Understanding the impact of painful diabetic neuropathy

Abstract

Painful neuropathy is a common and often distressing complication of diabetes. It has considerable impact on the social and psychological well-being of affected individuals. There are two distinct forms of painful neuropathy: an acute and self-limiting form that resolves within a year or a chronic form that can go on for years. There are now a number of drugs available for the treatment of neuropathic pain. However, some may fail to respond to these drugs or may have unacceptable adverse side effects. When this is the case, the patient's quality of life can be severely affected. Health care professionals need to assess the full impact of painful neuropathy. In this article we review a number of instruments that are used to assess the severity of painful neuropathy and its impact on the quality of life.

C-Peptide Reverses Nociceptive Neuropathy in Type 1 Diabetes

“…ainful or nociceptive diabetic neuropathy is a common and debilitating condition in neuropathic patients (1). The underlying mechanisms are complex and not completely understood (2).…”

Painful diabetic neuropathy

“…Pain is the most distressing symptom and is the main factor that prompts the patient to seek medical advice [4]. Focal and multifocal diabetic neuropathies, such as isolated cranial nerve palsies and proximal lower limb motor neuropathy, may also be associated with pain.…”

“…Focal and multifocal diabetic neuropathies, such as isolated cranial nerve palsies and proximal lower limb motor neuropathy, may also be associated with pain. Few studies have investigated the prevalence of painful diabetic neuropathy, and these have reported a prevalence rate of 7-20%; the variation reflecting the different criteria used to define neuropathic pain [4]. Nearly 25% of the type 1 diabetic patients enrolled in the European Diabetes (EURODIAB) prospective study developed neuropathic symptoms over a 7-year period [3].…”

“…Patients describe their pain in various terms as burning, prickling ("pins and needles"), lancinating, shooting ("like an electric shock"), cramping, aching, and report also contact hypersensitivity (allodynia) and "dead feeling" (numbness) in their legs [4]. Walking is experienced by some patients as the sensation of walking barefoot on 'pebbles' or 'scalding sand'.…”

“…In the latter case sleep is usually disturbed. It is therefore not surprising that such patients may be so disabled by the pain that they experience a reduction in their daily activities, or may even lose their employment, become profoundly depressed and have a poor quality of life [4].…”