Peripheral Neuropathy In People Research Articles

Structured Exercise Regimen in the Prevention of Peripheral Neuropathy in People with Type 2 Diabetes in a Low-Middle Income Country: An Open-Label, Randomized Controlled Trial

Structured Exercise Regimen in the Prevention of Peripheral Neuropathy in People with Type 2 Diabetes in a Low-Middle Income Country: An Open-Label, Randomized Controlled Trial

The prevalence of peripheral neuropathy among the patients with diabetes in Pakistan: a systematic review and meta-analysis

The most frequent complication of diabetes is peripheral neuropathy. The estimated prevalence of peripheral neuropathy in people with diabetes varies substantially between published studies in Pakistan. We conducted this meta-analysis to summarize the prevalence of peripheral neuropathy in people with diabetes. Different electronic databases were systematically searched using keywords and MeSH terms. Random-effects meta-analysis was conducted to pool the prevalence of peripheral neuropathy in people with diabetes in Pakistan. Heterogeneity was investigated by random-effects meta-regression and stratification. Two independent authors reviewed studies, extracted data, and conducted the risk of bias analysis. Nineteen studies with a total of 8487 diabetic patients were included. The overall pooled prevalence of diabetic peripheral neuropathy was 43.16% (95% CI 32.93–53.69%), with significant heterogeneity between estimates. The prevalence of peripheral neuropathy among those newly diagnosed with diabetes was 26.52% (95% CI 14.97–39.96%, n = 5). According to the subgroup meta-analysis, the pooled prevalence of diabetic peripheral neuropathy was highest in Khyber Pakhtunkhwa (55.29%; 95% CI 23.91–84.50%), followed by Sindh (40.04%; 95% CI 24.00–57.25%), and the lowest was found in Punjab (34.90%; 95% CI 15.05–57.95%). A significant association was found between the pooled prevalence estimate and the duration of diabetes. The results of this meta-analysis indicate a relatively high prevalence of peripheral neuropathy in people with diabetes in Pakistan. The study protocol has been registered in the PROSPERO, with the registration number CRD42022371617.

Tui Na for painful peripheral neuropathy in people with human immunodeficiency virus: A randomized, double-blind, placebo-controlled trial protocol.

Peripheral neuropathy (PN), including numbness, loss of sensation, paresthesia, a burning sensation, and stabbing pain in extremities, is a common complication in people with human immunodeficiency virus (PHIV). Medications commonly used to treat HIV-related PN are not effective and lead to many side effects. HIV-related PN symptoms may be alleviated or treated with a series of therapeutic Chinese foot massages (TCFM), which are non-invasive and relatively safe. However, relevant studies are lacking. This proposed trial is a prospective, two-arm, parallel, double-blinded, randomized controlled trial. This proposed trial aims to assess the effectiveness of TCFM on HIV-related PN in people with HIV (PHIV). The primary outcomes, measured at baseline, end of TCFM/placebo, and twelve weeks after, include (1), lower extremity pain, (2) lower extremity functioning, and (3) health-related quality of life. The secondary outcomes, measured throughout the trial process, include (1) recruitment and completion rate (No. of referred, No. of eligible, No. of enrolled, No. of withdrawals, trial recruitment rate, and trial completion rate), (2) participants' safety (No. and severity of adverse events), (3) treatment adherence (average time of each message session, No. of completed sessions, and No. of missed sessions), and (4) compliance (No. of participants completing the trial following the initial group assignment). An estimated 142 participants in total, or 71 participants in each arm, will be needed for this trial. This trial was registered at ClinicalTrials.gov of the National Institute of Health on Oct 26, 2022 (ClinicalTrials.gov Identifier: NCT05596123). The researchers expect to recruit participants starting in Feb. 2023 and ending in Feb 2025.

Epidemiology of HIV-associated peripheral neuropathy in people living with human immunodeficiency virus infection in Greece.

