Yuanjin Zhang1, Shaowei Zhang2, Liya Pan3, Baojun Wang4, Yuanlin Sun5, Lijun Gao6, Ling Wang7, Lijuan Cui8, Qing Zhang9, Heng Shang10, Suqin Jin11, Xing Qin12, Deqin Geng13, Xiaorong Yu14, Lin Yang15, Li Li16, Zuoxiao Li17, Chaoli Yan18, Hongbin Sun19, Tao Sun20, Baoxin Du21, Junying Cao22, Fengyun Hu23, Jianhua Ma24, Shengnian Zhou25, Fengli Zhao26, Wei Li27, Jianming Zheng28, Yanhui Yi29, Jianguo Xu30, Bo Hu31, Baoying Sheng32, Zhaohui Li33, Zhong Zhao34, Ting Yang35, Ni Wang36, Hongdong Zhao37, Dunzhu Mima38, Huaiqian Qu39, Yi Wang40, Fuxia Song41, Xinyi Li42, Nan Li43, Dongsheng Fan44. 1. Department of Neurology, Peking University Third Hospital, 49th North Garden Road, Haidian District, Beijing, China. 2. Department of Endocrinology, Shenyang Weikang Hospital, Shenyang, China. 3. Department of Neurology, The Fourth Affiliated Hospital of Guangxi Medical University, Liuzhou, China. 4. Department of Neurology, Baotou Central Hospital, Baotou, China. 5. Department of Neurology, Panjin Central Hospital, Panjin, China. 6. Department of Neurology, Affiliated Hospital of Chengde Medical University, Chengde, China. 7. Department of Endocrinology, Fukuang General Hospital of Liaoning Health Industry Group, Fushun, China. 8. Department of Endocrinology, Bengang General Hospital of Liaoning Health Industry Group, Benxi, China. 9. Department of Neurology, General Hospital of Ningxia Medical University, Yinchuan, China. 10. Department of Gastroenterology, Cangzhou People's Hospital, Cangzhou, China. 11. Department of Neurology, The Second Hospital of Shandong University, Jinan, China. 12. Department of Neurology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China. 13. Department of Neurology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China. 14. Department of Neurology, Linfen People's Hospital, Linfen, China. 15. Department of Neurology, The First Affiliated Hospital of Dali University, Dali, China. 16. Department of Gastroenterology, The First People's Hospital of Taian, Tai'an, China. 17. Department of Neurology, The Affiliated Hospital of Southwest Medical University, Luzhou, China. 18. Department of Endocrinology, The Affiliated Hospital of Inner Mongolia Medical University, Hohhot, China. 19. Department of Neurology, Sichuan Academy of Medical Sciences, Sichuan Provincial People's Hospital, Chengdu, China. 20. Pain Department, Shandong Provincial Hospital, Jinan, China. 21. Department of Neurology, Guangdong Traditional Chinese Medicine Hospital, Guangzhou, China. 22. Department of Neurology, Tianjin Gangkou Hospital, Tianjin, China. 23. Department of Neurology, Shanxi Provincial People's Hospital, Taiyuan, China. 24. Department of Neurology, The First Affiliated Hospital of Xinjiang Medical University, Ürümqi, China. 25. Department of Neurology, Qilu Hospital of Shandong University, Jinan, China. 26. Department of Neurology, Yuncheng Central Hospital, Yuncheng, China. 27. Department of Neurology, Henan Provincial People's Hospital, Zhengzhou, China. 28. Department of Neurology, Mindong Hospital of Fujian Medical University, Ningde, China. 29. Department of Neurology, The Second People's Hospital of Hunan Province, Brain Hospital of Hunan Province, Changsha, China. 30. Department of Neurology, Guiyang Sixth Hospital, Guiyang, China. 31. Department of Neurology, Union Hospital, Tongji Medical Collage of Huazhong University of Science and Technology, Wuhan, China. 32. Department of Neurology, The First Affiliated Hospital of Jiamusi University, Jiamusi, China. 33. Department of Neurology, People's Hospital of Xinxing Country, Yunfu, China. 34. Department of Neurology, Suzhou Municipal Hospital, Suzhou, China. 35. Department of Neurology, Tianjin Xiqing Hospital, Tianjin, China. 36. Department of Neurology, Central Hospital of Wafangdian, Dalian, China. 37. Department of Neurology, Nanjing First Hospital, Nanjing, China. 38. Department of Neurology, Tibet Autonomous Region People's Hospital, Lhasa, China. 39. Department of Neurology, Liaocheng People's Hospital, Liaocheng, China. 40. Department of Neurology, Huashan Hospital Fudan University, Shanghai, China. 41. Department of Neurology, Yantai Yuhuangding Hospital, Yantai, China. 42. Department of Neurology, Shanxi Bethune Hospital, Taiyuan, China. 43. Research Center of Clinical Epidemiology, Peking University Third Hospital, 49th North Garden Road, Haidian District, Beijing, China. linan917@163.com. 44. Department of Neurology, Peking University Third Hospital, 49th North Garden Road, Haidian District, Beijing, China. dsfan2010@aliyun.com.
