Tingling, stabbing pain, numbness or burning sensation in your hands and feet? It could be peripheral neuropathy, the most common type of diabetic neuropathy ­— and early diagnosis is key to avoid a life of disability.

Neuropathy is no joke. It is a condition wherein the nerves located outside of the brain and spinal cord — the peripheral nerves — are damaged or compressed. Infections, traumatic injuries, metabolic problems and inherited conditions are some of the underlying causes of PN. But the most common cause is diabetes.

Unfortunately, a staggering 80 percent of patients with diabetic neuropathy were undiagnosed, as revealed by a 2020 study by Georgios Ponirakis et al. Since a patient's PN symptoms may not seem too severe at its earliest stage, many continue about their daily lives without seeking medical attention.

If the underlying cause of peripheral neuropathy is not treated, a person may be at risk of developing a foot ulcer that becomes infected. Untreated, the ulcer can lead to gangrene, and in severe cases, the foot has to be amputated.

This is why P&G Health continues to advocate awareness on peripheral neuropathy. Aalok Agrawal, the senior vice president of P&G Health in Asia, India, Africa and Middle East, sat down with DAILY TRIBUNE via video conference to emphasize the need for neuropathy awareness in the Philippines.

"Peripheral neuropathy is a significant public health issue that I think needs a significant amount of more awareness from both healthcare practitioners, as well as from patients themselves. It can have a significant impact on both quality of life and serious complications," he said.

"And, to that end, you know, awareness remains very low. We think 80 percent of cases are untreated and undiagnosed. And our efforts, both on Neuropathy Awareness Week as well as World Diabetes Day, are to really bring out just how critical this public health issue is and to bring it up in its awareness. Because the most important thing for collective action here is the fact that this can be managed. This is something that we can diagnose early, and early diagnosis can help improve treatment outcomes, improve quality of life and prevent serious complications."

According to Agrawal, P&G Health's efforts are tailored across all groups, including the marginalized sector. Hence, they utilize accessible language to better communicate neuropathy to everybody.

"Our efforts are tailored across all groups. Our media, for example, is very much in Tagalog in some cases in Mindanao and Visayas, and we also tend to do more local language radio," he explained.

He also shared that P&G Health, apart from gathering global health experts to discuss neuropathy in medical forums and also partnering with media to spread knowledge on neuropathy, sees the importance of pharmacists in the war against PN.

"So we have a lot of engagement with pharmacists as they are the frontliners in many cases — especially for marginalized groups that may not even reach out to doctors but they would just go to a pharmacist and say, 'I have these symptoms; would you suggest something to me?' And again, our effort has been to educate pharmacists consistently about these risk factors, about asking the right questions, and then about being able to give some sort of first-line therapy while also hopefully referring these patients to a doctor to be able to follow up on their treatment," he explained.

He also explained that demystifying neuropathy is not a one-time event, but is an ongoing effort on the part of P&G Health.

"We go quite deep into the community. We're trying to continue to expand our outreach. We try to make our materials as widely available on as many educational platforms as possible so that we can, again, reach out to doctors who may not be able to physically attend our forum. So, you know, but I think all of the different partners in the community and in the ecosystem will be what will help us create this awareness amongst all of these different groups of patients."

He also underscores the importance of not just seeking immediate medical treatment once you experience unusual sensations on your hands and feet, but also subscribing to a healthy lifestyle to prevent or combat PN.

"Diet and exercise are so critical. We've got to help patients and consumers understand that a healthy diet with the right combination of fruits and vegetables, a balanced diet and nutrition and exercise for 30 to 60 minutes a day are going to be super critical for us to really overcome and manage both diabetes and peripheral neuropathy. So, it really has to be a combination of lifestyle as well as some early diagnosis and treatment. I hope that we can raise that awareness together to help both the Philippines and Asian consumers in general, who are generally at high risk of diabetes. We want to make sure that the entire region can help combat this public health issue."

When asked about a person's hesitancy in seeing a doctor for "mild" symptoms due to common reasons like health anxiety or stress over the financial costs of diagnostic tests and consultation, Agrawal gave this advice:

"I think the most important thing to help manage both financially and as well from a mental reassurance standpoint is actually an early diagnosis, because, frankly, the costs of not diagnosing early are far greater. You may postpone it for a few months or a year, but then when you're looking at these serious complications coming from peripheral neuropathy, or loss of sensation in the foot, which can become a foot ulcer and potentially lead to things like amputations and so on, that is a huge and almost unthinkable cost that anybody would have to bear," he said. "Early diagnosis, I think, can have a very favorable outcome and, in fact, will give you reassurance as well. It can help take care of the symptoms, regenerate the nerves and prevent this from progressing further to the point where it might actually become unaffordable later to do that."