Painful diabetic neuropathy (PDN) is a common complication of diabetes. Symptoms include, but are not limited to, tingling sensations, burning, numbness or excruciating stabbing pain. In the seven major pharmaceutical markets (7MM: the US, France, Germany, Italy, Spain, UK, and Japan), GlobalData epidemiologists found that only around 60% of PDN cases will be diagnosed by the end of 2023, with the US experiencing the highest number of undiagnosed cases due to the large number of PDN cases in this market.

Across the 7MM combined, GlobalData epidemiologists forecast 7.8 million total prevalent cases of PDN, of which only 4.6 million will be diagnosed by the end of the year (as shown in Figure 1). This forecast data demonstrates that approximately 60% of individuals with PDN are diagnosed by a physician. The lowest diagnosis rate is forecast to occur in Italy at 51.6%, while the highest is forecast in Germany at 65.6%. These low rates are likely to be driven by mild cases of PDN that go unnoticed by patients until they progress to severe pain that hinders daily activity.

According to a 2021 study published in Pain and Therapy by Zhang and colleagues, only about 25% of PDN patients had mild PDN, while nearly 75% had moderate to severe PDN. The study, conducted between 2018 and 2019, included 1,547 PDN patients who were part of a multi-centre registry spanning 51 hospitals across 22 provinces, five autonomous regions and four municipalities in mainland China. The results of this study are concerning, as they indicate a potential lack of early detection of mild PDN, which is likely to be driving the gap between diagnosed and undiagnosed cases.

The accurate and timely identification of PDN cases in the primary care setting is critical for improving patient outcomes. Future efforts should prioritise the implementation of routine screening programs that optimise the early detection and identification of less severe forms of PDN. Finally, educational programs should aim to increase both patient and physician awareness of PDN, as well as its progression, severity, and management.