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

Background 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. Methods 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; 301 participated. 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. Results 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. Conclusions 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.