Socioeconomic deprivation and painful neuropathy in type 1 diabetes: Implications for nurse-led screening

There are approximately 250000 people with type 1 diabetes in the UK (NICE, 2008). Diabetic neuropathy is the most common form of neuropathy in the western world and approximately 50% of people with diabetes have mild to severe forms of neuropathy (Abbott et al, 2011). The majority of these will undergo screening by practice nurses or podiatrists in primary care. Several distinct forms of neuropathy are associated with diabetes. The most common form of diabetic neuropathy is the distal symmetric sensorimotor neuropathy, which occurs in a glove and stocking pattern and is characterised by symptoms such as burning, shooting pain, tingling sensations and allodynia (pain secondary to a stimulus that does not normally cause pain). However, in many individuals, the neuropathy is insensate (Tesfaye et al, 1996). Diabetes care provision in the UK is much further ahead than in less developed countries around the world. However, it is clear from several reports that diabetes management is still a significant problem amongst those at a socioeconomic disadvantage (Diabetes UK, 2006). In this current study, we investigated the factors that influence the prevalence of symptomatic diabetic neuropathy in people with type 1 diabetes and analysed the prescribing of agents used to treat painful diabetic neuropathy.