Abstract
INTRODUCTION: This aim of this study was to delineate current clinical scenarios of painful diabetic peripheral neuropathy (PDN) and associated anxiety and depression among patients in Mainland China, and to report current therapy and clinical practices. METHODS: A total of 1547 participants were enrolled in the study between 14 June 2018 and 11 November 2019. Recruitment was conducted using a multilevel sampling method. Participants' demographics, medical histories, glucose parameters, Douleur Neuropathique 4 Questionnaire (DN4) scores, visual analogue scale (VAS) pain scores, Patient Health Questionnaire 9 (PHQ-9) scores, Generalised Anxiety Disorder 7 (GAD-7) scores and therapies were recorded. RESULTS: The male-to-female ratio was 1.09:1 (807:740), and the mean age at onset was 61.28 ± 11.23 years. The mean DN4 score (± standard deviation) was 4.91 ± 1.88. The frequencies of DN4 sub-item phenotypes were: numbness, 81%; tingling, 68.71%; pins and needles, 62.90%; burning, 53.59%; hypoaesthesia to touch, 50.16%; electronic shocks, 43.31%; hypoaesthesia to pinprick, 37.94%; brushing, 37.82%; painful cold, 29.61%; and itching, 25.86%. Age, diabetic duration, depression history, PHQ-9 score and GAD-7 score were identified as risk factors for VAS pain score. Peripheral artery disease (PAD) was a protective factor for VAS pain score. For all participants currently diagnosed with PDN and for those previously diagnosed PDN, fasting blood glucose (FBG) was a risk factor for VAS; there was no association between FBG and VAS pain score for PDN diagnosed within 3 months prior to recruitment. Utilisation rate of opium therapies among enrolled participants was 0.71% , contradiction of first-line guideline recommendation for pain relief accounted for 9.43% (33/350) and contradiction of second-line guideline recommendation for opium dosage form was 0.57% (2/350). CONCLUSION: Moderate to severe neuropathic pain in PDN was identified in 73.11% of participants. Age, diabetic duration, depression history, PHQ-9 score, GAD-7 score and FBG were risk factors for VAS pain scores. PAD was protective factor. The majority of pain relief therapies prescribed were in accordance with guidelines. TRIAL REGISTRATION: ClinicalTrials.gov identifier, NCT03520608, retrospectively registered, 2018-05-11.
INTRODUCTION: This aim of this study was to delineate current clinical scenarios of painful diabetic peripheral neuropathy (PDN) and associated anxiety and depression among patients in Mainland China, and to report current therapy and clinical practices. METHODS: A total of 1547 participants were enrolled in the study between 14 June 2018 and 11 November 2019. Recruitment was conducted using a multilevel sampling method. Participants' demographics, medical histories, glucose parameters, Douleur Neuropathique 4 Questionnaire (DN4) scores, visual analogue scale (VAS) pain scores, Patient Health Questionnaire 9 (PHQ-9) scores, Generalised Anxiety Disorder 7 (GAD-7) scores and therapies were recorded. RESULTS: The male-to-female ratio was 1.09:1 (807:740), and the mean age at onset was 61.28 ± 11.23 years. The mean DN4 score (± standard deviation) was 4.91 ± 1.88. The frequencies of DN4 sub-item phenotypes were: numbness, 81%; tingling, 68.71%; pins and needles, 62.90%; burning, 53.59%; hypoaesthesia to touch, 50.16%; electronic shocks, 43.31%; hypoaesthesia to pinprick, 37.94%; brushing, 37.82%; painful cold, 29.61%; and itching, 25.86%. Age, diabetic duration, depression history, PHQ-9 score and GAD-7 score were identified as risk factors for VAS pain score. Peripheral artery disease (PAD) was a protective factor for VAS pain score. For all participants currently diagnosed with PDN and for those previously diagnosed PDN, fasting blood glucose (FBG) was a risk factor for VAS; there was no association between FBG and VAS pain score for PDN diagnosed within 3 months prior to recruitment. Utilisation rate of opium therapies among enrolled participants was 0.71% , contradiction of first-line guideline recommendation for pain relief accounted for 9.43% (33/350) and contradiction of second-line guideline recommendation for opium dosage form was 0.57% (2/350). CONCLUSION: Moderate to severe neuropathic pain in PDN was identified in 73.11% of participants. Age, diabetic duration, depression history, PHQ-9 score, GAD-7 score and FBG were risk factors for VAS pain scores. PAD was protective factor. The majority of pain relief therapies prescribed were in accordance with guidelines. TRIAL REGISTRATION: ClinicalTrials.gov identifier, NCT03520608, retrospectively registered, 2018-05-11.
Authors: S Tesfaye; L Vileikyte; G Rayman; S H Sindrup; B A Perkins; M Baconja; A I Vinik; A J M Boulton Journal: Diabetes Metab Res Rev Date: 2011-10 Impact factor: 4.876
Authors: Yehuda Handelsman; Zachary T Bloomgarden; George Grunberger; Guillermo Umpierrez; Robert S Zimmerman; Timothy S Bailey; Lawrence Blonde; George A Bray; A Jay Cohen; Samuel Dagogo-Jack; Jaime A Davidson; Daniel Einhorn; Om P Ganda; Alan J Garber; W Timothy Garvey; Robert R Henry; Irl B Hirsch; Edward S Horton; Daniel L Hurley; Paul S Jellinger; Lois Jovanovič; Harold E Lebovitz; Derek LeRoith; Philip Levy; Janet B McGill; Jeffrey I Mechanick; Jorge H Mestman; Etie S Moghissi; Eric A Orzeck; Rachel Pessah-Pollack; Paul D Rosenblit; Aaron I Vinik; Kathleen Wyne; Farhad Zangeneh Journal: Endocr Pract Date: 2015-04 Impact factor: 3.443
Authors: Andreas C Themistocleous; Juan D Ramirez; Pallai R Shillo; Jonathan G Lees; Dinesh Selvarajah; Christine Orengo; Solomon Tesfaye; Andrew S C Rice; David L H Bennett Journal: Pain Date: 2016-05 Impact factor: 7.926