Mapping the journey of patients with painful diabetic peripheral neuropathy in the Philippines

Objectives@#Knowing the limited epidemiological studies on painful diabetic peripheral neuropathy (pDPN) in the Philippines, the present review aimed to map the prevalence of pDPN and identify the associated healthcare gaps. @*Materials and Methods@#A systematic search of MEDLINE, Embase and BIOSIS was conducted using predefine inclusion criteria, and relevant studies published in English between 2004 and 2021 were identified. An unstructured literature search was also conducted on public and government websites with no date restriction. Data combined from all sources were synthesized and presented as a simple mean.@*Results@#Three studies were considered for final analyses of the 26 articles retrieved from structured and unstructured searches. The sample sizes for the three studies were 103, 172, and 100, respectively. The simple mean prevalence of pDPN was estimated at 26.5%. Awareness of pDPN based on a published study was 89%. According to published studies, screening and diagnosis of pDPN were 65% and 76.7%, respectively. One-third of the patients with pDPN (75%) were treated. No literature is available for adherence and control.@*Conclusion@#Limited data exist on the different management stages of patients with pDPN in the Philippines. The study analysis will help address the knowledge gaps, improve patient care and pain management, and aid decisionmaking.

Dragon-tiger fighting needling therapy in treatment of painful diabetic peripheral neuropathy: a randomized controlled trial / 中国针灸

OBJECTIVE@#To compare the clinical therapeutic effect on painful diabetic peripheral neuropathy (PDPN) between dragon-tiger fighting needling and pregabalin capsules.@*METHODS@#A total of 60 patients with PDPN were randomized into an observation group and a control group, 30 cases in each one. On the base of treatment with routine anti-hyperglycaemic measures and nutritional neurotherapy, the dragon-tiger fighting needling was exerted at Sanyinjiao (SP 6), Zusanli (ST 36), Yinlingquan (SP 9) and Xuehai (SP 10) in the observation group, once daily. Pregabalin capsules were prescribed for oral administration in the control group, 75 mg, twice a day. The treatment for 2 weeks was as one course and 2 courses of treatment were required in total. The score of visual analogue scale (VAS), the score of MOS item short form health survey (SF-36) and nerve conduction velocity before and after treatment were compared between the two groups. The clinical therapeutic effect was evaluated in the two groups.@*RESULTS@#After treatment, VAS score was reduced as compared with before treatment in the two groups (@*CONCLUSION@#The dragon-tiger fighting needling therapy relieves painful symptoms, improves the quality of life and increases nerve conduction velocity in the patients with diabetic peripheral neuropathy, and the therapeutic effect is better than oral administration of pregabalin capsules.

Efficacy evaluation on flexible dozes of Pregabalin for treatment of peripheral neuropathy in refrac- tory painful diabetics / 上海预防医学

Objective ] To evaluate the efficacy and tolerability of a flexible-dose pregabalin regimen in patients with refractory painful diabetic peripheral neuropathy . [ Methods] A prospective, open, non-randomized design was adopted .A series of 48 patients with refractory painful diabetic peripheral neuropathy received pregabalin 150 to 300 mg/d for 4 weeks.Pain intensity and sleep interference score were measured using numerical rating scale at baseline and at 2 and 4 weeks after therapy.Secondary meas-ures for assessment of mood and overall efficacy included 17-item Hamilton depression scale ( HAMD -17), Hamilton anxiety scale ( HAMA) and patient global impression of change ( PGIC).Adverse events were recorded . [ Results] The 46 patients completed the 4 weeks study .The mean dose of pregabalin was (262.5 ±57.9)mg/d at endpoint.The mean pain score decreased from 6.2 ±1.0 at baseline to 4.3 ± 1.4 at 2 weeks and 3.0 ±1.6 at 4 weeks ( P all <0.01).The mean sleep interference score was 5.1 ±1.4, 3.3 ±1.4, 2.1 ±1.5 respectively (P all <0.01).Also, significant improvements were noted in the HAMD and HAMA score (P<0.01).And among them, 26 patients (56.5%) reported“very much improved” or“much improved” in PGIC.Pregabalin was generally well tolerated without severe side effects reported and only 2 patients ( 4 .2%) discontinued the study because of their dizziness , somnolence . [ Conclusion] Pregabalin 150 to 300 mg/d can effectively improve pain , sleep, anxiety/depression in patients with refractory painful diabetic peripheral neuropathy , and it was well-tolerated.