Johnny-Wei Bai1, Leif E Lovblom1, Marina Cardinez1, Alanna Weisman1, Mohammed A Farooqi1, Elise M Halpern1, Genevieve Boulet1, Devrim Eldelekli1, Julie A Lovshin1, Yuliya Lytvyn2, Hillary A Keenan3, Michael H Brent4, Narinder Paul5, Vera Bril6, David Z I Cherney2, Bruce A Perkins7. 1. Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, Toronto, Ontario, Canada. 2. Division of Nephrology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada. 3. Research Division, Joslin Diabetes Center, Boston, MA, USA. 4. Department of Ophthalmology and Vision Sciences, Department of Medicine, University of Toronto, Toronto, Ontario, Canada. 5. Joint Department of Medical Imaging, Division of Cardiothoracic Radiology, University Health Network, Toronto, Ontario, Canada. 6. The Ellen and Martin Prosserman Centre for Neuromuscular Diseases, Krembil Neuroscience Centre, Division of Neurology, Department of Medicine, University Health Network, University of Toronto, Toronto, Ontario, Canada. 7. Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, Toronto, Ontario, Canada; Division of Endocrinology and Metabolism, Department of Medicine, University of Toronto, Toronto, Ontario, Canada. Electronic address: BPerkins@mtsinai.on.ca.
Abstract
AIM: To determine the association of neuropathy and other complications with emotional distress and depression among patients with longstanding type 1 diabetes (T1DM). METHODS: Canadians with ≥50years of T1DM completed a questionnaire including assessment of distress and depression by the Problem Areas in Diabetes Scale (PAID) and Geriatric Depression Scale (GDS), respectively. Complications were determined using the Michigan Neuropathy Screening Instrument (Questionnaire Component), fundoscopy reports, renal function tests, and self-reported peripheral-(PVD) and cardiovascular (CVD) disease. Associations were analyzed by Poisson regression. RESULTS: Among 323 participants, 137 (42.4%) had neuropathy, 113 (36.5%) nephropathy, 207 (69.5%) retinopathy, 95 (29.4%) CVD, and 31 (9.8%) PVD. The neuropathy subgroup had higher prevalence of distress (13 (9.5%) vs. 6 (3.3%), p=0.029) and depression (34 (24.9%) vs. 12 (6.5%), p<0.001). Adjusting for diabetes complications, neuropathy was associated with higher PAID (adjusted RR 1.44 (95% CI 1.14-1.82), p=0.003) and GDS scores (adjusted RR1.57 (1.18-2.11), p=0.002). Independent of potential confounders, neuropathy remained associated with higher PAID (adjusted RR 1.39 (1.10-1.76), p=0.006) and GDS scores (adjusted RR 1.37 (1.03-1.83), p=0.032). Associations with neuropathy were not fully explained by neuropathic pain. CONCLUSION: Compared to other complications, neuropathy had the greatest association with distress and depression in longstanding T1DM, independent of pain. Strategies beyond pain management are needed to improve quality of life in diabetic neuropathy.
AIM: To determine the association of neuropathy and other complications with emotional distress and depression among patients with longstanding type 1 diabetes (T1DM). METHODS: Canadians with ≥50years of T1DM completed a questionnaire including assessment of distress and depression by the Problem Areas in Diabetes Scale (PAID) and Geriatric Depression Scale (GDS), respectively. Complications were determined using the Michigan Neuropathy Screening Instrument (Questionnaire Component), fundoscopy reports, renal function tests, and self-reported peripheral-(PVD) and cardiovascular (CVD) disease. Associations were analyzed by Poisson regression. RESULTS: Among 323 participants, 137 (42.4%) had neuropathy, 113 (36.5%) nephropathy, 207 (69.5%) retinopathy, 95 (29.4%) CVD, and 31 (9.8%) PVD. The neuropathy subgroup had higher prevalence of distress (13 (9.5%) vs. 6 (3.3%), p=0.029) and depression (34 (24.9%) vs. 12 (6.5%), p<0.001). Adjusting for diabetes complications, neuropathy was associated with higher PAID (adjusted RR 1.44 (95% CI 1.14-1.82), p=0.003) and GDS scores (adjusted RR1.57 (1.18-2.11), p=0.002). Independent of potential confounders, neuropathy remained associated with higher PAID (adjusted RR 1.39 (1.10-1.76), p=0.006) and GDS scores (adjusted RR 1.37 (1.03-1.83), p=0.032). Associations with neuropathy were not fully explained by neuropathic pain. CONCLUSION: Compared to other complications, neuropathy had the greatest association with distress and depression in longstanding T1DM, independent of pain. Strategies beyond pain management are needed to improve quality of life in diabetic neuropathy.
Authors: Daniel Scarr; Leif E Lovblom; Julie A Lovshin; Geneviève Boulet; Mohammed A Farooqi; Andrej Orszag; Alanna Weisman; Nancy Cardinez; Yuliya Lytvyn; Mylan Ngo; Hillary A Keenan; Michael H Brent; Narinder Paul; Vera Bril; David Z I Cherney; Bruce A Perkins Journal: Diabetologia Date: 2017-10-03 Impact factor: 10.122
Authors: David Kec; Aneta Rajdova; Jana Raputova; Blanka Adamova; Iva Srotova; Eva Kralickova Nekvapilova; Radka Neuzilova Michalcakova; Magda Horakova; Jana Belobradkova; Jindrich Olsovsky; Pavel Weber; Gabriel Hajas; Michaela Kaiserova; Radim Mazanec; Veronika Potockova; Edvard Ehler; Martin Forgac; Frank Birklein; Nurcan Üçeyler; Claudia Sommer; Josef Bednarik; Eva Vlckova Journal: Eur J Pain Date: 2021-10-10 Impact factor: 3.651
Authors: Daniel Scarr; Petter Bjornstad; Leif E Lovblom; Julie A Lovshin; Genevieve Boulet; Yuliya Lytvyn; Mohammed A Farooqi; Vesta Lai; Andrej Orszag; Alanna Weisman; Hillary A Keenan; Michael H Brent; Narinder Paul; Vera Bril; David Z I Cherney; Bruce A Perkins Journal: Kidney Int Rep Date: 2019-02-21