Are Mid-Level Health Providers Prepared for Diabetic Peripheral Neuropathy Screening? – A cross-sectional study from South India: doi: 10.7417/CT.2026.2168

Background Diabetic Peripheral Neuropathy is a common yet often underdiagnosed complication of diabetes. This study aims to evaluate the knowledge, perception and practice of Community Health Officers regarding Diabetic Peripheral Neuropathy in the South Indian state of Karnataka. Methods This cross-sectional study was conducted among 260 CHOs employed in Ayushman Arogya Mandirs of the district. Data were collected using a structured questionnaire that covered details of CHOs, training of DPN, knowledge, practice, and perceptions of DPN and its screening, as well as barriers encountered during screening of the condition. Results Among the 260 participants, 77.3% and 22.6% were females and males. The mean age of the participants was 30.9 years. We found 66.9% of the participants had moderate knowledge regarding DPN. The majority (76.1%) of participants did not have equipment to screen for neuropathy. Though all of them received training on NCD, 11.5% received training on DPN. Overall, 82% of the participants were confident in their ability to screen DPN, and 43.5% responded that they currently screen for DPN. Lack of screening equipment was one of the main barriers to the screening of DPN. Conclusion The study showed a moderate level of knowledge regarding DPN. Nearly half of the participants never screened for DPN routinely, which is driven largely by insufficient in-service training and a critical shortage of screening equipment. Integrating structured DPN training into their education curriculum and ensuring the availability of equipment at the centres represent high-priority policy interventions to reduce the burden of preventable diabetic complications.