‘Listen to your patients for early identification of Peripheral Neuropathy’ say leading Health Experts at P&G’s #KNOWTHESIGNS Scientific Forum

• Globally >50 million people suffer from PN1,2 with the burden rising every year • 1 in 2 Diabetics and 1 in 10 Pre-diabetics estimated to suffer from Peripheral Neuropathy • Vitamin B Deficiency affects quality of life of ~ 19% of all Diabetics • Unveil NEW NENOIN Study results on how B Vitamins improve sensory symptoms, motor function and motor strength in Peripheral Neuropathy

As part of World Diabetes Day 2023, P&G Health, brought together renowned health experts at the ‘#KNOWTHESIGNS Scientific Forum’. Hosted out of Jakarta and simulcast to 6 countries, the signature event was attended by >1000 healthcare practitioners from across Asia-Pacific, Middle East, India and Africa and saw deliberations on the latest clinical guidance and research findings on diagnoses and treatment of Peripheral Neuropathy in Diabetes and Pre-Diabetes. At the forum, the NEW findings of the NENOIN Clinical Study were also unveiled showing innovative results, which concluded that treatment with a fixed dose combination of vitamin B1, B6, and B12 led to significant improvement in nerve function measured via ankle reflexes, knee reflexes, muscle strength, and sensory perception in toes and fingers of patients with peripheral neuropathy.

With Diabetes Mellitus Type 2 being the leading cause6 of PN, the increasing prevalence of PN is closely linked to the rise in the number of diabetic patients. Diabetic Peripheral Neuropathy (DPN) is the result of damage to the nerves impacting quality of life of people as they are not able to go about their daily lives as comfortably. Symptoms of PN include numbness, tingling, prickling, and burning sensations in the hands and feet. B vitamin deficiency and polymedication are other high-risk factors along with diabetes, leading to peripheral nerve damage. Published studies across different countries confirm that up to 80% of patients with PN remain undiagnosed and untreated.

Aalok Agrawal, Senior Vice-President, P&G Health, Asia, India, Middle East & Africa said, As a partner to International Diabetes Federation (IDF), P&G Health is committed to continued efforts to raise awareness on Diabetes and its associated complications including Peripheral Neuropathy and Vitamin B Deficiency. An estimated 1 in 2 Diabetics2 and 1 in 103 Pre-diabetics suffer from Peripheral Neuropathy, while Vitamin B Deficiency affects the quality of life of ~19% of all people with diabetes,4,5. As part of our 2023 World Diabetes Day Initiative, our ‘#KNOWTHESIGNS Scientific Forum saw a multidisciplinary panel of experts from across the globe and the region come together to share their clinical recommendations on diagnoses and management of Peripheral Neuropathy in Diabetes and Pre-diabetes, impact of Vitamin B Deficiency on Quality of Life and the role of B vitamins in supporting healthy nerve functions”.

Expert Speak: 

