2717-LB: Clinical and Economic Burden Associated with Painful Diabetic Peripheral Neuropathy (PDPN) in Patients with Type 2 Diabetes (T2D)

Introduction and Objective: This study assessed the clinical and economic burden for patients with T2D and PDPN compared with patients with T2D and no diabetic peripheral neuropathy (DPN). Methods: This retrospective study used the Optum Clinformatics Data Mart (2019-2024). The PDPN cohort included adults with T2D initiating a PDPN pain-medication ± 60 days of a DPN diagnosis. A comparator cohort of adults with T2D and no DPN was created using propensity score matching. The index date was the first PDPN pain-medication around DPN for PDPN cohort and a randomly selected T2D claim for non-DPN cohort. Outcomes were evaluated over a 12-month follow-up including medication utilization, lower-limb medical events, healthcare resource utilization (HCRU), and healthcare costs. Bivariate analyses compared matched cohorts. Results: After matching, 40,329 PDPN patients and 75,913 non-DPN patients were included. Mean ages were similar (71.2 and 71.0 years). During follow-up, opioids (69.6%) and gabapentinoids (45.1%) were the PDPN medications used most by PDPN patients. When comparing the PDPN cohort to the non-DPN cohort, opioid utilization was markedly higher (69.6% vs 17.5%; Standardized Mean Difference (SMD) = 1.2), and they also had higher rates of medical events, including lower-limb infection/ulcers (9.7% vs 2.3%; SMD = 0.3) and falls (8.3% vs 4.6%; SMD = 0.1). HCRU and costs were higher in the PDPN group, with mean per-patient-per-month (PPPM) total cost at $3,615 vs $1,856 (SMD = 0.3). Among baseline insulin-naïve patients, more PDPN patients initiated basal insulin (8.4% vs 3.8%; SMD = 0.2) and they initiated insulin earlier (Mean 370.1 vs 438.7 days; SMD = 0.2). Conclusion: PDPN patients experienced a substantial burden compared with patients without DPN. Despite guidelines discouraging the use of opioids for PDPN, they were widely used by PDPN patients. These findings highlight the unmet need for improved pain management strategies for PDPN. Disclosure Y. Zhang: Employee; Current; Novo Nordisk A/S. Employee; Ended; Bayer AG. L. Xie: None. C. Swift: Employee; Current; Novo Nordisk. Stock/Shareholder; Current; Novo Nordisk. N. Laney: Employee; Current; Novo Nordisk. A.A. King: Speaker's Bureau; Current; Lilly. Advisory Panel; Current; Lilly. Speaker's Bureau; Current; Abbott. Advisory Panel; Current; Abbott, Novo Nordisk. Speaker's Bureau; Current; Novo Nordisk, Dexcom, Inc. Advisory Panel; Current; Dexcom, Inc. Speaker's Bureau; Current; AstraZeneca, Astellas Pharma Inc.