Associations between stages of diabetic polyneuropathy and quality of life, neuropathic pain, and well-being: A multicenter, cross-sectional analysis based on electroneuromyographic findings - 07/12/24

Doi : 10.1016/j.neucli.2024.103025

Emine Kılıçparlar Cengiz ^a,^⁎ , Yasemin Ekmekyapar Fırat ^b, Sibel Karşıdağ ^c, Abdurrahman Neyal ^d, Ali Kemal Erdemoğlu ^e, Nilgün Çınar ^f, Tuba Ekmekyapar ^g, Sibel Canbaz Kabay ^h, Fatma Akkoyun Arıkan ^h, Gönül Akdağ ^h, Gülsüm Çomruk ⁱ, Miruna Ateş ^f, Sude Kendirli Aslan ^f, Burcu Gökçe Çokal ^j, Bünyamin Tosunoğlu ^j, Naci Emre Bolu ^f, Ece Yanık ^a, Feray Savrun ^k, Zeliha Tülek ^l, Kimya Kılıçaslan ^l, Egemen Kaan Çakar ^k, Ebru Ergin Bakar ^j, Murat Mert Atmaca ^c, Buket Yılmaz ^b, Ayşe Münife Neyal ^b
^a Department of Neurology, Dr. Ersin Arslan Training and Research Hospital, Gaziantep, Türkiye
^b Department of Neurology, SANKO University School of Medicine, Gaziantep, Türkiye
^c Sultan 2 Abdulhamid Khan Educational and Research Hospital, Department of Neurology, Istanbul, Türkiye
^d Department of Neurology, Gaziantep Islam Science and Technology University School of Medicine, Gaziantep, Türkiye
^e Erdemoglu Neurology and Pain Clinic, Ankara, Türkiye
^f Department of Neurology, Maltepe University, School of Medicine, Istanbul, Türkiye
^g Department of Neurology, Malatya Training and Research Hospital, Malatya, Türkiye
^h Kutahya Health Sciences University, Faculty of Medicine, Department of Neurology, Kutahya, Türkiye
ⁱ Department of Neurology, Hatay Education and Research Hospital, Gaziantep, Türkiye
^j Department of Neurology, Ankara Training and Research Hospital, Ankara, Türkiye
^k Istanbul University, Cerrahpasa, Cerrahpasa Medical Faculty, Department of Neurology, Istanbul, Türkiye
^l Istanbul University-Cerrahpasa, Florence Nightingale Faculty of Nursing, Türkiye

^⁎Corresponding author.

Abstract

Aim

This study aimed to investigate the relationship between electrophysiological findings of diabetic neuropathy (DN) and patients' quality of life, neuropathic pain levels, and well-being.

Materials and Methods

A cross-sectional study was conducted in 12 centers in Turkey. DN patients were categorized into four stages based on electrophysiological findings using the Baba classification. Scales such as Short Form-36 (SF-36), Douleur Neuropathique 4-Questions (DN4), Brief Pain Inventory (BPI), and WHO-5 Well-Being (WHO-5 WB) were used to assess quality of life, pain, and well-being. Additional factors like HbA1c levels and diabetes duration were analyzed.

Results

Among 323 DN patients, 90 were in stage 1, 84 in stage 2, 72 in stage 3, and 77 in stage 4. There were no significant differences in age or gender between the stages. Diabetes duration and HbA1c levels were significantly lower in stage 1 compared to later stages. SF-36 and WHO-5 WB scores declined, while DN4 and BPI pain interference scores increased in the later stages. These findings persisted after adjusting for confounders such as age, BMI, comorbidities, and diabetes duration.

Conclusion

Patients with advanced-stage DN experienced a poorer quality of life, greater pain, and more frequent comorbidities compared to early-stage patients. Electrophysiological findings should be considered in the clinical management of DN.

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Keywords : Diabetes mellitus, Diabetic neuropathy, Nerve conduction studies, Diabetes complications, Quality of Life, Neuropathic Pain