Peripheral neuropathy is among the most common complications among people with HIV with prevalence rates varying widely among studies (10-58%). This study aims to assess the prevalence of HIV-associated peripheral neuropathy among HIV-positive people in Northern Greece monitored during the last 5-year period and investigate possible correlations with antiretroviral therapy, disease staging, and potential risk factors, as there is no prior epidemiological record in Greek patients. Four hundred twenty patients were divided into a group with peripheral neuropathy (n = 269), and those without (n = 151). Peripheral neuropathy was assessed with a validated Peripheral Neuropathy Screening tool. Statistical analyses were performed with SPSS, were two-tailed, and p-value was set at 0.05. The incidence of peripheral neuropathy was estimated at 35.9%. Age was found to correlate with higher odds of developing HIV-peripheral neuropathy, rising by 4%/year. Females encountered 77% higher probability to develop peripheral neuropathy. Stage 3 of the disease associated with higher occurrence of peripheral neuropathy (96% as compared to stage-1 patients). Among patients with peripheral neuropathy, the duration of antiretroviral therapy was found to be longer than in those without. Peripheral neuropathy remains one of the most common complications regardless of the antiretroviral-therapy type, indicating the involvement of other risk factors in its occurrence, such as the stage of the disease, age and gender. Therefore, the treating physician should screen patients as early and frequently as possible upon HIV-diagnosis to prevent the progression of this debilitating condition so that prolonged life-expectancy is accompanied by a good quality of life.

The Peripheral Neuropathy Prevalence and Characteristics Are Comparable in People with Obesity and Long-Duration Type1 Diabetes.

IntroductionPeripheral neuropathy is reported in obesity even in the absence of hyperglycaemia.ObjectiveTo compare the prevalence and characterise the phenotype of peripheral neuropathy in people living with obesity (OB) and long-duration type 1 diabetes (T1D).Patients and MethodsWe performed a prospective cross-sectional study of 130 participants including healthy volunteers (HV) (n = 28), people with T1D (n = 51), and OB (BMI 30–50 kg/m2) (n = 51). Participants underwent assessment of neuropathic symptoms (Neuropathy Symptom Profile, NSP), neurological deficits (Neuropathy Disability Score, NDS), vibration perception threshold (VPT) and evaluation of sural nerve conduction velocity and amplitude.ResultsPeripheral neuropathy was present in 43.1% of people with T1D (age 49.9 ± 12.9 years; duration of diabetes 23.4 ± 13.5 years) and 33.3% of OB (age 48.2 ± 10.8 years). VPT for high risk of neuropathic foot ulceration (VPT ≥ 25 V) was present in 31.4% of T1D and 19.6% of OB. Participants living with OB were heavier (BMI 42.9 ± 3.5 kg/m2) and had greater centripetal adiposity with an increased body fat percentage (FM%) (P < 0.001) and waist circumference (WC) (P < 0.001) compared to T1D. The OB group had a higher NDS (P < 0.001), VAS for pain (P < 0.001), NSP (P < 0.001), VPT (P < 0.001) and reduced sural nerve conduction velocity (P < 0.001) and amplitude (P < 0.001) compared to HV, but these parameters were comparable in T1D. VPT was positively associated with increased WC (P = 0.011), FM% (P = 0.001) and HbA1c (P < 0.001) after adjusting for age (R2 = 0.547). Subgroup analysis of respiratory quotient (RQ) measured in the OB group did not correlate with VPT (P = 0.788), nerve conduction velocity (P = 0.743) or amplitude (P = 0.677).ConclusionThe characteristics of peripheral neuropathy were comparable between normoglycaemic people living with obesity and people with long-duration T1D, suggesting that metabolic factors linked to obesity play a pivotal role in the development of peripheral neuropathy. Further studies are needed to investigate the mechanistic link between visceral adiposity and neuropathy.Supplementary InformationThe online version contains supplementary material available at 10.1007/s12325-022-02208-z.

Non-Pharmacological Self-Management Strategies for Chemotherapy-Induced Peripheral Neuropathy in People with Advanced Cancer: A Systematic Review and Meta-Analysis.

