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. 2011 Oct;34(10):2220-4.
doi: 10.2337/dc11-1108. Epub 2011 Aug 18.

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

Caroline A Abbott  1 , Rayaz A Malik, Ernest R E van Ross, Jai Kulkarni, Andrew J M Boulton
Affiliations

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

Caroline A Abbott et al. Diabetes Care. 2011 Oct.

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 < 0.001) and not affected by severity of neuropathy, insulin use, foot deformities, smoking, or alcohol. Women had 50% increased adjusted risk of painful symptoms compared with men (OR = 1.5 [1.4-1.6], P < 0.0001). Despite less neuropathy in South Asians (14%) than Europeans (22%) and African Caribbeans (21%) (P < 0.0001), painful symptoms were greater in South Asians (38 vs. 34 vs. 32%, P < 0.0001). South Asians without neuropathy maintained a 50% increased risk of painful neuropathy symptoms compared with other ethnic groups (P < 0.0001).

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.

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Figures

Figure 1
Figure 1
Percentage prevalence of neuropathic symptoms in 15,659 diabetic patients characterized by their level of clinical neuropathy.
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