Abstract
BackgroundPainful Diabetic Neuropathy (PDN) is a complication that affects up to one third of people living with diabetes. There is limited data on the prevalence of PDN from countries in the Middle East and North Africa. The aim of this study was to estimate the point prevalence of PDN in adults in Eastern Libya using the self-report Leeds Assessment of Neuropathic Symptoms and Signs (S-LANSS) pain scale.MethodsWe invited patients attending the Benghazi Diabetes Centre who had diabetes for ≥ 5 years to take part in the study. Patients provided consent and completed the Arabic S-LANSS. Anthropometrics, marital status, socioeconomic and education information was recoded and fasting plasma glucose concentration determined.ResultsFour hundred and fifty participants completed the study (age = 19 to 87 years, BMI = 17.6 to 44.2 kg/m2, 224 women). One hundred and ninety five participants (43.3%) reported pain in their lower limbs in the previous 6 months and 190/195 participants (97.4%) reported a S-LANSS score of ≥ 12 suggesting they had neuropathic pain characteristics. Thus, 42.2% (190/450) of participants with diabetes were categorised as experiencing pain with neuropathic characteristics. Mean ± SD duration of diabetes for participants with PDN (20.4 ± 6.5 years) was significantly higher compared with those without PDN (11.1 ± 4.6 years). Participants with PDN smoked tobacco for more years than those without pain (7.9 ± 12.3 years versus 1.1 ± 3.9 years respectively); had significantly higher fasting plasma glucose concentration (143.6 ± 29.3 mg/dl versus 120.0 ± 17.3 mg/dl) and had a significantly higher levels of education and employment status. The most significant predictors of PDN were duration of diabetes (OR = 25.85, 95% CI = 13.56–49.31), followed by smoking for men (OR = 8.28, 95% CI = 3.53–9.42), obesity (OR = 3.96, 95% CI = 2.25–6.96) and high fasting plasma glucose concentration (OR = 3.51, 95% CI = 1.99–6.21).ConclusionThe prevalence of PDN in people with diabetes in Eastern Libya was 42.2%. Risk factors for developing PDN were high fasting plasma glucose concentration, long duration of diabetes, and higher level of educational and employment status.
Highlights
Painful Diabetic Neuropathy (PDN) is a complication that affects up to one third of people living with diabetes
We conducted a systematic review that included eight surveys of seven countries from the Middle East and North Africa (MENA) region (Saudi Arabia, Algeria, Egypt, Lebanon, Jordan, Gulf States and Turkey) [16] and estimated the point prevalence of PDN associated with type 1 or type 2 diabetes to be 43.2% (95% CI = 30.1–57.2%, pooled sample = 7898 adults (3761 women), effect size = − 0.949)
The Benghazi Diabetes Centre (BDC) has been operational for 48 years and is one of the largest diabetes centres in Libya, servicing the Eastern region of the country
Summary
Painful Diabetic Neuropathy (PDN) is a complication that affects up to one third of people living with diabetes. The aim of this study was to estimate the point prevalence of PDN in adults in Eastern Libya using the self-report Leeds Assessment of Neuropathic Symptoms and Signs (S-LANSS) pain scale. Management of PDN in the MENA region appears to be inadequate with limited use of neuropathic screening tools and a paucity of data on the extent of the problem, especially in the Maghreb area (Libya, Tunisia, Algeria and Morocco) [12]. We conducted a systematic review that included eight surveys of seven countries from the MENA region (Saudi Arabia, Algeria, Egypt, Lebanon, Jordan, Gulf States and Turkey) [16] and estimated the point prevalence of PDN associated with type 1 or type 2 diabetes to be 43.2% (95% CI = 30.1–57.2%, pooled sample = 7898 adults (3761 women), effect size = − 0.949)
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