Prevalence of Painful Diabetic Peripheral Neuropathy among Patients with Diabetes Attending a Tertiary Outpatient Diabetes Clinic in Nigeria
Ekenechukwu E. Young
Department of Medicine, University of Nigeria and University of Nigeria Teaching Hospital, Ituku/Ozalla Enugu, Nigeria.
Chidimma B. Nwatu *
Department of Medicine, University of Nigeria and University of Nigeria Teaching Hospital, Ituku/Ozalla Enugu, Nigeria.
Oluchi S. Ekenze
Department of Medicine, University of Nigeria and University of Nigeria Teaching Hospital, Ituku/Ozalla Enugu, Nigeria.
Obinna D. Onodugo
Department of Medicine, University of Nigeria and University of Nigeria Teaching Hospital, Ituku/Ozalla Enugu, Nigeria.
Belonwu M. Onyenekwe
Department of Medicine, University of Nigeria and University of Nigeria Teaching Hospital, Ituku/Ozalla Enugu, Nigeria.
Ejiofor T. Ugwu
Department of Medicine, Enugu State University and Enugu State University Teaching Hospital, Enugu, Nigeria.
Chidi Ezeude
Department of Medicine, Nnamdi Azikiwe University Teaching Hospital, Nnewi Anambra State, Nigeria.
Chioma H. Ezike
Department of Medicine, University of Nigeria and University of Nigeria Teaching Hospital, Ituku/Ozalla Enugu, Nigeria.
*Author to whom correspondence should be addressed.
Abstract
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.
Keywords: Diabetic neuropathy, pain, DN4, Nigeria