Prevalence, severity and predictors of painful diabetic neuropathy: a cross-sectional study

Background. Painful diabetic peripheral neuropathy (PDPN) is a common yet underdiagnosed complication of diabetes that significantly impacts patients' quality of life. This study aimed to determine the prevalence, severity, and predictors of PDPN among patients with type 2 diabetes mellitus (T2DM) in Vietnam. Methods. This cross-sectional observational study was conducted at the Endocrinology Clinic of University Medical Center Ho Chi Minh City, Vietnam, from March to May 2024. A total of 453 patients with T2DM aged ≥18 years were enrolled. PDPN was diagnosed using the Douleur Neuropathique en 4 Questions (DN4) questionnaire, with a score ≥4 indicating neuropathic pain. The severity and functional impact of PDPN were assessed using the Brief Pain Inventory–Diabetic Peripheral Neuropathy (BPI-DPN) scale. Multivariate logistic regression was used to identify predictors of PDPN. Results. The prevalence of PDPN was 12.1%. Among affected individuals, 54.5% reported moderate and 18.2% reported severe worst pain in the past 24 hours. Pain interference was most pronounced in sleep (18.2% severe) and work (12.7% severe). Multivariate analysis identified atherosclerotic cardiovascular disease, diabetic retinopathy, duration of diabetes, insulin use, and use of moderate- or high-intensity statins as significant predictors of PDPN. Conclusion. PDPN is highly prevalent among Vietnamese patients with T2DM. Several predictors were identified, which may aid in early recognition and management. However, due to the cross-sectional design, causality cannot be established. Further longitudinal studies are needed to confirm these associations.