BackgroundDiabetic polyneuropathy (DPN) is one of the most common complications of diabetes and can exist with or without neuropathic pain. We were interested in how neuropathic pain impairs the quality of life in diabetic patients and what is the role of comorbidities in this condition.MethodsThe study included 80 patients with painful DPN (group “P”) and 80 patients with DPN, but without neuropathic pain (group “D”). Visual analogue scale (VAS) and Leeds assessment of neuropathic symptoms and signs (LANSS) pain scale were used for assessment of neuropathic pain, SF-36 standardized questionnaire for assessment of the quality of life and BDI questionnaire for assessment of depression.ResultsSubjects in group P had statistically significantly lower values compared to group D in all 8 dimensions and both summary values of the SF-36 scale. We ascribe the extremely low results of all parameters of SF-36 scale in group P to painful diabetic polyneuropathy with its complications. The patients in group D showed higher average values in all dimension compared to group P, but also somewhat higher quality of life compared to general population of Croatia in 4 of 8 dimensions, namely vitality (VT), social functioning (SF), role-emotional (RE) and mental health (MH), which was unexpected result.Clinically, the most pronounced differences between two groups were noted in sleeping disorders and problems regarding micturition and defecation , which were significantly more expressed in group P. The similar situation was with walking distance and color-doppler sonography of carotid arteries, which were significantly worse in group P. Consequently, subjects in group P were more medicated than the patients in group D, particularly with tramadol, antiepileptics and antidepressants.ConclusionPainful DPN is a major factor that influences various aspects of quality of life in diabetic patients. Additionally, this study gives an overview of diabetic population in the Republic of Croatia, information that could prove useful in future studies.

Hyponatraemia is an electrolyte disorder, defined as a serum sodium concentration (Na) <136 mmol/L. It occurs in up to 30% of hospitalised patients. The purpose of this study was to evaluate the frequency of hyponatraemia among all patients during a one month period in the emergency unit. During the one month period in 2014, 570 patients were included in this study. The study was approved by local ethics committees and patients provided written informed consent. Out of the 570 patients, 41 (7%) had hyponatraemia. The median age was 67 (65.02±14.09) years and the majority of the patients were men (M:F = 23:18; 56.1:43.9%). Mild hyponatraemia (serum Na 130-135 mmol/L) was found in 71% (29/41), moderate (serum Na 125-129 mmol/L) in 17% (7/41), severe (serum Na 120-124 mmol/L) in 5% (2/41), and extremely severe (serum Na< 120 mmol/L) in 7% (3/41) of patients. The treatment options included the restriction of fluid intake by administering hypertonic saline and loop diuretics. We should be alert to acute hyponatraemia, especially in elderly patients with neurological manifestations and poor prognosis. The presented data are an important contribution to the better understanding of the epidemiology of hyponatraemia in Croatia.

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