The results of this observational study suggest that one-third of all community-based diabetic patients have painful neuropathy symptoms, regardless of their neuropathic deficit. The study focused on a cohort of patients (n = 15,692) receiving community based diabetes care in northwest England as part of the North-West Diabetes Foot Care Study (NWDFCS). The NWDFCS is a population based investigation of diabetes-related foot problems in the community health care setting. Peripheral neuropathy was assessed as part of this study using neuropathy symptom score (NSS) and neuropathy disability score (NDS). The results found (direct from source):

• Prevalence of painful symptoms (NSS ≥5) and painful diabetic neuropathy (PDN, NSS ≥5 and NDS ≥3) was 34 and 21%, respectively.

• Painful symptoms occurred in 26% of patients without neuropathy (NDS ≤2) and 60% of patients with severe neuropathy (NDS >8).

• Adjusted risk of painful neuropathic symptoms in type 2 diabetes was double that of type 1 diabetes (odds ratio [OR] = 2.1 [95% CI 1.7–2.4], P < 0.001) and not affected by severity of neuropathy, insulin use, foot deformities, smoking, or alcohol.

• Women had 50% increased adjusted risk of painful symptoms compared with men (OR = 1.5 [1.4–1.6], P < 0.0001).

• Despite less neuropathy in South Asians (14%) than Europeans (22%) and African Caribbeans (21%) (P < 0.0001), painful symptoms were greater in South Asians (38 vs. 34 vs. 32%, P < 0.0001).

• South Asians without neuropathy maintained a 50% increased risk of painful neuropathy symptoms compared with other ethnic groups (P < 0.0001).

The study found that PDN was more prevalent in patients with type 2 diabetes, women, and people of South Asian origin. The authors write, “These areas demand further investigation and also highlight key groups who may warrant screening for PDN.”