title: An epidemiological study to assess the prevalence of diabetic peripheral neuropathic pain among adults with diabetes attending private and institutional outpatient clinics in South Africa.
abstract: OBJECTIVE
  To determine the prevalence of diabetic peripheral neuropathic pain (DPNP) among South African adults with type 1 or type 2 diabetes.
  
  
  METHODS
  This cross-sectional study recruited patients with diabetes from 50 institutional/private clinics. DPNP was diagnosed using Douleur Neuropathique 4 (DN4) questionnaire (score ≥4). Health-related quality-of-life (HRQoL) and sleep were assessed with EQ-5D and Daily Sleep Interference Scale (DSIS), respectively.
  
  
  RESULTS
  Prevalence of DPNP was 30.3% (n = 1046). Risk of DPNP was significantly increased in people aged 50-64 years (odds ratio [OR] 1.71, 95% confidence intervals [CI] 1.21, 2.41), with diabetes for ≥10 years (OR 1.55, 95% CI 1.15, 2.08), female patients (OR 1.58, 95% CI 1.18, 2.12), and black patients (OR 1.71, 95% CI 1.19, 2.46). Mean ± SD EQ-5D and DSIS scores were 0.84 ± 0.16 and 0.83 ± 1.90, respectively, in participants without DPNP versus 0.64 ± 0.25 and 3.62 ± 2.96, respectively, in those with DPNP.
  
  
  CONCLUSIONS
  DPNP is widely prevalent in South Africa. Despite its negative impact on HRQoL and sleep, DPNP is inadequately treated. DN4 is an easy-to-use, validated questionnaire that can be used widely as a DPNP screening tool in clinical practice.
authors.affiliation: Midrand Medical Centre, Midrand, South Africa andrewjacovides110@gmail.com.
authors.forename: Andrew
authors.initials: A
authors.lastname: Jacovides
authors.affiliation: Pfizer Laboratories, Johannesburg, South Africa.
authors.forename: Mampedi
authors.initials: M
authors.lastname: Bogoshi
authors.affiliation: Centre for Diabetes & Endocrinology, Johannesburg, South Africa.
authors.forename: Larry A
authors.initials: LA
authors.lastname: Distiller
authors.affiliation: Pfizer Global Innovative Pharma, Collegeville, PA, USA.
authors.forename: Ehab Y
authors.initials: EY
authors.lastname: Mahgoub
authors.affiliation: Department of Diabetes and Endocrinology, Nelson R Mandela School of Medicine, Durban, South Africa.
authors.forename: Mahomed Ka
authors.initials: MK
authors.lastname: Omar
authors.affiliation: Pfizer Global Established Pharma, New York, NY, USA.
authors.forename: Ismail A
authors.initials: IA
authors.lastname: Tarek
authors.affiliation: Pfizer Global Established Pharma, New York, NY, USA.
authors.forename: Dalia B
authors.initials: DB
authors.lastname: Wajsbrot
mesh_terms: D000368:Aged; D000554:Ambulatory Care Facilities; D003430:Cross-Sectional Studies; D003922:Diabetes Mellitus, Type 1 / Q000150:complications* / Q000473:pathology; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000473:pathology; D003929:Diabetic Neuropathies / Q000150:complications* / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009437:Neuralgia / Q000150:complications* / Q000453:epidemiology*; D012892:Sleep Deprivation / Q000473:pathology; D013019:South Africa / Q000453:epidemiology; D011795:Surveys and Questionnaires
keywords: Diabetes; South Africa; peripheral neuropathic pain; prevalence