Bridging gaps in diabetic neuropathy care: A Delphi-based regional consensus from the Gulf Cooperation Council.
Diabetic peripheral neuropathy (DPN) is a common complication of diabetes in the Gulf Cooperation Council (GCC) region, associated with delayed diagnosis, significant pain burden, and preventable complications. This Delphi-based consensus aimed to identify regional gaps in screening and management to develop practical, evidence-based recommendations tailored to GCC healthcare systems.
A three-round Delphi process was conducted involving 12 diabetes experts from six GCC countries, who reviewed international guidelines, identified unmet clinical needs, and voted on consensus statements addressing epidemiology, screening, diagnosis, and treatment, with consensus defined as ≥75% agreement.
The panel reached strong agreement on shifting from symptom-driven to proactive care, recommending routine annual screening for all individuals with diabetes and prediabetes. Experts also emphasized early, integrated management combining lifestyle modification, cardiovascular risk reduction, pathogenetic therapies, and individualized pharmacologic treatment of neuropathic pain. Key barriers identified included limited consultation time, high clinical workload, suboptimal awareness of DPN among clinicians and patients, and restricted access to guideline-recommended therapies due to regulatory constraints.
This regional consensus highlights the need for standardized, proactive care of patients with DPN, across the GCC. Implementation of systematic screening, early multimodal management, and policy-level improvements in access to therapies may improve patients' quality of life and reduce complications.
A three-round Delphi process was conducted involving 12 diabetes experts from six GCC countries, who reviewed international guidelines, identified unmet clinical needs, and voted on consensus statements addressing epidemiology, screening, diagnosis, and treatment, with consensus defined as ≥75% agreement.
The panel reached strong agreement on shifting from symptom-driven to proactive care, recommending routine annual screening for all individuals with diabetes and prediabetes. Experts also emphasized early, integrated management combining lifestyle modification, cardiovascular risk reduction, pathogenetic therapies, and individualized pharmacologic treatment of neuropathic pain. Key barriers identified included limited consultation time, high clinical workload, suboptimal awareness of DPN among clinicians and patients, and restricted access to guideline-recommended therapies due to regulatory constraints.
This regional consensus highlights the need for standardized, proactive care of patients with DPN, across the GCC. Implementation of systematic screening, early multimodal management, and policy-level improvements in access to therapies may improve patients' quality of life and reduce complications.
Authors
Alshaikh Alshaikh, Alattar Alattar, Hassoun Hassoun, Alshammary Alshammary, Elbadawi Elbadawi, Aldossari Aldossari, Al Busaidi Al Busaidi, Alsifri Alsifri, Muzaffar Muzaffar, Hussein Hussein, Talaat Talaat, Effat Effat, Elsaghier Elsaghier, Malik Malik
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