Improving pain control in diabetic neuropathy

Area of Science:

• Neurology
• Endocrinology
• Pain Medicine

Background:

• Diabetic neuropathy impacts a significant portion of the global population, estimated at 1.9% worldwide.
• In the UK alone, it affects approximately 2.25 million individuals with diabetes mellitus.
• It encompasses various clinical forms, broadly categorized into focal/multifocal and symmetrical neuropathies.

Purpose of the Study:

• To describe the prevalence and clinical presentation of diabetic neuropathy.
• To highlight peripheral diabetic neuropathy as the most common subtype.
• To introduce accessible tools for neuropathic pain assessment in community settings.

Main Methods:

• Review of existing literature and clinical classifications of diabetic neuropathy.
• Description of the typical patient-reported symptoms, including neuropathic pain descriptors (burning, shooting, electric shocks).
• Introduction of the Leeds Assessment of Neuropathic Symptoms and Signs (LANSS) questionnaire as a practical assessment tool.

Main Results:

• Peripheral diabetic neuropathy is characterized by chronic, distal, symmetrical sensory loss and often severe pain.
• Pain commonly starts in the feet and progresses proximally to the knees and upper limbs in a 'glove and stocking' pattern.
• The LANSS questionnaire, combining symptom questions and examination findings, provides a score (out of 24) to indicate neuropathic pain likelihood (≥ 12).

Conclusions:

• Diabetic neuropathy, particularly the peripheral sensory subtype, is a prevalent and painful condition.
• Accessible tools like the LANSS questionnaire can facilitate early identification and management of neuropathic pain in primary care.
• Effective assessment is crucial for timely intervention and improved patient outcomes in diabetic neuropathy management.