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Exp Clin Endocrinol Diabetes 2015; 123(07): 423-427
DOI: 10.1055/s-0035-1549966
Article
© Georg Thieme Verlag KG Stuttgart · New York

Socioeconomic Deprivation Independently Predicts Painful Diabetic Neuropathy in Type 2 Diabetes

S. G. Anderson
1   Cardiovascular Sciences Research Group, The University of Manchester, Manchester, United Kingdom
,
R. P. Narayanan
2   Department of Obesity and Endocrinology, University of Liverpool
,
N. S. Malipatil
3   Vascular Research Group, The University of Manchester
,
H. Roberts
4   Department of Medicine, Leighton Hospital, Crewe
,
G. Dunn
5   Department of Podiatry, East Cheshire NHS Trust, Macclesfield
,
A. H. Heald
4   Department of Medicine, Leighton Hospital, Crewe
6   The School of Medicine and Manchester Academic Health Sciences Centre, University of Manchester
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Publikationsverlauf

received 31. Dezember 2014
first decision 08. April 2015

accepted 22. April 2015

Publikationsdatum:
11. Juni 2015 (online)

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Abstract

Objective: Painful peripheral neuropathy in people with type 2 diabetes is a disabling complication. We explored associations of this condition with socioeconomic deprivation.

Research Design and Methods: The Townsend index of socioeconomic deprivation was examined in the pseudonymised GP records of 15388 (44.1% female) individuals with type 2 diabetes in the Cheshire county of England, and related to prevalence of drug treated painful diabetic neuropathy. We also analysed prescription trends with respect to pharmacotherapy for neuropathy pain relief.

Results: Treatment for neuropathic pain was initiated in 3 266 (21.2%) of patients. Those on treatment were older [68.2 (95% CI 67.8–68.7) vs. 66.6 (66.4–66.8) years] than those not on treatment. There was no difference in HbA1c (7%, 55 mmol/mol).

There were significant differences between the groups for the Townsend deprivation index, with a greater proportion (30.6% vs. 22.8% of patients with treated neuropathic pain) having a score of ≥1 (Χ2=83.9, p<0.0001).

Multivariate logistic regression analyses indicated that each unit increment in the Townsend index was associated with an 6% increased odds of requiring neuropathic pain treatment [odds ratio (95%CI) 1.06 (1.05–1.08), p<0.0001] independent of 5 year age band, BMI, gender, systolic BP, eGFR, HbA1C and total cholesterol.

Conclusions: In this study using pseudonymised clinical records, a higher level of socioeconomic deprivation seemingly may predispose to severe neuropathic pain in diabetes requiring pharmacological intervention. Targeted allocation of healthcare resources to this group may offer clinical benefits.

Key words

neuropathy - diabetes - deprivation
 

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