Understanding the impact of diabetic peripheral neuropathy and neuropathic pain on quality of life and mental health in 6,960 people with diabetes

Objectives: Diabetic peripheral neuropathy (DPN) and neuropathic pain impacts Quality of Life (QoL) and mental health negatively. This cross-sectional survey study aimed to 1) elucidate the associations between painful and painless DPN and QoL, mental health and socioeconomic factors, 2) assess the prevalence of sensory pain descriptors, and 3) evaluate the association between descriptors and the above factors.

Research Design and Methods: Participants were grouped into people with (n=1,601) and without (n=5,359) DPN based on the Michigan Neuropathy Screening Instrument questionnaire. Participants with DPN were subsequently divided into people with (n=1,085) and without (n=516) concomitant neuropathic pain based on the modified Douleur Neuropathique en 4 Questions-interview.

Results: The study showed diminished QoL (SF36: 55.1 [36.7, 73.6], 82.2 [63.6, 90.9]) and poorer mental health (HADS-A: 5.00 [2, 9], 2.00 [1, 5]. HADS-D: 4.00 [1, 8], 1.00 [0, 3]) in participants with DPN compared to participants without DPN. The addition of pain diminished QoL (SF36: 50.7 [34.8, 69.8]) and mental health (HADS-A: 6 [3, 10], HADS-D: 4 [1, 8]) further.

The most prevalent pain descriptor in participants with painful DPN were burning pain (73%), while the most prevalent sensory descriptor was pins-and-needles (93%). An interesting finding is the high prevalence of itch (44%). Weak associations with mental health and QoL were present for cold pain, electric pain, and itch.

Conclusions: An increased focus on differences in QoL, mental health, and pain phenotypes is of importance to move the field forward towards more interdisciplinary, personalized treatment.