Journal Article

Diabetic polyneuropathy with/out neuropathic pain in Mali: A cross-sectional study in two reference diabetes treatment centers in Bamako (Mali), Western Africa

Albakaye, Mohamed, Coulibaly, Souleymane Papa, Coulibaly, Awa, Traoré, Hamar A., Diallo, Salimata, Diallo, Seybou H., Konipo, Fatoumata dite Nènè, Ouologem, Madani, Daou, Mariam, Nizard, Julien, Mahamadou, Saliou, Sow Sylla, Djeneba, Guinto, Cheick Oumar, Damier, Philippe, Péréon, Yann, Sissoko, Adama S., Traoré, Zoumana, Maiga, Youssoufa, Sangaré, Modibo, Attal, Nadine, Sangho, Oumar, Giumelli, Bernard

2020

Overview

Diabetic polyneuropathy (DPN) with or without neuropathic pain is a frequent complication of diabetes. This work aimed to determine the prevalence of diabetic polyneuropathy, to describe its epidemiological aspects, and to analyze the therapeutic itinerary of patients with DPN. This was a cross-sectional, descriptive study performed synchronously over six months at two major follow-up sites for patients with diabetes in Mali. DPN was diagnosed based on the Michigan Neuropathy Screening Instrument (MNSI). The neuropathic nature of the pain and the quality of life of patients were evaluated by the DN4 and the ED-5D scale, respectively. We used three (3) different questionnaires to collect data from patients (one at inclusion and another during the follow-up consultation) and from the caregivers of patients with DPN. We included 252 patients with diabetes, and DPN was found to have a healthcare facility-based prevalence of 69.8% (176/252). The sex ratio was approximately three females for every male patient. The patients were mostly 31 to 60 years of age, 83% had type 2 diabetes, and 86.9% had neuropathic pain Approximately half of the patients (48.3%) had autonomic neuropathy and they reported moderate to intense pain, which was mainly described as a burning sensation. The patients exhibited impaired exteroceptive and proprioceptive sensations in 51.7% of cases. The patients smoked tobacco in 3.4% of cases, while 36.6% of the patients were obese and had dyslipidemia. The caregivers clearly indicated that appropriate medications were not readily accessible or available for their patients with DPN. The healthcare facility-based prevalence of DPN with or without neuropathic pain was high in our cohort. These inexpensive and easy-to-use tools (MNSI, DN4) can be used to adequately diagnose DPN in the African context. In Mali, screening and early treatment of patients at risk of DPN should allow for a reduction of the burden of the disease, while caregivers need to be adequately trained to manage DPN.

• Publisher: Public Library of Science,Public Library of Science (PLoS)
• Subject: Adolescent / Adult / Autonomic nervous system / Biology and Life Sciences / Blood pressure / Burning / Cardiac arrhythmia / Care and treatment / Cross-Sectional Studies / Dental surgery / Diabetes / Diabetes mellitus / Diabetes mellitus (non-insulin dependent) / Diabetic neuropathies / Diabetic Neuropathies - complications / Diabetic Neuropathies - therapy / Diabetic neuropathy / Diagnosis / Dyslipidemia / Electrocardiography / Epidemiology / Female / Health care / Health Care Costs / Health care facilities / Health Knowledge, Attitudes, Practice / Health services / Humans / Laboratories / Male / Mali / Medicine / Medicine and Health Sciences / Middle Aged / Neuralgia - complications / Neuralgia - drug therapy / Neuralgia - economics / Neurology / Neuromuscular diseases / Neuropathy / Obesity / Orthostatic hypotension / Pain / Patients / People and Places / Polyneuropathies / Polyneuropathy / Proprioception / Quality of Life / Referral and Consultation / Risk Factors / Sex ratio / Statistics / Teaching hospitals / Tobacco / Womens health / Young Adult