Diagnosis, management and impact of painful diabetic peripheral neuropathy: A patient survey in four European countries

Aims: The aim of this study was to assess patient perspectives and experiences of the impact of neuropathic pain, painful diabetic neuropathy (pDPN) diagnosis and treatment, and the patient–healthcare professional (HCP) relationship. Methods: We conducted a quantitative online survey in Germany, the Netherlands, Spain, and the UK among adults with diabetes who responded “yes” to at least four of ten questions of in the Douleur Neuropathique en 4 Questions (DN4) questionnaire. Results: Of 3626 respondents, 576 met the eligibility criteria. Daily pain was rated as moderate or severe by 79 % of respondents. Most participants reported a negative impact of their pain on sleep (74 %), mood (71 %), exercise (69 %), concentration (64 %) and daily activities (62 %), and 75 % of those in employment had missed work because of their pain in the past year. Overall, 22 % of respondents avoided discussing pain with their HCP, 50 % had not received formal pDPN diagnosis, and 56 % had not used prescribed pain medications. Although two-thirds (67 %) of respondents reported feeling satisfied or very satisfied with treatment, 82 % of these patients still experienced daily moderate or severe pain. Conclusions: Neuropathic pain in people with diabetes affects daily life and remains underdiagnosed and undertreated in clinical practice.