Non-pharmacological self-management interventions for chemotherapy-induced peripheral neurotherapy (CIPN) are of clinical interest; however, no systematic review has synthesized the evidence for their use in people with advanced cancer. Five databases were searched from inception to February 2022 for randomized controlled trials assessing the effect of non-pharmacological self-management interventions in people with advanced cancer on the incidence and severity of CIPN symptoms and related outcomes compared to any control condition. Data were pooled with meta-analysis. Quality of evidence was appraised using the Revised Cochrane Risk of Bias Tool for Randomized Trials (RoB2), with data synthesized narratively. Grading of Recommendations, Assessment, Development and Evaluations (GRADE) was applied to assess the certainty of the evidence. Thirteen studies were included, which had a high (69%) or unclear (31%) risk of bias. Greatest confidence was found for physical exercise decreasing CIPN severity (SMD: −0.89, 95% CI: −1.37 to −0.41; p = 0.0003; I2 = 0%; n = 2 studies, n = 76 participants; GRADE level: moderate) and increasing physical function (SMD: 0.51, 95% CI: 0.02 to 1.00; p = 0.04; I2 = 42%; n = 3 studies, n = 120; GRADE level: moderate). One study per intervention provided preliminary evidence for the positive effects of glutamine supplementation, an Omega-3 PUFA-enriched drink, and education for symptom self-management via a mobile phone game on CIPN symptoms and related outcomes (GRADE: very low). No serious adverse events were reported. The strongest evidence with the most certainty was found for physical exercise as a safe and viable adjuvant to chemotherapy treatment for the prevention and management of CIPN and related physical function in people with advanced cancer. However, the confidence in the evidence to inform conclusions was mostly very low to moderate. Future well-powered and appropriately designed interventions for clinical trials using validated outcome measures and clearly defined populations and strategies are warranted.

The Effect of Structured Exercise Compared with Education on Neuropathic Signs and Symptoms in People at Risk of Neuropathic Diabetic Foot Ulcers: A Randomized Clinical Trial.

Background and Objectives: Lifestyle interventions such as exercise prescription and education may play a role in the management of peripheral neuropathy in people with diabetes. The aim of this study was to determine the effect of undertaking an exercise program in comparison with an education program on the signs and symptoms of peripheral neuropathy in people with diabetes at risk of neuropathic foot ulceration. Materials and Methods: Twenty-four adult participants with diabetes and peripheral neuropathy were enrolled in this parallel-group, assessor blinded, randomised clinical trial. Participants were randomly allocated to one of two 8-week lifestyle interventions, exercise or education. The primary outcome measures were the two-part Michigan Neuropathy Screening Instrument (MNSI) and vibratory perception threshold (VPT). Secondary outcome measures included aerobic fitness, balance and lower limb muscular endurance. Results: Participants in both lifestyle interventions significantly improved over time for MNSI clinical signs (MD: −1.04, 95% CI: −1.68 to −0.40), MNSI symptoms (MD: −1.11, 95% CI: −1.89 to −0.33) and VPT (MD: −4.22, 95% CI: −8.04 to −0.40). Although the interaction effects did not reach significance, changes in values from pre to post intervention favoured exercise in comparison to control for MNSI clinical signs (MD −0.42, 95% CI −1.72 to 0.90), MNSI clinical symptoms (MD −0.38, 95% CI −1.96 to 1.2) and VPT (MD −4.22, 95% CI −12.09 to 3.65). Conclusions: Eight weeks of exercise training or lifestyle education can improve neuropathic signs and symptoms in people with diabetes and peripheral neuropathy. These findings support a role for lifestyle interventions in the management of peripheral neuropathy.

British Association of Dermatologists guidelines for the management of people with cutaneous lupus erythematosus 2021.

The overall objective of the guideline is to provide up-to-date, evidence-based recommendations for the management of cutaneous lupus erythematosus (CLE) in the presence or absence of systemic lupus erythematosus (SLE) in adults, young people and children. The document aims to: offer an appraisal of all relevant literature up to December 2020, focusing on any key developments address important, practical clinical questions relating to the primary guideline objective. provide guideline recommendations and if appropriate research recommendations.

Peripheral neuropathy in people living with human immunodeficiency virus and acquired immunodeficiency syndrome on antiretroviral therapy

Background: Peripheral neuropathy is a common neurological complication in people with human immunodeficiency virus (HIV) infection. HIV-associated sensory neuropathy (HIV-SN) is defined as the presence of neuropathic symptoms and at least an abnormal perception of vibrations of a 128 Hz tuning fork on the great toe or abnormal ankle reflexes or both. Brief peripheral neuropathy screening (BPNS) tool is employed in identifying HIV-SN based on a directed symptom questionnaire and limited clinical examination. The present study was conducted to determine the prevalence and drug regimens related to peripheral neuropathy in people living with HIV and Acquired immunodeficiency syndrome (AIDS) on antiretroviral therapy (ART) so as to help improve the care for those on ART. The objective was to study the prevalence of peripheral neuropathy in people living with HIV and AIDS on ART using AIDS clinical trials group validated BPNS tools.Methods: Cross-sectional study on 198 HIV-seropositive cases aged above 18 years on ART attending centre of excellence (CoE) ART centre, RIMS Imphal. The presence of peripheral neuropathy was examined by using a BPNS among the participants.Results: Peripheral neuropathy was found in 46 (23.2%) out of 198 participants using BPNS. In this study a positive association between the duration of treatment with ART and use of protease inhibitor regimes with the development of peripheral neuropathy was significant.Conclusions: Peripheral neuropathy in patient with HIV and AIDS on ART had significant association with duration of treatment with ART and use of protease inhibitor combination in the ART regime.

