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Prevalence of peripheral neuropathy and associated pain in patients with diabetes mellitus: Evidence from a cross-sectional study

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Abstract

Background

Diabetic peripheral neuropathy (DPN) is the most common and troublesome complication of diabetes mellitus. It affects almost half the population with diabetes and worsens quality of life of the patient. This study was aimed to determine the prevalence of peripheral neuropathy and associated pain in patients with diabetes mellitus.

Methods

This was a cross-sectional study conducted over a period of six months. Patient’s ≥ 18 years with confirmed diagnosis of diabetes mellitus were included in the study. Patients with hypothyroidism, medical illness such as cancer, liver or renal disease, cervical or lumbar spondylosis, pregnant patients with diabetes and patients receiving any treatment that might influence nerve function (e.g., cytotoxic or antiepileptic agents) were excluded from the study. DPN was diagnosed using 10 g monofilament test. The S-LANSS questionnaire was used to assess the associated painful symptoms. Association was calculated using chi-square test. A p- value of ≤0.05 was considered statistically significant. All the statistical analysis was performed using SPSS v22.

Result

The overall prevalence of DPN was found to be 28.85% from which 88% patients were found to have painful symptoms. A significant association of DPN was observed with the duration of diabetes (p = 0.004), poor glycaemic control (p = 0.03) and other diabetic complications such as nephropathy (p = 0.002). No association of neuropathy was found with retinopathy and hypertension. Duration of diabetes (>15 years), and HbA1c (>9%) was found to be positively associated the painful DPN.

Conclusion

The current study found a high prevalence of DPN and it was found to be significantly associated with duration of diabetes, poor glycaemic control and nephropathy.

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References

  1. Zychowska M, Rojewska E, Przewlocka B, Mika J. Mechanisms and pharmacology of diabetic neuropathy–experimental and clinical studies. Pharmacol Rep. 2013;65:1601–10.

    Article  CAS  Google Scholar 

  2. Diabetes Facts and Figures. International Diabetes Federation. Available at: https://www.idf.org/aboutdiabetes/what-is-diabetes/facts-figures.html. Accessed on 20th April 2020.

  3. Hussain S, Habib A, Najmi AK. Anemia prevalence and its impact on health-related quality of life in Indian diabetic kidney disease patients: evidence from a cross-sectional study. Journal of Evidence-Based Medicine. 2019;12:243–52.

    Article  Google Scholar 

  4. Hussain S, Habib A, Singh A, Akhtar M, Najmi AK. Prevalence of depression among type 2 diabetes mellitus patients in India: a meta-analysis. Psychiatry Res. 2018;270:264–73.

    Article  Google Scholar 

  5. Hussain S, Jamali MC, Habib A, et al. Diabetic kidney disease: an overview of prevalence, risk factors, and biomarkers. Clinical Epidemiology and Global Health. 2020. https://doi.org/10.1016/j.cegh.2020.05.016.

  6. Abbott CA, Malik RA, van Ross ER, et al. Prevalence and characteristics of painful diabetic neuropathy in a large community-based diabetic population in the UK. Diabetes Care. 2011;34:2220–4.

    Article  Google Scholar 

  7. Chaplin S. ADA position statement on diabetic neuropathy. Prescriber. 2017;28:39–40.

    Article  Google Scholar 

  8. Vinik AI, Nevoret M-L, Casellini C, Parson H. Diabetic neuropathy. Endocrinol Metab Clin. 2013;42:747–87.

    Article  Google Scholar 

  9. Dyck PJ, Kratz K, Karnes J, et al. The prevalence by staged severity of various types of diabetic neuropathy, retinopathy, and nephropathy in a population-based cohort the Rochester diabetic neuropathy study. Neurology. 1993;43:817–7.

  10. Aslam A, Singh J, Rajbhandari S. Pathogenesis of painful diabetic neuropathy. Pain Res Treat. 2014;2014:1–7.

    Article  Google Scholar 

  11. Pop-Busui R, Boulton AJ, Feldman EL, et al. Diabetic neuropathy: a position statement by the American Diabetes Association. Diabetes Care. 2017;40:136–54.

    Article  CAS  Google Scholar 

  12. Marks JB. The forgotten complication. Clinical Diabetes. 2005;23:3–4.

    Article  Google Scholar 

  13. Pradeepa R, Rema M, Vignesh J, Deepa M, Deepa R, Mohan V. Prevalence and risk factors for diabetic neuropathy in an urban south Indian population: the Chennai urban rural epidemiology study (CURES-55). Diabet Med. 2008;25:407–12.