  • Speaking at the forum, Rayaz. A. Malik (Assistant Dean for Clinical Research at Weill Cornell Medicine-Qatar) stated, “Early diagnosis of DPN allows for timely risk factor reduction and improvement of this most common disabling complication of diabetes. Primary care physicians play a pivotal role in recognizing DPN. Asking the right questions and undertaking simple diagnostic testing can have a major positive impact on the lives of patients with DPN by enabling pain relief and prevention of foot ulceration and amputation.  Leveraging advanced diagnostic tools like Corneal Confocal Microscopy (CCM) and AI introduces a new paradigm to the early diagnosis and management of DPN. 
  • According to Dr. Rizaldy Pinzon (Neurologist at Neurology Department, Bethesda Hospital, Yogyakarta – Indonesia), “As a medical professional, it is crucial to emphasize the significance of timely treatment for Peripheral Neuropathy (PN). Initiating treatment promptly can provide substantial benefits in managing symptoms and mitigate further neurological damage. Timely intervention can enhance sensory perception, alleviate painful symptoms, and prevent complications such as infections, ulcers and eventually diabetic foot amputation. It is important for primary care physicians to remain vigilant and promptly treat any alterations in the patient’s lower extremities, including numbness, paresthesia, or neuropathic pain.” 
  • Speaking about the role of Pharmacists, Dr. Kenny P Merin (Pharmacist, and Assistant Vice President, Academics & Research of Lyceum of the Philippines University Davao – Philippines), “Pharmacists are an integral part of the healthcare team and can provide valuable support to patients with PN, yet often we are underutilized. Pharmacists are often the first point of contact and can drive early awareness of patient’s condition, offer guidance on lifestyle modifications, and help optimize medication regimens. Pharmacists can also recommend over-the-counter treatments (e.g., therapeutic dose of Neurotropic B vitamins) for PN symptom relief. By actively engaging with patients and healthcare professionals, let’s join hands to improve PN patients’ long-term health and well-being.”
  • Talking about the condition in India, Dr. Vaishali Deshmukh (Consultant and Head of the Endocrinology Department at Deenanath Mangeshkar Hospital (DMH) Erandawane Pune – India) commented, “Unfortunately, India has become the diabetes capital of the world. With 74.2 million people living with diabetes and alarming prevalence of pre-diabetes in India, half of these individuals are at risk of developing DPN. Collaborative efforts between healthcare professionals, patient education, and early referral to specialists are essential steps to improve the management of DPN in India.”
  • Adding from South Africa, Dr Ankia Coetzee (Consultant endocrinologist, past president of Society of Diabetes Endocrinology and Metabolism of South-Africa (SEMDSA) – South Africa),One of the current challenges in driving better management of DPN is the need for increased awareness among both primary care physicians and patients. It is crucial for healthcare providers to receive ongoing education and training on DPN diagnosis, and right treatment options. Patients should be educated about the importance of regular foot and DPN examinations, glycemic control, and adherence to prescribed medications. By addressing these challenges through holistic education like P&G Health WDD campaign and collaborative care, we can enhance the management and outcomes of individuals with DPN in South Africa.”
  • Sharing more details about the NENOIN Study, Dr Inna Eiberger, Global Medical Director, P&G Health Nerve Care Franchise shared, “PN is associated with poor functional mobility and compromised motor symptoms, in addition to sensory symptoms. These symptoms significantly worsen the quality of life of patients. Results from the NENOIN study concluded that the synergistic combination of vitamins B1, B6, and B12 can not only relief symptoms but also significantly improve nerve function in patients with PN which is a critical learning. This further underlines how early screening for PN and timely treatment can help improve quality of life and treatment outcomes”.
  • Ahead of World Diabetes Day 2023, P&G Health continued awareness efforts with an innovative #KnowtheSigns campaign. “Our #KnowtheSigns campaign is a step change in the approach towards health awareness, as for the first time, we have leveraged Artificial Intelligence (AI) to make the invisible condition of PN & Vitamin B deficiency visible and more relatable to consumers. We hope to help people understand the condition by shedding light on daily struggles and symptoms. Not many people are aware that early diagnosis can help enable better treatment outcomes and better quality of life, and damaged nerves can be regenerated if nerve damage has not progressed too far,” Aalok added.



1       In 2021, there were 393 Mn diabetic patients8 in the Asia Pacific, Middle East, and African regions projected to rise to 603 Mn by 20458.

2       An estimated 80% patients remain undiagnosed and untreated7, with ratio being similar across different countries globally.

3       Diabetic PN is seen in very high proportion of diabetes patients in Southeast Asia; in some countries up to almost 60%8

4       A study from the Philippines in 2000 from the Diabcare-Asia project, which assessed 2,708 patients in diabetes centers, reported a prevalence of 42% for diabetic neuropathy, based on medical records9.

5       Peripheral Neuropathy affects 34–35% of UAE population with diabetes10.

6       Saudi Arabia ranks the second highest in the Middle East and is seventh in the world for the rate of diabetes11. Painful Diabetic Peripheral Neuropathy is seen in over 65% of the patients with Diabetes in Saudi Arabia12.

7       In Indonesia, the number of diabetic people increased from 10.7 million in 2019 to 19.5 million in 2021 rising from seventh to fifth rank for the highest number of diabetes sufferers in the world13. In a study from Bali, of 110 patients with type 2 diabetes mellitus and neuropathy based on electromyography, 54% had painful diabetic neuropathy 14.

8       In Singapore, prevalence of diabetic Peripheral Neuropathy was reported to be 28% and the significant risk factors are age, Indian ethnicity, insulin use, diabetic retinopathy and stoke 15.

9       Various epidemiological studies from India showed wide prevalence of nerve damage varying from 5 to 2400 per 10,000 population in different community studies16. The estimates on prevalence of nerve damage in India vary widely from 13.1–45.0% in different populations which could be attributed to different types of diabetes 17.

10    In Malaysia, 51% of diabetics were found to be diagnosed with peripheral neuropathy 18

11    Painful diabetic PN is significantly associated with disruptions in employment status and work productivity. Of working patients, 59% reported being less productive at work 19.

12    < 1/3rd of physicians recognizes signs of DPN. Undiagnosed cases contributing greatly to the high rates of morbidity and mortality of diabetes20. Up to 50 % of patients are asymptomatic and therefore often remain undiagnosed and are at risk of insensate injury 21.

13    Other than knowledge about the condition, information on who is at risk, the consequences of PN in relation to reduced quality of life and increased risk of foot ulcers needs to be disseminated to the public, to encourage early self-referral 22. Once the diagnosis of PN has been made, it is important to educate patients of the dangers of PN.


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