Feasibility randomized‐controlled trial of online acceptance and commitment therapy for painful peripheral neuropathy in people living with HIV: The OPEN study

Neuropathic pain negatively affects quality of life among people living with HIV (PLWH). This study examined the feasibility of conducting a full-scale randomized-controlled trial of online acceptance and commitment therapy ("ACT OPEN") for neuropathic pain in PLWH. Using a parallel-groups design, thirty-eight participants were randomized to ACT OPEN or a waitlist control (2:1). Participants completed standard self-report outcome measures at baseline, and two- and five-months post-randomization. Participants were aware of their allocation, but assessment was blinded. Twenty-five participants were randomized to ACT OPEN and 13 to the control (of 133 referrals). ACT OPEN completion was 69% and two-month trial retention was 82%. Treatment credibility and satisfaction scores for ACT OPEN were comparable to scores reported in previous trials of cognitive-behavioural treatments for pain. Four adverse events were reported during the study, including one serious adverse event; all of these were unrelated to the research procedures. Small to moderate effects and 95% confidence intervals suggest that the true effect may favour ACT OPEN for improvements in pain intensity/interference and depression. A full-scale RCT of online ACT for pain management in PLWH may be feasible with refinements to trial design to facilitate recruitment. Research on pain management in people living with HIV has primarily focused on pharmacological treatments with limited success. This is the first study to show the potential feasibility of a psychological treatment based on acceptance and commitment therapy delivered online and tailored for pain management in people with HIV ("ACT OPEN"). ACT OPEN may be a promising treatment in this population and further evaluation in a full-scale randomized-controlled trial appears warranted. The trial was registered (clinicaltrials.gov; NCT03584412).

Clinical utility of the DN4 questionnaire in the assessment of neuropathic pain in patients with type 2 diabetes: experience from a newly-created diabetes clinic in Cameroon

INTRODUCTION: Early diagnosis of peripheral neuropathy in people with diabetes mellitus is important. Screening tools are either expensive or cumbersome, and thus impractical in low-resource settings. The DN4 questionnaire is a simple alternative. We assessed the performance of the DN4 Questionnaire in detecting neuropathic pain associated with diabetic peripheral neuropathy in patients with type 2 diabetes.

Diabetic peripheral neuropathy in people with type 2 diabetes: too little too late.

Diabetic peripheral neuropathy in people with type 2 diabetes is poorly managed because of its insidious onset, delayed diagnosis and more complex aetiology resulting from the contribution of not only hyperglycaemia, but also ageing, hyperlipidaemia, hypertension and obesity. Because there is no US Food and Drug Adminstration-approved disease-modifying therapy for diabetic peripheral neuropathy, the key to ameliorating it in type 2 diabetes has to be through earlier diagnosis and timely multi-factorial risk factor reduction. The management of painful diabetic peripheral neuropathy also requires a detailed appraisal of the choice of therapy, taking into account efficacy, patient wishes, comorbidities, side effect profile and potential for abuse.

Association between deterioration in muscle strength and peripheral neuropathy in people with diabetes

AimsDiabetic peripheral neuropathy (DPN) is a major risk factor for sarcopenia or frailty in older patients with diabetes. In this study, we investigated the association between DPN and muscle strength in type 2 diabetes. MethodsDPN was assessed using the Michigan Neuropathy Screening Instrument Questionnaire (MNSI-Q) and Physical Examination (MNSI-PE) in 230 subjects with type 2 diabetes. Handgrip strength (HGS) was measured using an electronic grip strength dynamometer. ResultsThe prevalence of DPN was 26.4% in men and 34.7% in women. HGS was significantly lower in men with DPN compared with men without DPN (27.0 ± 9.4 vs. 29.7 ± 8.4 kg, p = 0.036). This effect was not seen in women. In men, multivariate regression analysis showed that HGS was negatively associated with the MNSI-Q (β = −1.200, p = 0.003) and MNSI-PE scores (β = −0.937, p = 0.046) and resulted in an abnormal 10-gram monofilament test score (β = −10.895, p < 0.001). However, HGS was not significantly associated with neuropathy in women. ConclusionsMuscle strength was lower in men with DPN than in those without DPN. Assessment of muscle function may have clinical implications in the prevention of sarcopenia and frailty in men with DPN.

