- Antiepileptic drug (AED) use is relatively low in patients recently diagnosed with diabetic polyneuropathy (DPN) in Germany.
Why this matters
- Neuropathic pain is one of the most common and debilitating DPN symptoms.
- AEDs such as γ-aminobutyric acid analogues and other anticonvulsants are well-tolerated and associated with decreased peripheral neuropathic pain.
- Retrospective study of 48,324 adults diagnosed with DPN at 1238 German general and diabetologist practices during 2008-2017.
- Funding: None.
- Within 5 years of DPN diagnosis,16.4% of patients were prescribed ≥1 AED at a median of 150 days, with 30% treated on the day of diagnosis.
- Most frequent AEDs prescribed were pregabalin (46.7%), gabapentin (45.3%), and carbamazepine (4.2%).
- Diabetologists were more likely than general practitioners to prescribe pregabalin (55.1% vs 36.8%).
- After adjustments, significant predictors of AED therapy were (HR; 95% CI):
- Female sex: 1.22 (1.15-1.30);
- Private health insurance coverage: 1.22 (1.07-1.40);
- General practice follow-up: 1.85 (1.69-2.03);
- HbA1c ≥10%: 1.36 (1.20-1.54);
- Previous neurology referral: 1.47 (1.33-1.62);
- Previous hospital admission: 1.51 (1.34-1.70);
- Depression diagnosis: 1.15 (1.07-1.24); and
- Type 1 vs type 2 diabetes: 1.30 (1.09-1.56).
- Lack of detail about severity, complications.
- Deceased patients counted as lost to follow-up.
- No data available on treatment follow-up, diabetes duration.