Unveiling the Demographics and Clinical Characteristics of Diabetic Neuropathy: Findings From the National Health Insurance Service, 2012–2017

BACKGROUND: Diabetic neuropathy (DN) is the most common chronic complication of Type 2 diabetes mellitus (T2DM), with reported prevalence ranging from 23% to 54.5%. This study evaluated the prevalence, clinical characteristics, and treatments of DN using Korean National Health Insurance Service (NHIS) data from 2012 to 2017. METHODS: We analyzed NHIS sample data for 8.7 million individuals stratified by age, sex, eligibility, and income. DN was defined using ICD-10 codes (E10.4-E14.4, G59.0, G63.2, G99.0) and concurrent prescriptions for diabetes and DN. Annual DN prevalence among diabetes patients was calculated, and treatment patterns and patient characteristics were compared between those with and without DN. RESULTS: DN prevalence declined from 23.4% in 2012 to 21.5% in 2017. About half of DN patients received pharmacologic treatment-mainly monotherapy (up to 82%), followed by dual (15%) and triple therapy (3%). The most prescribed drugs were α-lipoic acid (52.1%-55.0%), anticonvulsants (30.4%-34.5%), tricyclic antidepressants, SNRIs, and γ-linolenic acid. DN patients were generally older, more often female, and had more comorbidities such as hypertension, dyslipidemia, cardiovascular disease, diabetic foot, and amputations. They were also more likely to use insulin or multiple oral agents. CONCLUSION: About one-quarter of patients with T2DM had DN, and half received treatment, mostly α-lipoic acid monotherapy. DN patients tended to be older and had multiple comorbidities, resulting in higher hospitalization rates.