The Social and Vocational Burden of Diabetic Peripheral Neuropathy: A Cross-Sectional Study on Daily Functioning and Employment Status

Abstract

A cross-sectional descriptive study was conducted to determine the social and vocational burden of diabetic peripheral neuropathy (DPN), and 384 adults with type 2 diabetes were selected from diabetic and physiotherapy outpatient departments of Karachi and Hyderabad (Sindh), Pakistan. The Douleur Neuropathique 4 (DN4) was used to screen for neuropathy; an employment status/questionnaire to assess work disruption; and the WHO Disability Assessment Schedule 2.0 (WHODAS 2.0). DPN was confirmed in 63.8% of participants; among those, 44.2% had decreased work hours or lost their jobs due to neuropathic symptoms. 39.7% of the confirmed DPN participants reported moderate to severe functional disability. Significant positive correlation was observed between the severity of neuropathy and disability scores (rs = 0.531, p < 0.001), and a significant negative correlation was observed between the severity of neuropathy and employment continuity (rs = −0.478, p < 0.001) using Spearman's correlation. The severity of DPN was a single factor significantly associated with employment disruption and daily functional impairment, after adjusting for age, diabetes duration, and glycemic control, by regression analysis. Participants with sedentary jobs experienced considerably less disruption at work than those with physically demanding jobs. The results presented here indicate that diabetic peripheral neuropathy is a big social and economic burden and directly affects workforce participation in Pakistan, with the need for early screening, occupational accommodation, and accessible rehabilitation services for working-age adults with diabetes.