Is health related quality of life influenced by diabetic neuropathic pain among type II diabetes mellitus patients in Ethiopia?

Abstract

BackgroundPolyneuropathy is one of the commonest complications of long-standing diabetes. Progressive sensory loss can predispose patients to foot ulcer and the neuropathy oftentimes causes pain. The pain can significantly affect the quality of life of patients.ObjectivesTo describes the health-related quality of life of patients with type II diabetes mellitus suffering from painful diabetic peripheral neuropathy at two referral hospitals in Addis Ababa, Ethiopia, 2017.MethodsAn institution based cross sectional study with internal comparison was conducted among a sample of 220 type II diabetes mellitus patients in a 1:1 matched ratio of those with and without diabetes associated peripheral neuropathic pain. All were having regular follow up at two hospitals in Addis Ababa, Ethiopia. The Short Form (SF-36) health-related quality of life instrument was used to collect data on quality of life while basic socio-demographic and other disease specific features were collected using a structured questionnaire. Descriptive statistics was used to examine the mean scores of health related quality of life. Cronbach’s alpha coefficient and Pearson’s correlation coefficient were applied to estimate the internal consistency, and the level of agreement between the different domains of SF-36, respectively. To measure association between health related quality of life domains and explanatory variables, independent T-test and ANOVA were performed followed by multiple linear regression analyses.ResultsThe health related quality of life of type II diabetes mellitus patients with peripheral neuropathic pain was poorer than those without pain in all the eight domains and the two summary scores by SF-36 (p < 0.001). Higher mean score difference was observed in Mental Component Summary Score (MCS) (14.6) compared to Physical Component Score (PCS) (9.3). Among the eight domains, the largest mean difference was found with the physical one (39.1) followed by mental health (38.2) and physical functioning (30). Pain intensity had a statistically significant negative correlation with all domains as well as the two summary scores. Younger age, a higher level of education, being single, a higher monthly income, normal body mass index, HbA1c less than seven mmo/L, absence of other diabetic complications and taking only oral hypoglycemic agents were found to predict better health related quality of life.ConclusionThe presence of diabetic peripheral neuropathic pain was found to negatively influence the health-related quality of life of type II diabetic patients; the greatest impact being on the ‘role physical’ and ‘mental health’ domains. Older age, presence of diabetes related complications, longer duration of illness negatively influenced the health-related quality of life.

Prevalence and associated factors of foot ulcer among diabetic patients in Ethiopia: a systematic review and meta-analysis

“…Accordingly, the prevalence ranged from 7.15% (95%CI: 3.73, 10.56) in Oromia region [12,16,17] to 19.31% (95%CI: 2.7. 41.37) in Addis Ababa [11,15,27]. The funnel plot was asymmetry, and the Egger's test also showed statistically significant publication bias (p = 0.001) at 5% significant level ( Table 2).…”

“…The [11] and lowest (1.36%) [27] prevalence of diabetic foot ulcer was reported in Addis Ababa (Fig. 2).…”

“…Studies from 4 regions and 1 town administrative of the country were included. Oromia [12,16,17], Amhara [19,25,26], and AA [11,15,27] contributing three studies in each region and 1 from southern nationalities [18] and 1 from Tigray [24] region ( Table 1).…”

Neuroprotective effect of diosgenin in a mouse model of diabetic peripheral neuropathy involves the Nrf2/HO-1 pathway

“…There is a common complication in people with diabetes that is characterized by greater sensitivity to noxious stimuli than that of normal people (hyperalgesia) [5]. Clinically, the symptoms of diabetic peripheral neuropathy seriously affect the quality of life and mental health of patients, so treating these symptoms of DPN in the clinic is a new challenge [6]. Currently, there are very few available therapies for diabetic neuropathy because therapeutic opportunities are limited by many factors, such as serious adverse reactions and ineffectiveness.…”

<p>Health-Related Quality of Life and Associated Factors Among Type Two Diabetic Patients on Follow-Up in Dessie Comprehensive Specialized Hospital, Dessie, North East Ethiopia, 2020</p>

“…[9][10][11][12][13][14][15] In addition to this, similar studies conducted in different countries revealed that the burden of diabetic related chronic complications are responsible for high morbidity and mortality with significantly reduced HRQOL among type two diabetic patients in developed and low income countries. [16][17][18][19][20][21] Depression was also the major determinant factor in HRQOL with respect to physical and psychological domains in developed and low income countries. 17,21,22 In Ethiopia, diabetic related chronic complications and co-morbidity diseases have negative impact on HRQOL with respect to physical health, psychological health, social health and environmental health.…”