    Article  CAS  Google Scholar 

  14. Dros J, Wewerinke A, Bindels PJ, van Weert HC. Accuracy of monofilament testing to diagnose peripheral neuropathy: a systematic review. The Annals of Family Medicine. 2009;7:555–8.

    Article  Google Scholar 

  15. Yang Z, Chen R, Zhang Y, et al. Scoring systems to screen for diabetic peripheral neuropathy. Cochrane Database of Systematic Reviews. 2014.

  16. Bansal V, Kalita J, Misra U. Diabetic neuropathy. Postgrad Med J. 2006;82:95–100.

    Article  CAS  Google Scholar 

  17. Yoo M, D'silva LJ, Martin K, et al. Pilot study of exercise therapy on painful diabetic peripheral neuropathy. Pain Med. 2015;16:1482–9.

    Article  Google Scholar 

  18. Barrett AM, Lucero MA, Le T, et al. Epidemiology, public health burden, and treatment of diabetic peripheral neuropathic pain: a review. Pain Med. 2007;8:S50–62.

    Article  Google Scholar 

  19. Sadosky A, Schaefer C, Mann R, et al. Burden of illness associated with painful diabetic peripheral neuropathy among adults seeking treatment in the US: results from a retrospective chart review and cross-sectional survey. Diabetes, metabolic syndrome and obesity: targets and therapy. 2013;6:79.

    Article  Google Scholar 

  20. Davies M, Brophy S, Williams R, Taylor A. The prevalence, severity, and impact of painful diabetic peripheral neuropathy in type 2 diabetes. Diabetes Care. 2006;29:1518–22.

    Article  Google Scholar 

  21. Paul U, Sinharay K, Bhattacharyya A, Pal SK. Update in diabetic neuropathy with special reference to Indian scenario. J Indian Med Assoc. 2012;110:616–22.

    PubMed  Google Scholar 

  22. Carrington AL, Shaw JE, Van Schie CH, et al. Can motor nerve conduction velocity predict foot problems in diabetic subjects over a 6-year outcome period? Diabetes Care. 2002;25:2010–5.

    Article  Google Scholar 

  23. Association WM. World medical association declaration of Helsinki. Ethical principles for medical research involving human subjects. Bulletin of the World Health Organization. 2001;79:373.

    Google Scholar 

  24. Von Elm E, Altman DG, Egger M, et al. The strengthening the reporting of observational studies in epidemiology (STROBE) statement: guidelines for reporting observational studies. Int J Surg. 2014;12:1495–9.

    Article  Google Scholar 

  25. Hussain S, Habib A, Najmi AK. Limited knowledge of chronic kidney disease among type 2 diabetes mellitus patients in India. Int J Environ Res Public Health. 2019;16:1443.

    Article  Google Scholar 

  26. Association AD. Report of the expert committee on the diagnosis and classification of diabetes mellitus. Diabetes Care. 2001;24:S5–S20.

    Article  Google Scholar 

  27. Parisi MCR, Giannella D, Fernandes TD, Rezende KF, Nery M. Diabetic foot screening: study of a 3000 times cheaper instrument. Clinics. 2011;66:1105–7.

    Article  Google Scholar 

  28. Katon JG, Reiber GE, Nelson KM. Peripheral neuropathy defined by monofilament insensitivity and diabetes status: NHANES 1999–2004. Diabetes Care. 2013;36:1604–6.

    Article  Google Scholar 

  29. Yunus Y, Rajbhandari S. Insensate foot of diabetic foot ulcer can have underlying silent neuropathic pain. Int Wound J. 2011;8:301–5.

    Article  CAS  Google Scholar 

  30. Cho SI, Lee CH, Park G-H, Park CW, Kim HO. Use of S-LANSS, a tool for screening neuropathic pain, for predicting postherpetic neuralgia in patients after acute herpes zoster events: a single-center, 12-month, prospective cohort study. J Pain. 2014;15:149–56.

    Article  Google Scholar 

  31. Torrance N, Ferguson JA, Afolabi E, et al. Neuropathic pain in the community: more under-treated than refractory? PAIN®. 2013; 154: 690–99.

  32. Bennett MI, Smith BH, Torrance N, Potter J. The S-LANSS score for identifying pain of predominantly neuropathic origin: validation for use in clinical and postal research. J Pain. 2005;6:149–58.

