Listen to your patients for early identification of peripheral neuropathy: health experts

DUBAI: As part of World Diabetes Day 2023, P&G Health brought together renowned health experts at the ‘#KnowtheSigns Scientific Forum’.

Hosted out of Jakarta and simulcast to six countries, the signature event was attended by more than 1,000 healthcare practitioners from across Asia-Pacific, Middle East, India and Africa and saw deliberations on the latest clinical guidance and research findings on diagnoses and treatment of peripheral neuropathy in diabetes and pre-diabetes.

At the forum, the new findings of the Nenoin Clinical Study were also unveiled showing innovative results, which concluded that treatment with a fixed dose combination of vitamin B1, B6, and B12 led to significant improvement in nerve function measured via ankle reflexes, knee reflexes, muscle strength, and sensory perception in toes and fingers of patients with peripheral neuropathy.

With diabetes mellitus Type 2 being the leading cause6 of PN, the increasing prevalence of PN is closely linked to the rise in the number of diabetic patients. Diabetic peripheral neuropathy (DPN) is the result of damage to the nerves impacting quality of life of people as they are not able to go about their daily lives as comfortably. Symptoms of PN include numbness, tingling, prickling, and burning sensations in the hands and feet. B vitamin deficiency and poly-medication are other high-risk factors along with diabetes, leading to peripheral nerve damage. Published studies across different countries confirm that up to 80 percent of patients with PN remain undiagnosed and untreated.

Aalok Agrawal, Senior Vice-President, P&G Health, Asia, India, Middle East & Africa, said, “As a partner to International Diabetes Federation (IDF), P&G Health is committed to continued efforts to raise awareness on diabetes and its associated complications including peripheral neuropathy and Vitamin B deficiency. An estimated 1 in 2 Diabetics and 1 in 103 pre-diabetics suffer from peripheral neuropathy, while Vitamin B deficiency affects the quality of life of ~19 percent of all people with diabetes. As part of our 2023 World Diabetes Day Initiative, our ‘#KNOWTHESIGNS Scientific Forum’ saw a multidisciplinary panel of experts from across the globe and the region come together to share their clinical recommendations on diagnoses and management of peripheral neuropathy in diabetes and pre-diabetes, impact of Vitamin B deficiency on quality of life and the role of B vitamins in supporting healthy nerve functions”.

Expert Speak:

Speaking at the forum, Prof Rayaz A Malik (Assistant Dean for Clinical Research at Weill Cornell Medicine-Qatar) stated, “Early diagnosis of DPN allows for timely risk factor reduction and improvement of this most common disabling complication of diabetes. Primary care physicians play a pivotal role in recognising DPN. Asking the right questions and undertaking simple diagnostic testing can have a major positive impact on the lives of patients with DPN by enabling pain relief and prevention of foot ulceration and amputation. Leveraging advanced diagnostic tools like corneal confocal microscopy (CCM) and AI introduces a new paradigm to the early diagnosis and management of DPN.

Dr Rizaldy Pinzon (neurologist at Neurology Department, Bethesda Hospital, Yogyakarta – Indonesia) said: “As a medical professional, it is crucial to emphasise the significance of timely treatment for peripheral neuropathy. Initiating treatment promptly can provide substantial benefits in managing symptoms and mitigate further neurological damage. Timely intervention can enhance sensory perception, alleviate painful symptoms, and prevent complications such as infections, ulcers and eventually diabetic foot amputation. It is important for primary care physicians to remain vigilant and promptly treat any alterations in the patient’s lower extremities, including numbness, paresthesia, or neuropathic pain.”

Speaking about the role of pharmacists, Dr Kenny P Merin (pharmacist and Assistant Vice President, Academics & Research of Lyceum of the Philippines University Davao – Philippines) said: “Pharmacists are an integral part of the healthcare team and can provide valuable support to patients with PN, yet often we are underutilised. Pharmacists are often the first point of contact and can drive early awareness of patient’s condition, offer guidance on lifestyle modifications, and help optimise medication regimens. Pharmacists can also recommend over-the-counter treatments (e.g., therapeutic dose of neurotropic B vitamins) for PN symptom relief. By actively engaging with patients and healthcare professionals, let’s join hands to improve PN patients’ long-term health and well-being.”

Talking about the condition in India, Dr Vaishali Deshmukh (consultant and head of the Endocrinology Department at Deenanath Mangeshkar Hospital (DMH) Erandawane Pune – India) commented, “Unfortunately, India has become the diabetes capital of the world. With 74.2 million people living with diabetes and alarming prevalence of pre-diabetes in India, half of these individuals are at risk of developing DPN. Collaborative efforts between healthcare professionals, patient education, and early referral to specialists are essential steps to improve the management of DPN in India.”

Adding from South Africa, Dr Ankia Coetzee (consultant endocrinologist, past president of Society of Diabetes Endocrinology and Metabolism of South-Africa (SEMDSA) – South Africa) said, “One of the current challenges in driving better management of DPN is the need for increased awareness among both primary care physicians and patients. It is crucial for healthcare providers to receive ongoing education and training on DPN diagnosis, and right treatment options. Patients should be educated about the importance of regular foot and DPN examinations, glycaemic control, and adherence to prescribed medications. By addressing these challenges through holistic education like P&G Health WDD campaign and collaborative care, we can enhance the management and outcomes of individuals with DPN in South Africa.”

Sharing more details about the NENOIN Study, Dr Inna Eiberger (Global Medical Director, P&G Health Nerve Care Franchise) shared, “PN is associated with poor functional mobility and compromised motor symptoms, in addition to sensory symptoms. These symptoms significantly worsen the quality of life of patients. Results from the Nenoin study concluded that the synergistic combination of vitamins B1, B6, and B12 can not only relief symptoms but also significantly improve nerve function in patients with PN which is a critical learning. This further underlines how early screening for PN and timely treatment can help improve quality of life and treatment outcomes”.

Ahead of World Diabetes Day 2023, P&G Health continued awareness efforts with an innovative #KnowtheSigns campaign. “Our #KnowtheSigns campaign is a step change in the approach towards health awareness, as for the first time, we have leveraged artificial intelligence (AI) to make the invisible condition of PN and Vitamin B deficiency visible and more relatable to consumers. We hope to help people understand the condition by shedding light on daily struggles and symptoms. Not many people are aware that early diagnosis can help enable better treatment outcomes and better quality of life, and damaged nerves can be regenerated if nerve damage has not progressed too far,” Aalok added.