An epidemiological study to assess the prevalence of diabetic peripheral neuropathic pain among adults with diabetes attending private and institutional outpatient clinics in South Africa

• Published in: Journal of international medical research 2014-08, Vol.42 (4), p.1018-1028
• Main Authors: Jacovides, Andrew, Bogoshi, Mampedi, Distiller, Larry A, Mahgoub, Ehab Y, Omar, Mahomed KA, Tarek, Ismail A, Wajsbrot, Dalia B
• Format: Article
• Language: English
• Subjects: Aged; Ambulatory Care Facilities; Biological and medical sciences; Cranial nerves. Spinal roots. Peripheral nerves. Autonomic nervous system. Gustation. Olfaction; Cross-Sectional Studies; Diabetes Mellitus, Type 1 - complications; Diabetes Mellitus, Type 1 - pathology; Diabetes Mellitus, Type 2 - complications; Diabetes Mellitus, Type 2 - pathology; Diabetes. Impaired glucose tolerance; Diabetic Neuropathies - complications; Diabetic Neuropathies - epidemiology; Endocrine pancreas. Apud cells (diseases); Endocrinopathies; Etiopathogenesis. Screening. Investigations. Target tissue resistance; Female; Humans; Male; Medical sciences; Middle Aged; Nervous system (semeiology, syndromes); Neuralgia - complications; Neuralgia - epidemiology; Neurology; Pharmacology. Drug treatments; Sleep Deprivation - pathology; South Africa - epidemiology; Surveys and Questionnaires
• ISSN: 0300-0605; 1473-2300
• DOI: 10.1177/0300060514525759

Objective To determine the prevalence of diabetic peripheral neuropathic pain (DPNP) among South African adults with type 1 or type 2 diabetes. Methods This cross-sectional study recruited patients with diabetes from 50 institutional/private clinics. DPNP was diagnosed using Douleur Neuropathique 4 (DN4) questionnaire (score ≥4). Health-related quality-of-life (HRQoL) and sleep were assessed with EQ-5D and Daily Sleep Interference Scale (DSIS), respectively. Results Prevalence of DPNP was 30.3% (n = 1046). Risk of DPNP was significantly increased in people aged 50–64 years (odds ratio [OR] 1.71, 95% confidence intervals [CI] 1.21, 2.41), with diabetes for ≥10 years (OR 1.55, 95% CI 1.15, 2.08), female patients (OR 1.58, 95% CI 1.18, 2.12), and black patients (OR 1.71, 95% CI 1.19, 2.46). Mean ± SD EQ-5D and DSIS scores were 0.84 ± 0.16 and 0.83 ± 1.90, respectively, in participants without DPNP versus 0.64 ± 0.25 and 3.62 ± 2.96, respectively, in those with DPNP. Conclusions DPNP is widely prevalent in South Africa. Despite its negative impact on HRQoL and sleep, DPNP is inadequately treated. DN4 is an easy-to-use, validated questionnaire that can be used widely as a DPNP screening tool in clinical practice.