Use of graded Semmes Weinstein monofilament testing for ascertaining peripheral neuropathy in people with and without diabetes

AimsTo assess peripheral neuropathy (PN) using graded Semmes Weinstein monofilaments (SWMs) and determine factors associated with PN among adult volunteers with and without diabetes. MethodsAdult volunteers were assessed for distal sensory PN using three graded SWMs. Four PN levels were defined: 0 (no PN; felt all three filaments), 1 (subclinical PN; insensate to 1-g filament), 2 (insensate to 10-g), or 3 (insensate to 75-g). Levels 2–3 were considered clinical PN. Associations with PN were determined using ordinal logistic regression. ResultsIn 1564 subjects (median age 41.9 years, 50.1% women), PN was subclinical or worse in 68.9% and clinical in 11.2%. Age-sex-race-adjusted prevalence of clinical PN was greater in people with diabetes (15.3%) than without (6.1%; P < 0.001). Associated factors included older age, male sex, greater BMI, greater heart rate, lower mean arterial pressure, and family history of diabetes or cardiovascular diseases. Higher PN levels associated with worse albuminuria and retinopathy. Only older age and male sex associated with PN both in people with and without diabetes. ConclusionsPN is common in our sample, notably in those without diabetes, although diabetes greatly increases its risk. Using graded SWMs may have a prognostic value as it permits the identification of subclinical PN.

Associations of Serum S100B and S100P With the Presence and Classification of Diabetic Peripheral Neuropathy in Adults With Type 2 Diabetes: A Case-Cohort Study.

Novel biomarkers of diabetic peripheral neuropathy provide potentially useful information for early identification and treatment of diabetic neuropathy, ultimately serving to reduce the burden of disease. This study was designed to investigate the potential associations of serum S100B and S100P (calcium-modulated proteins) with the presence and classification of diabetic peripheral neuropathy in adults with type 2 diabetes. In a case-cohort setting, the data of 44 participants diagnosed with diabetic peripheral neuropathy, 44 control participants with type 2 diabetes but free of peripheral neuropathy and 87 healthy control individuals were collected and analyzed. Serum S100P concentrations were elevated in participants with diabetic peripheral neuropathy compared with their controls with type 2 diabetes (median [IQR]: 2,235 pg/mL [1,497.5 to 2,680] vs. 1,200 pg/mL [975 to 1,350)], respectively; p<0.001). Conversely, serum S100B values were comparable in these 2 groups (p=0.570). Those with the typical diabetic peripheral neuropathy had significantly higher serum S100P levels compared to their counterparts with the atypical group of diabetic peripheral neuropathies (p=0.048). The independent significant association between serum S100P and diabetic peripheral neuropathy persisted into the multivariable adjusted logistic regression model (OR for S100P: 1.004 [95% CI 1.002 to 1.006]; p<0.001). The present study's findings demonstrated that serum S100P is a more significant indicator of peripheral neuropathy in type 2 diabetes than is serum S100B. Prospective longitudinal studies are required to confirm the prognostic value of baseline serum S100P to predict incident peripheral neuropathy in people with diabetes.

The Experience of Chemotherapy-induced Peripheral Neuropathy in People with Cancer

The Experience of Chemotherapy-induced Peripheral Neuropathy in People with Cancer

SENAM KAKI MENINGKATKAN SENSASI SENSORIS DIABETISI DENGAN DIABETIC PERIPHERAL NEUROPATHY

Hipoxia on axon and myelin caused by microangiopathy can lead to Diabetic Peripheral Neuropathy in people with diabetes. The aim of this research is to know the effect of foot gymnastics on DPN in people with diabetes. The study was conducted by quasi-pre-post experiment without group control of 13 people with DPN. Average number of DPN points before foot exercises = 4.42 points and after exercises = 0.46 points from 20 checkpoints. After exercising legs every 2 days for 6 weeks, all (100%) of the respondents experienced an increase in sensory sensation and 83.3% of them were free of DPN. T-paired t-test results obtained t value = 3.80 with a significance value of 0.003, so it is concluded that foot gymnastics can increase sensory sensation in diabetic patients with DPN.

