The impact of neuropathic pain and other comorbidities on the quality of life in patients with diabetes

Abstract

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.

Effects of Pain and Disability on Quality of Life in Patients with Diabetic Polyneuropathy

“…Furthermore, we found a significant worsening in all domains of SF-36 in patients with painful diabetic neuropathy confirmed with abnormal electrophysiological evaluation results, in particular. Suggesting our results, a previous study revealed statistically significant lower values in patients with PDN in all domains of SF-36 [25]. Some other studies demonstrate a significant alteration in physical, mental and general health components of OQL in patients with PDN [26].…”

Effect of Co-Morbid Conditions on Persistent Neuropathic Pain after Brachial Plexus Injury in Adult Patients

“… 18 Likewise, painful diabetic polyneuropathy significantly affects various aspects of the quality of life, including sleep disorders. 19 Similar to these studies, we observed a statistically significant change in pain severity after the 2-year follow-up in patients who manifested co-morbid illness compared to those who did not manifest a comorbidity. Therefore, the physician should be vigilant and regularly screen these high-risk patients for depression or other psychiatric illness, especially when a change in pain symptoms or functional impairment is noticed.…”

Cross-centre replication of suppressed burrowing behaviour as an ethologically relevant pain outcome measure in the rat: a prospective multicentre study

“…49 , 65 , 75 Animal studies mostly rely on stimulus-evoked measures of sensory gain, whereas clinical trials use patient-reported outcomes focusing on spontaneous pain intensity, functioning, and quality of life. Although spontaneous pain and decreased quality of life are reported across chronic pain conditions, 11 , 16 , 52 , 56 sensory gain is common only in a subset of clinical pain conditions caused by peripheral nerve trauma and inflammation but is rare in others, such as polyneuropathies caused by diabetes and HIV. 39 , 51 , 52 , 56 This has brought into question the translational strength of relying on sensory gain as the sole pain outcome measure preclinically.…”