RESUMOObjetivo: Avaliar o impacto dos sintomas depressivos e da dor neuropática na qualidade de vida (QV) de pacientes diabéticos com polineuropatia distal diabética (PNDD). Métodos: Foram avaliados 204 pacientes com diabetes melito tipo 2. O diagnóstico de PNDD foi realizado por meio do Escore de Sintomas Neuropáticos e Escore de Comprometimento Neuropático. A gravidade da dor neuropática foi avaliada por meio da Escala Visual Analógica (EVA); os sintomas depressivos, por meio do Inventário Beck de Depressão (IBD); a QV, com o World Health Organization Quality of Life abreviado (WHOQOL-bref). Resultados: Pacientes com PNDD apresentaram escores mais altos no IBD (12,6 ± 7,2 versus 9,9 ± 7,3; p = 0,018) e no EVA (5,0 ± 2,4 versus 2,6 ± 2,9, p < 0,001). Em relação à QV, apresentaram escores mais baixos no domínio físico (52,8 ± 15,5 versus 59,2 ± 17,0; p = 0,027) e ambiental (56,6 ± 12,3 versus 59,6 ± 13,6; p = 0,045). Conclusões: Pacientes diabéticos com PNDD apresentam pior QV nos domínios físico e ambiental do WHOQOL-bref, provavelmente devido à maior sintomatologia depressiva e gravidade de dor. Arq Bras Endocrinol Metab. 2009;53(9):1103-11 Descritores Qualidade de vida; depressão; neuropatia diabética; dor neuropática ABSTRACT Objective: To investigate the impact of depressive symptoms and neuropathic pain in the quality of life (QL) of diabetic patients with diabetic distal polyneuropathy (DDP). Methods: Two hundred and four patients with type 2 diabetes mellitus were evaluated. The diagnosis of DDP was achieved using the Neuropathy Disability Score and Neuropathy Symptom Score questionnaires. The severity of neuropathic pain was assessed by means of a Visual Analogue Scale (VAS); the severity of depression, by means of the Beck Depression Inventory (BDI); and QL was assessed by means of the World Health Organization Quality of Life Instrument-bref (WHOQOLbref). Results: Patients with DDP presented significant higher scores in BDI (12.6 ± 7.2 versus 9.9 ± 7.3; p = 0.018) and in VAS (5.0 ± 2.4 versus 2.6 ± 2.9; p < 0.001). They also presented significant lower scores in the physical (52.8 ± 15.5 versus 59.2 ± 17.0; p = 0.027) and environmental domains (56.6 ± 12.3 versus 59.6 ± 13.6; p = 0,045). Conclusions: Diabetic patients with DDP presented a worse QL in the physical and environmental domains of the WHOQOL-bref, probably due to more depressive symptoms and the severity of pain. INTRODUÇÃO O diabetes melito (DM) é uma doença metabólica complexa, multifatorial e de presença global (1). É caracterizada por hiperglicemia crônica associada a distúrbios no metabolismo dos carboidratos, lipídios e proteínas, resultante de defeitos na secreção e/ou na ação da insulina (2). Cerca de 85% a 90% dos pacientes portadores de DM possuem o chamado DM tipo 2 (DMT2) (3).
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