Impact of Painful Diabetic Peripheral Neuropathy on the Quality of Life of Patients in Goa, India: A Cross-sectional Study

Abstract

Introduction: The state of Goa has the highest prevalence of diabetes and prediabetes in India. Pain because of abnormalities in the somatosensory system due to diabetes is referred to as Painful Diabetic Peripheral Neuropathy (PDPN). A common complication associated with PDPN is poor Quality of Life (QoL), which can lead to lifelong disability. Aim: To estimate the prevalence of PDPN and its impact on QoL in patients in Goa, India. Materials and Methods: In this cross-sectional observational study, 320 participants were screened at Goa Medical College, Bambolim, Goa, India, from August 2021 to August 2022, and 288 were diagnosed with Diabetic Peripheral Neuropathy (DPN). Among those 288 individuals, 91 reported experiencing PDPN, as assessed using the Douleur Neuropathique 4 (DN-4) questionnaire. The investigator interviewed participants aged 18 to 75 years, of all genders, who were diagnosed with either Type 1 or Type 2 diabetes. Baseline characteristics, including age, weight, height, Body Mass Index (BMI), duration of diabetes, and results from the lateralisation test using the graded motor imagery app, were recorded. Participants were assessed using the Neuropathy Symptom Score, and only those who scored at least 1 were included, indicating the presence of DPN. These participants then completed the DN-4 questionnaire; those scoring 3 or more were diagnosed with PDPN. Subsequently, QoL was assessed using the RAND QoL questionnaire {RAND Short Form Survey (SF-36)}. Demographic and clinical characteristics were presented as mean±Standard Deviation (SD). Comparisons between patients with PDPN and those without PDPN were made using an Independent t-test. The normality of continuous variables was tested using the Kolmogorov-Smirnov test. All analyses were carried out using IBM Statistical Package for the Social Sciences (SPSS) (version 28.0). Results: The prevalence of PDPN was found to be 31.6%, with significant impairments in the physical functioning, social functioning, and pain domains (p-value <0.001). Conclusion: The prevalence of PDPN was found to be 31.6%. Significant impairments in various QoL domains were noted in participants with PDPN.

Keywords

• activities of daily living
• diabetes mellitus
• painful peripheral neuropathy