Prevalence of painful diabetic peripheral neuropathy among patients suffering from diabetes mellitus in Saudi Arabia

Abstract

Objective:

To determine the prevalence of painful diabetic peripheral neuropathy in adult patients with diabetes mellitus (type 1 and 2) attending outpatient clinics in Saudi Arabia and to determine the demographic profile and pharmaceutical management of these patients.

Research design and methods:

Eligible patients from 100 outpatient clinics treating patients with diabetes mellitus across Saudi Arabia completed an epidemiologic questionnaire to obtain demographic information and medication history. Following this, the validated DN4 pain questionnaire was used to identify the presence of painful diabetic peripheral neuropathy (score of ≥4).

Results:

A total of 1039 patients were enrolled. Following the DN4 pain questionnaire, an overall prevalence of painful diabetic peripheral neuropathy of 65.3% (n = 678) was found. The age of patients, their sex, and the duration of underlying diabetes were found to be statistically significant factors in the development of painful diabetic peripheral neuropathy. No statistically significant difference was found between smoking history, body mass index, or racial origin and presence of painful diabetic peripheral neuropathy. On initial evaluation, 42.3% (n = 440) stated they were receiving treatment for pain. Following evaluation using the DN4 pain questionnaire, the number prescribed therapeutic pain management increased to more than two thirds (68.7%, n = 714) of which 62.3% (n = 579) were prescribed pregabalin.

Conclusions:

In patients with reduced pain intensity DN4 has not been directly compared with other tools to measure neuropathic pain; however, using the DN4 in this study 65.3% of adult outpatients with type 1 and 2 diabetes in Saudi Arabia were found to have painful diabetic peripheral neuropathy; far higher than anticipated.

Key words::

• Diabetes mellitus
• Painful diabetic peripheral neuropathy
• Prevalence
• Saudi Arabia

Transparency

Declaration of funding

This study was sponsored by Pfizer Inc.

Declaration of financial/other relationships

M.R.H. has disclosed receiving honorarium from Pfizer, MSD, Eli Lilly, Novo Nordisk, and Sanofi Aventis. A.K. has disclosed that he has no relevant financial relationships. A.Z. and A.H.M. have disclosed receiving honorarium from Pfizer. M.S. was a Pfizer employee at the time of the study and A.H. is a current Pfizer employee.

Peer reviewers may receive honoraria from CMRO for their review work. Peer Reviewers 1 and 2 have disclosed that they have no relevant financial relationships.

Acknowledgments

Editorial support was provided by A. M. Manwaring of PAREXEL and was funded by Pfizer Inc.

The authors would like to thank the investigators:

A.B. Shaarawy, A.K. Bazareel, A.R. Thodi, A.S. Valappil, A.R. Hanadi, A.H. Alsamia, A.H. Mohamed, A.M. Ali, A.M. Al Ajlani, A.S. Haleem, A.M. Brekdar, A.M. Deraz, A.A. Gomaa, A.B. Aziz, A.A. Rahman, A.H. Samia, A.H. Khalil, A.A. Ibrahim, A.A. Ayad, B.M. Dahha, B.H. Abdulaziz, E. Allam, E. Khairy, E.M. Fahmy, F.S. Mikhail, F. Waliullah, F.Z. Elabdien, F.A. Younes, F.G. El-Bahly, G.E. El-Kassas, G.G. Girgis, G. Mathew, H. Al Bustanj, H.M. Mahfouz, H.S. Ibrahim, H. El Gendy, H.M. Fouad, H.E. Nasr, I.A. Khattaby, J.K. Palikunnil, J. Alexander, K. Abbas, M. El Saadany, M.M. Takla, M.S. Ibrahim, M.R. Hajjaj, M.N. Eldin, M.I. Atwa, M. Abdel-Fattah, M.A. Mahrous, M. El Sayed, M.H. Essawy, M.C. Sewaha, M.O. Al-Kaki, M.A. Ismail, M. El-Gazzar, M.A. Agag, M.A. Khalil, M.A. El Quersh, M.A. Al Assal, M.A. Ibrahim, M.A. Jaber, M. Aqel, M.A. Elgendy, M.A. Fawzy, M.A. Khan, M.G. Turkmany, M. Dweik, M.M. Anwar, M.M. Motawee, M.A. El Fiky, M. El-Hassan, M. Omar, M.O. El Ghossain, M.S. Elnazer, M.S. Al Toukhi, M.G. Al Helwani, M.A. Barakat, M.A. Kamil, M.M. Kamal, M.M. Yousif, M.F. Omar, M.M. Ghazi, M.S. Shieha, N.I. El-Shenawi, N.W. Douai, N.M. Fareed, N.A. Haleem, N.M. Jazieh, O.A. Fawzy Aly, O.H. Abdel Hamid, O.M. Omar, R.A. Ali El Khabiry, R.H. Aldahshoury, R.S. Kumar, R.S. Rahman, R.A. Kamal, R.M. Abdul Aleem, S.H. Elsayed, S.A. Khader, S.T. Albedewy, S.A. Hussien, S. Manzar, S. Kasim, T.F. Abdulaziz, T.G. Soliman, T.M. Yousef, T.R. Samaa, W.A. Yousry, W. Shawkat, Z.I. Dallo. Pfizer Inc.: R. Assad, E. Youseif.