İsmet MELEK, Boran URFALI, Evrim ASLAN, Senem URFALI, Esra DOĞRU HUZMELİ, Murat GÜNTEL, İrem HUZMELİ, Nilufer ÇETİŞLİ KORKMAZ

Characteristics of neuropathic pain in patients with diabetes mellitus

AbstractAim: Epidemiological data on the frequency, quantity, and consequences of symptomatic diabetic neuropathy remain poor. We conducted this study to examine the characteristic of neuropathic pain in patients with diabetes mellitus (DM).Materials and Methods: Average daily pain intensity was measured using a 100 mm visual analog scale (VAS). Localization of the pain, position that aggravated pain, frequency of the pain, duration of the pain, pain’s influence on daily living activities were examined.Results: The average patient age was 62.56 years and the number of males was 21 (42%). 29 Patients had only DM and 13 patients had hypertension (HT) plus DM, 4 patients had DM+HT+heart disease. The mean of pain according to VAS was 6.86±2.79. Thirtytwo patients defined that the pain affected their daily living activities negatively; 30 patients’ pain localization was lower extremity,12patients’ was upper and lower extremity; mostly pain was aggravated by standing and 40 patients’ pain frequency was as every day; 24 patients’ pain duration was less than 1 year and 18 patients’ was between 1-5 years.Conclusion: Studies on diabetic neuropathy are important drivers to improve the treatment of these patients. Neuropathic pain is considered to be more serious than other types of pain. So patients diagnosed with DM should be examined for neuropathic pain and the treatment plan should include pain decreasing medication and/or neurosurgical interventions.

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1. International Diabetes Federation IDF Diabetes Atlas, 7th ed Brussels: International Diabetes Federation, 2015 Available at: http://wwwdiabetesatlasorg Accessed 24062019.
2. Colloca L, Ludman T, Bouhassira D, et al. Neuropathic pain. Nat Rev Dis Primers 2017;3:2.
3. Feldman EL, Callaghan BC, Pop-Busui R, et al. Diabetic neuropathy. Nat Rev Dis Primers 2019;5:19-92.
4. Boulton AJ, Vileikyte L, Ragnarson-Tennvall G, et al. The global burden of diabetic foot disease. Lancet 2005;366:1719-24.
5. Tesfaye S, Boulton AJ, Dickenson AH. Mechanisms and management of diabetic painful distal symmetrical polyneuropathy. Diabetes Care 2013;36:2456-65.
6. Gylfadottir SS, Weeracharoenkul D, Andersen ST, et al. Painful and non-painful diabetic polyneuropathy: Clinical characteristics and diagnostic issues. J Diabetes Investig 2019;10:1148-57.
7. Gore M, Brandenburg NA, Dukes E, et al. Pain severity in diabetic peripheral neuropathy is associated with patient functioning, symptom levels of anxiety and depression, and sleep. J Pain Symptom Manage 2005;30:374-85.
8. Lankhorst S, Keet SW, Bulte CS, et al. The impact of autonomic dysfunction on peri-operative cardiovascular complications. Anaesthesia 2015;70:336-43.
9. Assunção A, Campos D, Marques R, et al. The impact of demographic and clinical characteristics on diabetic painful neuropathy. Rom J Intern Med 2020;58:13-9.
10. Abbott CA, Malik RA, van Ross ER, et al. Prevalence and characteristics of painful diabetic neuropathy in a large community-based diabetic population in the U.K. Diabetes Care 2011;34:2220-4.
11. Gould D, Kelly D, Goldstone L, et al. Examining the validity of pressure ulcer risk assessment scales: developing and using illustrated patient simulations to collect the data. J Clin Nurs 2001;10:697-706.
12. Meisinger C, Döring A, Thorand B, et al. Body fat distribution and risk of type 2 diabetes in the general population: are there differences between men and women? The MONICA/KORA Augsburg cohort study. Am J Clin Nutr 2006;84:483-9.
13. https://www.mayoclinic.org/diseases-conditions/ diabetic-neuropathy/symptoms-causes/syc- 20371580 Accessed date: 24.06.2019.Miralles-García JM, de Pablos-Velasco P, Cabrerizo L, Pérez M, López- Gómez V. Prevalence of distal diabetic polyneuropathy using quantitative sensory methods in a population with diabetes of more than 10 years' disease duration. Endocrinol Nutr 2010;57:414-20.
14. Bouhassira D, Letanoux M, Hartemann A. Chronic pain with neuropathic characteristics in diabetic patients: a French cross-sectional study. PLOS ONE 2013;8.
15. Khdour MR. Treatment of diabetic peripheral neuropathy: a review. J Pharm Pharmacol 2020;72:863-72.
16. Aguiar FLXdS, Ramos LFP, Bichara CNC. Detection of pain with neuropathic characteristics in patients with diabetes mellitus assisted in primary care units. BrJP 2018;1:15-20.
17. Bril V, England J, Franklin GM, et al. Evidence-based guideline: Treatment of painful diabetic neuropathy: report of the American Academy of Neurology, the American Association of Neuromuscular and Electrodiagnostic Medicine, and the American Academy of Physical Medicine and Rehabilitation. Neurology 2011;76:1758-65.
18. Duby JJ, Campbell RK, Setter SM, et al. Diabetic neuropathy: an intensive review. Am J Health Syst Pharm 2004;61:160-73.
19. de Vos CC, Rajan V, Steenbergen W, et al. Effect and safety of spinal cord stimulation for treatment of chronic pain caused by diabetic neuropathy. J Diabetes Complications 2009;23:40-5.
20. Jermendy G. Clinical consequences of cardiovascular autonomic neuropathy in diabetic patients. Acta Diabetol 2003;40:3-122.