Prevalence and associated factors of probable neuropathic pain among adults with type 2 diabetes in Turkish primary care: a cross-sectional study

Neuropathic pain is a common and disabling complication of type 2 diabetes mellitus (T2DM) that adversely affects quality of life and functional capacity, yet it is frequently under-recognised and undertreated, particularly in primary care. Most evidence on diabetic neuropathic pain comes from hospital-based populations, and data from Turkish primary care—especially among working-age adults—are limited. We aimed to estimate the prevalence of probable neuropathic pain among adults with T2DM in primary care and to identify associated demographic, clinical and laboratory factors. Cross-sectional study of adults aged 18–65 years with T2DM duration ≥ 1 year registered at a family health centre in Türkiye. A stratified random sample of 400 patients was invited. Data were collected by interview and medical record review. Probable neuropathic pain was defined as the Self-completed Leeds Assessment of Neuropathic Symptoms and Signs (S-LANSS) score ≥ 12. Associations were examined using multivariable logistic regression. Out of 400 patients invited, 301 (75.3%) participated in the study. Participants were 53.2% female; mean age 55.1 ± 9.7 years; median diabetes duration 120 months (interquartile range (IQR) 48–180). The prevalence of probable neuropathic pain was 25.9% (95% confidence interval (CI) 21.1–31.3). In the multivariable model, glycated haemoglobin (HbA1c) ≥ 9% (vs. < 7%; odds ratio (OR) 2.29, 95% CI 1.11–4.75) and primary school or less education (vs. university or higher; OR 3.04, 95% CI 1.01–9.13) were independently associated with probable neuropathic pain, whereas age, diabetes duration, hypertension and comorbidity were not independently significant after adjustment. About one in four working-age adults with T2DM in primary care reported probable neuropathic pain. Screening and education-tailored counselling, alongside intensified support for glycaemic control, may be particularly important for patients with poor glycaemic control and lower education.