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. 2020 Mar;161(3):574-583.
doi: 10.1097/j.pain.0000000000001744.

Diabetic polyneuropathy and pain, prevalence, and patient characteristics: a cross-sectional questionnaire study of 5,514 patients with recently diagnosed type 2 diabetes

Sandra Sif Gylfadottir  1   2 , Diana Hedevang Christensen  1   3 , Sia Kromann Nicolaisen  3 , Henning Andersen  1   4 , Brian Christopher Callaghan  1   5 , Mustapha Itani  1   6 , Karolina Snopek Khan  1   2   4 , Alexander Gramm Kristensen  1   2   7 , Jens Steen Nielsen  8 , Søren Hein Sindrup  1   6 , Niels Trolle Andersen  9 , Troels Staehelin Jensen  1   2   4 , Reimar Wernich Thomsen  3 , Nanna Brix Finnerup  1   2   4
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Diabetic polyneuropathy and pain, prevalence, and patient characteristics: a cross-sectional questionnaire study of 5,514 patients with recently diagnosed type 2 diabetes

Sandra Sif Gylfadottir et al. Pain. 2020 Mar.

Abstract

Most studies of diabetic polyneuropathy (DPN) and painful DPN are conducted in persons with longstanding diabetes. This cross-sectional study aimed to estimate the prevalence of DPN and painful DPN, important risk factors, and the association with mental health in recently diagnosed type 2 diabetes. A total of 5514 (82%) patients (median diabetes duration 4.6 years) enrolled in the Danish Centre for Strategic Research in Type 2 Diabetes cohort responded to a detailed questionnaire on neuropathy and pain. A score ≥4 on the MNSI questionnaire determined possible DPN, whereas pain presence in both feet together with a score ≥3 on the DN4 questionnaire determined possible painful DPN. The prevalence of possible DPN and possible painful DPN was 18% and 10%, respectively. Female sex, age, diabetes duration, body mass index, and smoking were associated with possible DPN, whereas only smoking showed a clear association with possible painful DPN (odds ratio 1.52 [95% confidence interval: 1.20-1.93]). Possible DPN and painful DPN were independently and additively associated with lower quality of life, poorer sleep, and symptoms of depression and anxiety. Possible DPN itself had greater impact on mental health than neuropathic pain. This large study emphasizes the importance of careful screening for DPN and pain early in the course of type 2 diabetes.

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Conflict of interest statement

The authors have no conflicts of interest to declare.

Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article.

Figures

Figure 1.
Figure 1.
Flowchart of study population. DD2, Danish Centre for strategic research in type 2 diabetes; MNSIq, Michigan Neuropathy Screening Instrument questionnaire, DN4, Douleur Neuropathique en 4 questions. aReason for nonparticipation: No reason provided: 89 (39.6%), no surplus energy because of other comorbidity: 18 (8.0%), no surplus energy because of death/illness among near relative: 3 (1.3%), dementia and other conditions hindering adequate answers to the questionnaire: 21 (9.3%), too busy/no free time: 4 (1.8%), well-regulated/solely diet-treated thus feeling the questionnaire is not relevant: 25 (11.1%), mail delivery not possible (invalid address, full or locked mailbox): 31 (13.8%), died in the period February to end of questionnaire survey: 9 (4.0%), and other single reasons: 25 (11.1%).
Figure 2.
Figure 2.
Possible DPN and possible painful DPN definitions. MNSIq, Michigan Neuropathy Screening Instrument questionnaire, DN4, Douleur Neuropathique en 4 questions. The numbers in the figure corresponds to the distribution of patients in the cohort of patients with available data on the criteria for both possible DPN and painful DPN (N = 5249). The numbers are evident from Table 2. DPN, diabetic polyneuropathy.
See this image and copyright information in PMC

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