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

Vesna Dermanovic Dobrota,Pero Hrabac,Vesna Lukinovic-Skudar,Kristijan Peros,Ingrid Prkacin,Savko Dobrota,Vanja Basic Kes,Dinko Skegro,Neva Brkljacic,Ranko Smiljanic,Martina Tomic

doi:10.1186/s12955-014-0171-7

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.

Highlights

Diabetic polyneuropathy (DPN) is one of the most common complications of diabetes and can exist with or without neuropathic pain
The first group of 80 subjects consisted of patients with painful diabetic polyneuropathy, while the other group consisted of patients with diabetic polyneuropathy, but without pain
One hundred and sixty subjects included in the research were divided in two groups – diabetic patients with painful polyneuropathy and diabetic patients with polyneuropathy, but without painful sensations

Summary

Introduction

Diabetic polyneuropathy (DPN) is one of the most common complications of diabetes and can exist with or without neuropathic pain. Diabetes is one of the most common chronic noninfectious diseases and one of the leading public health problems of the modern society It has high prevalence and ascending trend in the number of patients in all countries. In Croatia (which is classified as developed country by King [2]), according to Croatian National Institute of Public Health (HZJZ) and the National Diabetes Registry CroDiab, the incidence of diabetes was 6.3% in the year 2011, with the total of 230.084 patients older than 18 years [3,4]. The average life span is up to 15 years shorter in diabetic patients

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