Prevalence of Painful Diabetic Peripheral Neuropathy among Patients with Diabetes Attending a Tertiary Outpatient Diabetes Clinic in Nigeria

Aims: To determine the prevalence of painful diabetic peripheral neuropathy (pDPN) and its associated risk factors using the Douleur Neuropathique en 4 (DN4) questionnaire in a cohort of patients with diabetes attending a tertiary hospital in Nigeria.

Study Design: The study was a cross-sectional descriptive study.

Place and Duration of Study: The study was conducted in the outpatient diabetes clinic of the University of Nigeria Teaching Hospital, which is a tertiary hospital located about 15 km outside Enugu. Enugu is a town in South East Nigeria. The study was conducted between June and August 2017.

Methodology: A systematic random sample of 1 in 4 diabetic patients attending the outpatient clinic were recruited and screened following informed consent. Socio-demographic data was collected and fasting blood glucose recorded. The DN4 questionnaire was administered and the total score calculated. A DN4 score of ≥4 was recorded as diagnostic of pDPN. Data collected was analyzed using SPSS V23.

Results: A total of 272 patients; (46.3%) males were recruited. Type 2 diabetes was present in 95.6% and 57.4% had hypertension. Poor glycemic control was present in 79.2% and 44.5% had pDPN. In addition, pDPN was more prevalent in those on insulin (P =.007, OR =1.96) and diabetes duration more than 10 years (P = .004, OR = 1.92) and was not significantly associated with age, gender, body mass index or glycemic control. Significant predictors of pDPN in the regression model were, treatment with insulin (P = .022, CI - 1.100 - 3.347) and diabetes duration greater than 10 years (P = 0.015, CI - 1.141 - 3.365).

Conclusion: pDPN was common in diabetic patients and associated with insulin use and diabetes duration > 10 years.