Single Sensor Gait Analysis to Detect Diabetic Peripheral Neuropathy: A Proof of Principle Study.

This study explored the potential utility of gait analysis using a single sensor unit (inertial measurement unit [IMU]) as a simple tool to detect peripheral neuropathy in people with diabetes. Seventeen people (14 men) aged 63±9 years (mean±SD) with diabetic peripheral neuropathy performed a 10-m walk test instrumented with an IMU on the lower back. Compared to a reference healthy control data set (matched by gender, age, and body mass index) both spatiotemporal and gait control variables were different between groups, with walking speed, step time, and SDa (gait control parameter) demonstrating good discriminatory power (receiver operating characteristic area under the curve >0.8). These results provide a proof of principle of this relatively simple approach which, when applied in clinical practice, can detect a signal from those with known diabetes peripheral neuropathy. The technology has the potential to be used both routinely in the clinic and for tele-health applications. Further research should focus on investigating its efficacy as an early indicator of or effectiveness of the management of peripheral neuropathy. This could support the development of interventions to prevent complications such as foot ulceration or Charcot's foot.

Vitamin B12 is Found Sufficient in Newly Diagnosed Type 2 Diabetes in a Hospital Based Study

Background: Vitamin B12 deficiency may be related to peripheral neuropathy in people with type 2 diabetes mellitus (T2DM). Level of B12 in T2DM observed by many investigators showed variable results. Studies on vitamin B12 in T2DM are very limited in Bangladesh. Objectives: To observe serum vitamin B12 level in newly diagnosed T2DM patients. Methods: Observational cross-sectional study encompassing 50 newly diagnosed T2DM and 50 controls as per American Diabetes Association (ADA) criteria. Vitamin B12 and Hemoglobin A1c (HbA1c) were measured for all. Results: Both mean (492.46±28.82 vs. 346.48±19.65 pg/mL, mean±SEM; p=&lt;0.001) and median (435.50 vs. 334.50 pg/mL) values of serum vitamin B12 were found to be higher in T2DM than those of controls. None of the diabetic subjects were found to be B12 deficient whereas 6 were borderline deficient; these frequencies were 7 and 11 respectively among the controls. Vitamin B12 level was statistically similar in patients with or without clinically evident peripheral neuropathy (mean±SEM; 523.48±39.39 vs. 441.84±38.76 pg/mL, p=0.172). B12 level showed positive correlation with fasting plasma glucose (FPG, r=0.285, p=0.061) and HbA1c (r=0.287, p= 0.043) in diabetes group but there was no correlation with body mass index (BMI). Conclusion: Vitamin B12 is found sufficient in newly diagnosed Bangladeshi T2DM patients.

Socioeconomic Deprivation Independently Predicts Painful Diabetic Neuropathy in Type 2 Diabetes

Painful peripheral neuropathy in people with type 2 diabetes is a disabling complication. We explored associations of this condition with socioeconomic deprivation. The Townsend index of socioeconomic deprivation was examined in the pseudonymised GP records of 15388 (44.1% female) individuals with type 2 diabetes in the Cheshire county of England, and related to prevalence of drug treated painful diabetic neuropathy. We also analysed prescription trends with respect to pharmacotherapy for neuropathy pain relief. Treatment for neuropathic pain was initiated in 3 266 (21.2%) of patients. Those on treatment were older [68.2 (95% CI 67.8-68.7) vs. 66.6 (66.4-66.8) years] than those not on treatment. There was no difference in HbA1c (7%, 55 mmol/mol).There were significant differences between the groups for the Townsend deprivation index, with a greater proportion (30.6% vs. 22.8% of patients with treated neuropathic pain) having a score of ≥1 (Χ(2)=83.9, p<0.0001).Multivariate logistic regression analyses indicated that each unit increment in the Townsend index was associated with an 6% increased odds of requiring neuropathic pain treatment [odds ratio (95%CI) 1.06 (1.05-1.08), p<0.0001] independent of 5 year age band, BMI, gender, systolic BP, eGFR, HbA1C and total cholesterol. In this study using pseudonymised clinical records, a higher level of socioeconomic deprivation seemingly may predispose to severe neuropathic pain in diabetes requiring pharmacological intervention. Targeted allocation of healthcare resources to this group may offer clinical benefits.