Prevalence and characteristics of painful diabetic neuropathy in a large community-based diabetic population in the U.K.

TLDR: One-third of all community-based diabetic patients have painful neuropathic symptoms, regardless of their neuropathic deficit, which highlights a significant morbidity due to painful neuropathy and identifies key groups who warrant screening for PDN.

Abstract: OBJECTIVE To assess, in the general diabetic population, 1 ) the prevalence of painful neuropathic symptoms; 2 ) the relationship between symptoms and clinical severity of neuropathy; and 3 ) the role of diabetes type, sex, and ethnicity in painful neuropathy. RESEARCH DESIGN AND METHODS Observational study of a large cohort of diabetic patients receiving community-based health care in northwest England ( n = 15,692). Painful diabetic neuropathy (PDN) was assessed using neuropathy symptom score (NSS) and neuropathy disability score (NDS). RESULTS Prevalence of painful symptoms (NSS ≥5) and PDN (NSS ≥5 and NDS ≥3) was 34 and 21%, respectively. Painful symptoms occurred in 26% of patients without neuropathy (NDS ≤2) and 60% of patients with severe neuropathy (NDS >8). Adjusted risk of painful neuropathic symptoms in type 2 diabetes was double that of type 1 diabetes (odds ratio [OR] = 2.1 [95% CI 1.7–2.4], P P P P P CONCLUSIONS One-third of all community-based diabetic patients have painful neuropathy symptoms, regardless of their neuropathic deficit. PDN was more prevalent in patients with type 2 diabetes, women, and people of South Asian origin. This highlights a significant morbidity due to painful neuropathy and identifies key groups who warrant screening for PDN.