Assessing Quality Of Life In Diabetic Neuropathy: Condition‐Specific Or Generic Approach?

Abstract

Studies that assessed Quality of Life (QoL) in patients with diabetic peripheral neuropathy (DPN) used generic measures, focusing on extremes of DPN. This study compared the performance of the neuropathy‐specific QoL measure (NeuroQoL) with the generic SF36, in diabetic patients with varying severity of DPN. 120 DPN patients were included, mean age 61 years, diabetes duration 12 years. DPN severity was assessed by neuropathy disability score (NDS) and vibration perception threshold (VPT): symptom severity by neuropathy symptom score (NSS). All NeuroQoL domains showed significant differences (eg., social; interpersonal relationships p < 0.01) between patients subdivided into those with moderate/severe symptoms (NSS > =6) compared to those with mild (NSS < 6), in contrast to only 2 SF36 domains (mental health; bodily pain p < 0.05). Similarly, when patients were subdivided according to DPN severity (moderate/severe: VPT > =25 and NDS > =6; mild: VPT < 25; NDS < 6), NeuroQoL domains (eg., negative symptoms; sexual problems p < 0.05) demonstrated differences between the groups whereas virtually no differences were seen in SF36. Furthermore, NeuroQoL maintained its ability to differentiate between those with mild (VPT < 25); moderate (VPT:25 to 35) and severe (VPT > 35) DPN, whereas SF36's discriminatory power was lost. All significant differences remained after accounting for confounding variables. Thus, NeuroQoL detects more subtle differences between DPN patients and should therefore be more sensitive to change over time than the SF36.