duloxetine or tricyclic antidepressants.Conclusion: pDPN is common but under-diagnosed and inadequately treated in the Middle East and North Africa. Physicians in the region are encouraged to implement screening for pDPN and manage patients according to published guidelines.

Management of neuropathic pain in patients with diabetic peripheral neuropathy and low back pain in Saudi Arabia: Evidence and gaps

“…Doleur Neuropathique en 4 Questions [DN4]), a thorough examination of feet for ulcers in patients with diabetes, and the treatment goal of achieving a clinically meaningful pain reduction using first-line agents. [ 45 ]…”

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

“…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 ]…”