Prevalence of painful diabetic peripheral neuropathy among patients with diabetes mellitus in the Middle East region.

The prevalence of painful diabetic peripheral neuropathy (DPN) was evaluated in type 1 or type 2 diabetes mellitus patients (n = 4097) attending outpatient clinics across the Middle East. Overall, 53.7% of 3989 patients with DN4 data met the criteria for painful DPN (Douleur Neuropathique-4 [DN4] scores ≥ 4). Significant predictors of painful DPN included long history (≥ 10 years) of diabetes (odds ratio [OR] 2.43), age ≥ 65 years (OR 2.13), age 50 - 64 years (OR 1.75), presence of type 1 versus type 2 diabetes (OR 1.59), body mass index > 30 kg/m(2) (OR 1.35) and female gender (OR 1.27). Living in one of the Gulf States was associated with the lowest odds of having painful DPN (OR 0.44). The odds of painful DPN were highest among patients with peripheral vascular disease (OR 4.98), diabetic retinopathy (OR 3.90) and diabetic nephropathy (OR 3.23). Because of the high prevalence and associated suffering, disability and economic burden of painful DPN, it is important that diabetic patients are periodically screened, using a simple instrument such as the DN4, and receive appropriate treatment if symptoms develop.

Sildenafil for erectile dysfunction in the Middle East: observational analysis of patients with diabetes and/or hypertension treated in the clinical practice setting.

The effectiveness and tolerability of 12 weeks of open-label treatment with sildenafil citrate for erectile dysfunction (ED) associated with a diagnosis of diabetes mellitus and/or hypertension were assessed in clinical practice in three Middle Eastern countries. The dose was initially 50 mg and was adjusted by the physician as needed (permissible dose range 25 - 100 mg). Total mean ± SD score on the five-item version of the International Index of Erectile Function (severe ED, score 0 - 7; no ED, score 22 - 25) was 13.6 ± 5.7 at baseline (4556 patients) and increased significantly to 21.7 ± 4.1 at week 12. Global effectiveness was rated as good or very good by 91.4% of patients, 93.9% rating their sexual activity as spontaneous and 91.4% as natural. Discontinuation of sildenafil due to adverse events was infrequent (0.5%). Tolerability was rated as good or very good by 95.7% of patients. It is concluded that sildenafil was a well-tolerated and highly effective treatment of ED in outpatients with diabetes and/or hypertension from the three Middle Eastern countries studied.

Prevalence of neuropathic pain among patients with chronic low-back pain in the Arabian Gulf Region assessed using the leeds assessment of neuropathic symptoms and signs pain scale.

This prospective, multicentre, epidemiological study was designed to assess the prevalence of neuropathic pain among adults with chronic low-back pain (LBP) in the Arabian Gulf region. A total of 1134 patients recruited from the outpatient medical setting were assessed using the Leeds Assessment of Neuropathic Symptoms and Signs (LANSS) Pain Scale. A LANSS Pain Scale score ≥ 12 was used to differentiate between patients with a neuropathic contribution to their pain and those with nociceptive pain only. Using this criterion, 628 patients (55%) were classified as having neuropathic pain. Factors associated with neuropathic pain included advanced age, female gender and diabetes with or without hypertension. It was concluded that neuropathic pain is a major contributor to chronic LBP in the Gulf region, and that the LANSS Pain Scale is a practical and rapidly administered screening test for distinguishing the relative contributions of neuropathic and nociceptive pain in patients with chronic LBP that resulted in the use of a more appropriate treatment.