ECE2022 Eposter Presentations Diabetes, Obesity, Metabolism and Nutrition (318 abstracts)
1Hedi Chaker Hospital, Department of Endocrinology, Sfax, Tunisia; 2Hedi Chaker Hospital, Department of Family Medicine, Sfax, Tunisia; 3Hedi Chaker Hospital, Department of Epidemiology, Sfax, Tunisia
Introduction: Distal and symmetrical peripheral polyneuropathy is the most frequent type of diabetic neuropathy. Its painful form (PDN) is the most common cause of non-traumatic neuropathic pain and can place a heavy burden on patients lives. Despite the major impact that it can have on the quality of life, PDN is generally underdiagnosed because of a large interindividual variability of symptoms and in the absence of well-established diagnostic criteria.
Aim: To determine the prevalence of PDN and to identify the different risk factors of its occurrence within Tunisian diabetic patients.
Methods: This was a cross-sectional study conducted in the endocrinology-diabetology department of Hedi Chaker hospital Sfax Tunisia, in which we collected adults with diabetes. The DN4 Questionnaire was used to diagnose PDN.
Results: A total of 185 patients were recruited. The mean age of patients was 54.9 years with a slight female predominance (54.1% Vs 45.9%). Patients with type 2 diabetes represented 82.7% against 17.3% with type 1 diabetes. The mean duration of diabetes evolution was 12.31 years. The average of HbA1c level was 10.27%. Among diabetes complications, PDN was the most frequent in our study (48.1%). The mean DN4 score was 3.57. Significant predictors of PDN included advanced age (P = 0.004), high waist circumference (P = 0.01), long history of diabetes (P = 0.000017), insulin therapy in patients with type 2 diabetes (P = 0.03), in addition to some comorbidities such as dyslipidemia, sedentary life style, diabetic retinopathy, erectile dysfunction and history of leg ulcer. Some features of foot examination were also found to be risk factors of PDN namely trophic disorders (P = 0.02), dry skin (P = 0.00016), hyperkeratosis (P < 0.001), foot deformity (P = 0.004), abolition of patellar and Achilles reflexes (P < 0.001) and positive monofilament test (P < 0.001)
Conclusion: In conclusion, the present study demonstrated that the prevalence of painful diabetic neuropathy is very high among our population. This emphasizes the need to screen periodically diabetic patients using a simple instrument such as the DN4 questionnaire and to educate regularly at risk patients about predictors of PDN.