Polyneuropathy is inadequately treated despite increasing symptom intensity in individuals with and without diabetes (PROTECT follow‐up study)

Abstract

Aims/Introduction Despite its major clinical impact, distal symmetric polyneuropathy remains frequently undiagnosed and undertreated in clinical practice. We previously reported in the PROTECT Study that 70% of type 2 diabetes patients with distal symmetric polyneuropathy were unaware of having the latter condition. Materials and Methods In the present follow‐up after 2.5±0.7 years, 122 and 85 participants with and without type 2 diabetes, respectively, completed questionnaires to obtain information about the further course of disease and its management. Results At follow‐up, 49 and 48% of the respondents with type 2 diabetes and without diabetes, respectively, reported that the intensity of paresthesia or numbness in the feet increased, while for burning and pain in the feet the corresponding percentages were 56 and 61%. However, 33 and 40% of the respondents with type 2 diabetes and without diabetes, respectively, reporting neuropathic symptoms at follow‐up did not receive any pharmacotherapy. Pharmacotherapy of neuropathic symptoms at follow‐up among participants with type 2 diabetes and without diabetes included mainly WHO Step 1 analgesics (except for acetylsalicylic acid) (17% each), pregabalin/gabapentin (20% and 12%), vitamin B complex (13% and 22%), benfotiamine (13% and 2%), opioids (7% and 12%), antidepressants (4% and 5%), and α‐lipoic acid (4% and 2%). Conclusions These findings point to insufficient care, inadequate treatment adherence, or limited efficacy of treatments in patients with polyneuropathy, suggesting that effective measures should be implemented to correct these health care deficits.