Painful diabetic neuropathy - clinic communication gaps and opportunities

Nearly 19 million Americans (8.3% of the population) have diabetes and it is estimated that another 7 million are yet undiagnosed. About 60% to 70% of people with diabetes have mild to severe forms of nervous system damage and neuropathic symptoms are common associated symptoms. We surveyed 1004 US adults with Type I or Type II diabetes experiencing any symptoms of diabetic peripheral neuropathy (DPN). We also surveyed 500 healthcare practitioners who treat patients with diabetes Healthcare providers estimate a lower prevalence of pain symptoms (41%) than patients report (83%); and estimate a lower impact on daily activities (38%) than patients report (77%). Despite painful symptoms and limitations in daily activities, fewer than half of patients with diabetic nerve pain are formally diagnosed. Fewer than half of those with painful DPN say they speak about it regularly with their doctors and most say that symptoms are discussed only briefly or in passing (72%) rather than in detail (28%). Nearly three quarters (73%) of HCPs report discussing DPN symptoms at most or all visits, and 45% report that when they speak about these symptoms they are discussed in detail. Misperceptions about how to manage DPN are common among both patients and healthcare providers. There are substantial disparities in patient report and clinician estimations. Targeted educational outreach and tools that facilitate clinical communication between patients and health care providers in the area of diabetic neuropathy may have significant impact given the high prevalence of the problem and the demonstrable disparities in patient experiences and provider perceptions. Supported by a grant from Pfizer.