Correlation of clinical and neurophysiological findings with health related quality of life in patients with diabetic polyneuropathy

The Predictors of Painful Diabetic Neuropathy and Its Effect on Quality of Life

BACKGROUND

Knowing the prevalence and predictors of neuropathic pain and its impacts on the quality of life (QoL) using measurement tools is important for good diabetes management. In Turkish society, neuropathic pain, its predictors and its impact on the quality of life of diabetics are not considered enough.

OBJECTIVES

This study examined the prevalence and predictors of neuropathic pain and its impacts on the quality of life in diabetics in Rize Province, Turkey.

DESIGN

This study was designed as a cross-sectional, correlational study.

SETTING

Data collected through face-to-face interviews. The sample size was determined using the formula [n= N t²pq / d² (N-1) + t²pq].

PARTICIPANT

The sample of the study consisted of 122 people with diabetes who visited the diabetes outpatient clinic of the hospital.

METHODS

A Personal Information Form, Douleur Neuropathique en 4 questions (DN4), and Leeds Assessment of Neuropathic Symptoms and Signs (LANSS) were used to collect data. Pain intensity was measured using Visual Analogue Scale (VAS) RESULTS: The prevalence of the diagnosed painful diabetic polyneuropathy (PDPN) was found to be 22.9%. On the other hand, the prevalence of the undiagnosed PDPN was found to be 44.3% according to DN4 and 27.9% according to LANSS. The VAS pain score was determined as 1.99±1.20 (range: 1-5). In the people with PDPN, nephropathy was seen 4.514 times more frequently according to DN4 and 7.217 times more frequently according to LANSS. Painful diabetic peripheral neuropathy had negative effects on all dimensions of QoL except for social function and mental health (p <0.05).

CONCLUSIONS

It is important for nurses to determine the prevalence and predictive factors of PDPN in their region and to evaluate the effect of pain on the quality of life of diabetics. Nurses should attempt to increase the quality of life of people with diabetes by reducing the predictors affecting pain.

Comparação entre pico de torque e flexibilidade dos membros inferiores de indivíduos com e sem diabetes mellitus tipo 2

RESUMO O objetivo deste trabalho foi comparar o pico de torque e flexibilidade dos membros inferiores de indivíduos com e sem diabetes mellitus tipo 2 (DM2). O método foi o estudo com grupos expostos e não expostos ao DM2. Foram incluídos indivíduos com diagnóstico médico de DM2, encaminhados para eletroneuromiografia, e não expostos ao DM2. Foram excluídos da pesquisa indivíduos com idade superior a 70 anos ou que, por algum motivo, não conseguiram realizar um ou dois dos testes. A amostra foi não probabilística, composta por 64 indivíduos: 34 (53,1%) expostos ao DM2 e 30 não expostos; 50 (78,1%) eram do sexo feminino, a idade média era de 60,7±7,1 anos, e o membro inferior dominante era o direito em 57 (89,1%) dos indivíduos. Comparando indivíduos com e sem diagnóstico de DM2, observou-se redução do torque de flexão à esquerda, em velocidade angular de 120° (25,94±2,26 vs. 33,79±2,4nm, p=0,027, respectivamente). Relatou-se menor valor do torque de dorsiflexão à direita, em velocidade angular de 60°, dos diabéticos em relação aos não diabéticos (10,95±0,89 vs. 13,95±0,96nm, p=0,033, respectivamente). Ao comparar indivíduos com DM2, com e sem diagnóstico de neuropatia diabética periférica (NDP), notou-se maior déficit de flexão entre os indivíduos neuropatas em comparação com não neuropatas (46,57±9,47 vs. 11,63±13,85nm, p=0,049, respectivamente). Não foram encontradas diferenças estatisticamente significativas ao comparar os grupos de expostos e não expostos ao DM2 e diabéticos neuropatas e não neuropatas.

SF-36 total score as a single measure of health-related quality of life: Scoping review

According to the 36-Item Short Form Health Survey questionnaire developers, a global measure of health-related quality of life such as the “SF-36 Total/Global/Overall Score” cannot be generated from the questionnaire. However, studies keep on reporting such measure. This study aimed to evaluate the frequency and to describe some characteristics of articles reporting the SF-36 Total/Global/Overall Score in the scientific literature. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses method was adapted to a scoping review. We performed searches in PubMed, Web of Science, SCOPUS, BVS, and Cochrane Library databases for articles using such scores. We found 172 articles published between 1997 and 2015; 110 (64.0%) of them were published from 2010 onwards; 30.0% appeared in journals with Impact Factor 3.00 or greater. Overall, 129 (75.0%) out of the 172 studies did not specify the method for calculating the “SF-36 Total Score”; 13 studies did not specify their methods but referred to the SF-36 developers’ studies or others; and 30 articles used different strategies for calculating such score, the most frequent being arithmetic averaging of the eight SF-36 domains scores. We concluded that the “SF-36 Total/Global/Overall Score” has been increasingly reported in the scientific literature. Researchers should be aware of this procedure and of its possible impacts upon human health.

Xanthine Oxidase Activity in Type 2 Diabetes Mellitus Patients with and without Diabetic Peripheral Neuropathy

This study investigated the relationship between serum xanthine oxidase (XOD) activity and the occurrence of diabetic peripheral neuropathy (DPN) in type 2 diabetes mellitus (T2DM) patients. Serum XOD activity, ischemia-modified albumin (IMA), uric acid (UA), albumin, glycated hemoglobin (HbA1c), advanced glycation end products (AGE), total free thiols, atherogenic index of plasma (AIP), and body mass index (BMI) were measured in 80 T2DM patients (29 with and 51 without DPN), and 30 nondiabetic control subjects. Duration of diabetes, hypertension, medication, and microalbuminuria was recorded. Serum XOD activities in controls, non-DPN, and DPN were 5.7 ± 2.4 U/L, 20.3 ± 8.6 U/L, and 27.5 ± 10.6 U/L (p < 0.01), respectively. XOD activity was directly correlated to IMA, UA, BMI, HbA1c, and AGE, while inversely correlated to serum total free thiols. A multivariable logistic regression model, which included duration of diabetes, hypertension, AIP, HbA1c, UA, and XOD activity, revealed HbA1c [OR = 1.03 (1.00-1.05); p = 0.034] and XOD activity [OR = 1.07 (1.00-1.14); p = 0.036] as independent predictors of DPN. Serum XOD activity was well correlated to several other risk factors. These results indicate the role of XOD in the development of DPN among T2DM patients.