    Article  Google Scholar 

  33. Hussain S, Habib A, Hussain MS, Najmi AK. Potential biomarkers for early detection of diabetic kidney disease. Diabetes Res Clin Pract. 2020;161:108082.

    Article  CAS  Google Scholar 

  34. Bijli AH, Rasool A, Wani AH, et al. Footboards: indigenous and novel method of screening for diabetes peripheral neuropathy–a pilot study. Indian journal of endocrinology and metabolism. 2017;21:293.

    Article  Google Scholar 

  35. D’Souza M, Kulkarni V, Unnikrishnan Bhaskaran HA, et al. Diabetic peripheral neuropathy and its determinants among patients attending a tertiary health care Centre in Mangalore, India. Journal of public health research. 2015;4.

  36. Darivemula S, Nagoor K, Patan SK, et al. Prevalence and its associated determinants of diabetic peripheral neuropathy (DPN) in individuals having type-2 diabetes mellitus in rural South India. Indian journal of community medicine: official publication of Indian Association of Preventive & Social Medicine. 2019;44:88.

    Google Scholar 

  37. Ashok S, Ramu M, Deepa R, Mohan V. Prevalence of neuropathy in type 2 diabetic patients attending a diabetes Centre in South India. Japi. 2002;50:546–50.

    CAS  PubMed  Google Scholar 

  38. Aslam A, Singh J, Rajbhandari S. Prevalence of painful diabetic neuropathy using the self-completed Leeds assessment of neuropathic symptoms and signs questionnaire in a population with diabetes. Can J Diabetes. 2015;39:285–95.

    Article  Google Scholar 

  39. Liberman O, Peleg R, Shvartzman P. Chronic pain in type 2 diabetic patients: a cross-sectional study in primary care setting. Eur J Gen Pract. 2014;20:260–7.

    Article  Google Scholar 

  40. Halawa MR, Karawagh A, Zeidan A, Mahmoud AEDH, Sakr M, Hegazy A, et al. Prevalence of painful diabetic peripheral neuropathy among patients suffering from diabetes mellitus in Saudi Arabia. Curr Med Res Opin. 2010;26:337–43.

  41. Nisar MU, Asad A, Waqas A, et al. Association of diabetic neuropathy with duration of type 2 diabetes and glycemic control. Cureus. 2015;7.

  42. Jambart S, Ammache Z, Haddad F, Younes A, Hassoun A, Abdalla K, et al. Prevalence of painful diabetic peripheral neuropathy among patients with diabetes mellitus in the Middle East region. J Int Med Res. 2011;39:366–77.

  43. Garoushi S, Johnson MI, Tashani OA. A cross-sectional study to estimate the point prevalence of painful diabetic neuropathy in eastern Libya. BMC Public Health. 2019;19:78.

    Article  Google Scholar 

  44. Mijnhout G, Alkhalaf A, Kleefstra N, Bilo HJ. Alpha lipoic acid: a new treatment for neuropathic pain in patients with diabetes. Neth J Med. 2010;68:158–62.

    CAS  PubMed  Google Scholar 

  45. Vasudevan D, Naik MM, Mukaddam QI. Efficacy and safety of methylcobalamin, alpha lipoic acid and pregabalin combination versus pregabalin monotherapy in improving pain and nerve conduction velocity in type 2 diabetes associated impaired peripheral neuropathic condition.[MAINTAIN]: Results of a pilot study. Annals of Indian Academy of Neurology. 2014;17:19.

    Article  CAS  Google Scholar 

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Authors and Affiliations

  1. Department of Pharmacology, School of Pharmaceutical Education and Research, Jamia Hamdard, New Delhi, 110062, India

    Harveen Baxi & Kiran Dubey

  2. Department of Medicine, Hamdard Institute of Medical Sciences and Research, Jamia Hamdard, New Delhi, 110062, India

    Anwar Habib

  3. Department of Pharmacognosy & Phytochemistry, R. V Northland Institute of Pharmacy, Dadri, Uttar Pradesh, India

    Md Sarfaraj Hussain

  4. Departmen of Pharmaceutical Medicine, School of Pharmaceutical Education and Research, Jamia Hamdard, New Delhi, 110062, India

    Salman Hussain

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  1. Harveen Baxi
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Correspondence to Kiran Dubey.

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Baxi, H., Habib, A., Hussain, M.S. et al. Prevalence of peripheral neuropathy and associated pain in patients with diabetes mellitus: Evidence from a cross-sectional study. J Diabetes Metab Disord 19, 1011–1017 (2020). https://doi.org/10.1007/s40200-020-00597-y

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