ECE2024 Eposter Presentations Diabetes, Obesity, Metabolism and Nutrition (383 abstracts)
Hedi Chaker University Hospital, Department of Endocrinology, 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 elderly 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 geriatric patients.
Methods: This was a cross-sectional study conducted in the endocrinology-diabetology department of Hedi Chaker hospital Sfax Tunisia, in which we collected elderly patients with diabetes. The DN4 Questionnaire was used to diagnose PDN.
Results: A total of 52 elderly patients were recruited. The mean age of patients was 70.6 years with a slight female predominance (55.8% Vs 44.2%). All the patients had type 2 diabetes. The mean duration of diabetes evolution was 13.54 years. The average of HbA1c level was 10.35%. Among diabetes complications, PDN was the most frequent in our study (53.8%). The mean DN4 score was 3.83. Significant predictors of PDN included long history of diabetes (P=0.04), high levels of glycated hemoglobin (HbA1c) (P=0.04) and insulin therapy within type 2 diabetic patients (P=0.029), in addition to some comorbidities such as sweating disorders and history of leg ulcer. Some features of foot examination were also found to be risk factors of PDN namely trophic disorders (P=0.05), dry skin (P=0.004), hyperkeratosis (P<0.001), abolition of Achilles reflexes (P<0.001) and positive monofilament test (P<0.005).
Conclusion: The present study demonstrated that the prevalence of PDN is high among our geriatric population. This emphasizes the need to screen periodically diabetic elderly patients using a simple instrument such as the DN4 questionnaire and to educate at risk patients about predictors of PDN regularly.