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Pain. 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.

Author information

1
The International Diabetic Neuropathy Consortium (IDNC), Department of Clinical Medicine, Faculty of Health, Aarhus University, Aarhus, Denmark.
2
Department of Clinical Medicine, Danish Pain Research Center, Aarhus University, Aarhus, Denmark.
3
Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark.
4
Department of Neurology, Aarhus University Hospital, Aarhus, Denmark.
5
Department of Neurology, University of Michigan, Ann Arbor, MI, United States.
6
Department of Neurology, Odense University Hospital, Odense, Denmark.
7
Department of Clinical Neurophysiology, Aarhus University Hospital, Aarhus, Denmark.
8
Danish Centre for Strategic Research in Type 2 Diabetes, Steno Diabetes Center Odense, Odense University Hospital, Odense, Denmark.
9
Biostatistics, Department of Public Health, Aarhus University, Aarhus, Denmark.

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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