UAE set for pain emergence alongside high rate of diabetes

The UAE has the second highest rate of diabetes in the world affecting almost 20% of the overall population, rising to 40% in the over 60 age group, according to the latest World Health Organisation data.

Of those with diabetes more than half will go on to develop nerve damage in their limbs, of which 26% with Type 2 diabetes will suffer nerve pain that often presents as a burning pain, numbness or tingling in one or more of the limbs.

This means approximately 250,000 people with diabetes are likely to suffer from painful diabetic neuropathy by the middle of 2009, if the UAE's population rises to more than five million as predicted by the Ministry of Economy in May.

"Pain in diabetes is common, it happens quite frequently," confirmed local pain expert Dr. Mohamed Saadah, a consultant neurologist in Dubai.

"It can come with long durations of disease, say after ten years, however some patients with Type 2 diabetes present with pain, which can be difficult to diagnose.

"The pain can be generalised in four limbs or involve one limb, or sometimes there can be some sort of facial or back pain, it depends of the type of nerve damage,"

Dr. Saadah explained.

Dr. Ayman Al Mofti, consultant rheumatologist in Dubai, added that most patients with diabetes were unaware of the complication of nerve pain, which is treatable with newer drugs.

"They do not realise diabetes can cause painful symptoms, it is an added frustration that they are not aware of. Chronic pain has a significant impact on people, it is debilitating, and has a psychological impact as people cannot run their own lives, and it affects their mood leading to depression and anxiety" he said.

"There are some diabetic patients who are not under care. They know about the illness and they neglect it, but then the pain brings them back to the doctor. It is a difficult complication to treat but now there are newer treatments that can help," Dr. Al Mofti said.

Treatment includes drugs such as Pfizer's Lyrica (pregabalin), which is licenced for neuropathic pain and specifically for diabetic nerve pain. It reduces pain by modulating the "over-excited" nerve cells that prevents them from firing pain signals.

Studies show that taking the drug at the recommended dose of 75mg/twice a day for one week, followed by 150 mg twice a day for eight weeks, results in a significant reduction in pain scores and pain-related sleep interference.

More than 200 doctors attended the pain symposia held in Dubai and Abu Dhabi on June 29 and 30, where they heard presentations from leading international pain management experts.