Endocrine Abstracts

Introduction: Peripheral neuropathy is one of the most common complications of diabetes. Its prevalence is very different according to the studies ranging from 8 to almost 60%. The symptomatology can be very polymorphic. Its painful form, painful diabetic neuropathy (PDN), is the most common cause of peripheral neuropathy.

Objective of the study: Our objective was to determine the prevalence and factors associated with PDN.

Material and methods: This is a descriptive cross-sectional observational study including 623 patients followed in the endocrinology and metabolic diseases department of the Ibn Rochd University Hospital in Casablanca in a day hospital or in conventional hospitalization between January 2021 and July 2022. The painful diabetic neuropathy was assessed by the DN4 score. Statistical analysis of the data was performed using SPSS version 25.

Results: We included 623 patients, 63.4% of whom were women. The average age of the patients was 51.4 ± 16.1 years. Diabetes was type 2 for 79.9% of patients. The mean HbA1c was 10.22 ± 2.53%. Among our patients, 30.8% were obese. The prevalence of PDN was 22.2%. Diabetic retinopathy was the most frequent complication with a percentage of 24.2%. In bivariate analysis, the risk factors associated with PDN were: age > 69 years (P<0.001), arterial hypertension (P=0.005), dyslipidemia (P=0.001), duration of diabetes > 10 years (P<0.001), HbA1c >7% (P<0.001), retinopathy (P<0.001), nephropathy (P<0.001), autonomic neuropathy (P<0.001), coronary artery disease (P<0.001) and obliterating arteriopathy of the lower limbs (P<0.001). In multivariate analysis, the predominant risk factors for PDN were: HbA1c> 7% (P=0.01 and Odds ratio at 3.7), retinopathy (P<0.001 and Odds ratio at 3.37), autonomic neuropathy (P<0.001 and odds ratio at 3.23) and coronary artery disease (P=0.005 and odds ratio at 3.47). All of the patients with PDN were put on pregabalin with a good evolution.

Conclusion: Diabetic neuropathy can have an impact on the quality of life of patients, prompting its detection by the DN4 score. Its management must include good glycemic control, management of risk factors and symptomatic treatment of pain.