Diabetic Peripheral Neuropathy: When Patients Present with Pain

Abstract

Diabetes mellitus (DM) is a chronic medical condition affecting 29million Americans and over 360million people world-wide.1 Diabetic polyneuropathy (DPN) is a common, debilitating, and distressing microvascular complication of diabetes that develops in up to 50% of patients with DM.2 This disorder is defined as the presence of symptoms and/or signs of peripheral nerve dysfunction in patients with diabetes after exclusion of all other causes of neuropathy.3 Neuropathy is usually a late finding in type 1 diabetes; however, it can be an early finding in type 2 diabetes – sometimes present at the time of diagnosis. DPN, also referred to as distal symmetrical sensory polyneuropathy (DSP), has two main clinical consequences: diabetic peripheral neuropathic pain (DPNP) and the insensate foot which predisposes to neuropathic foot ulceration. The prevalence of DPNP was 34% in a 2011 UK study.4 Extrapolating, this would be about 10million in the US and over 120million people worldwide.