Abstract

ObjectiveThe purpose of this study is to describe the current clinical situation of patients with painful diabetic peripheral neuropathy (DPN) and related anxiety, depression, and the quality of life of patients in mainland China, and to report the current status of the use of analgesics.MethodsBetween June 15, 2021, and October 15, 2021, a total of 401 participants participated in the study. Recruitment was carried out using a multi-level sampling method. Participants’ demographics, medical history, analgesic use, Michigan Symptom Score (MNSI), Numerical Rating Scale (NRS) pain score, Patient Health Questionnaire 9 (PHQ-9) score, Generalized Anxiety Disorder 7 (GAD) -7) Score, quality of life score (SF-12) and diabetes treatment status were collected.ResultsAmong the participants, there were 236 male patients and female patients. Participants were 322 patients over 40 years old. Regarding the use of analgesics: 132 patients reported using analgesics, 221 patients reported not using analgesics, and 48 patients reported having used analgesics. The results of the scale showed that the scores of NRS, GAD-7, PHQ-9 and SF-12 were 5.12 ± 2.15, 6.33 ± 3.67, 8.46 ± 4.07 and 47.84 ± 19.92 for patients who used analgesics, Compared with patients who did not use analgesics (NRS: 1.99 ± 1.7, GAD-7: 1.81 ± 2.81, PHQ-9: 3.13 ± 4.10, SF-12: 78.34 ± 21.66) there are significant differences (p< 0.001). In addition, patients’ NRS scores are also closely related to GAD-7, PHQ-9 and SF-12 scores.ConclusionThe severity of symptoms, mental status and quality of life of patients who used analgesics were more severe than those of patients who did not use analgesics. Pregabalin is still the preferred analgesic for patients with painful DPN, and the use of opioids in my country is extremely low, which is consistent with current international guidelines. Age, diabetic duration, DPN duration, PHQ-9 score, GAD-7 score and SF-12 scores are closely related to NRS pain scores. In addition, there are still a considerable number of patients who have not used analgesics due to financial burdens and other reasons, suggesting that China still has insufficient pain management in DPN patients.

Highlights

  • Diabetic Peripheral Neuropathy (DPN) is one of the important complications of type 2 diabetes and the most common cause of neuropathy in developed countries

  • Current studies believe that the changes of microvascular, such as the abnormal structure and function of blood vessels and nerves and the adjustment of peripheral blood flow are closely related to painful DPN; coupled with the release of oxidative stress and inflammatory factors, the combined action of the three leads to peripheral The changes in nerve structure and function eventually lead to painful DPN [4,5,6]

  • The results showed that the Michigan Neuropathy Screening Instrument (MNSI) symptom score of DPN patients who used analgesics was much higher than that of patients who did not use analgesics

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Summary

Introduction

Diabetic Peripheral Neuropathy (DPN) is one of the important complications of type 2 diabetes and the most common cause of neuropathy in developed countries. It is estimated that about 50% of diabetic patients are affected; its most common form It is chronic, distal and symmetric sensorimotor polyneuropathy. Studies have shown that about 20-50% of diabetic patients and about 60% of DPN patients will present with painful neuropathy. Studies have shown that up to 60% of diabetic patients are deeply affected by painful diabetes, leading to the occurrence of serious physical and social diseases, and seriously affecting the quality of life of patients [9]. It is estimated that the annual treatment cost of each DPN patient is twice that of diabetic patients, while the cost of moderate to severe pain patients is 4 times that of non-pain DPN patients. The management of painful DPN changes remains a challenge in the clinic [10]

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