Painful diabetic neuropathy: a cross-sectional survey of health state impairment and treatment patterns

Tölle, Thomas R.; Xu, Xiaoli; Sadosky, Alesia

doi:10.1016/j.jdiacomp.2005.09.007

Cited by 183 publications

(185 citation statements)

References 36 publications

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“…Tölle e cols. (13) relataram previamente que a gravidade da dor neuropática está relacionada proporcionalmente ao grau de interferência na condição de saúde e funcionalidade do paciente. Galer e cols.…”

Section: Sintomas Depressivosunclassified

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Sintomas depressivos e qualidade de vida em pacientes diabéticos tipo 2 com polineuropatia distal diabética

Moreira

Amancio

Brum

et al. 2009

Arq Bras Endocrinol Metab

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RESUMOObjetivo: Avaliar o impacto dos sintomas depressivos e da dor neuropática na qualidade de vida (QV) de pacientes diabéticos com polineuropatia distal diabética (PNDD). Métodos: Foram avaliados 204 pacientes com diabetes melito tipo 2. O diagnóstico de PNDD foi realizado por meio do Escore de Sintomas Neuropáticos e Escore de Comprometimento Neuropático. A gravidade da dor neuropática foi avaliada por meio da Escala Visual Analógica (EVA); os sintomas depressivos, por meio do Inventário Beck de Depressão (IBD); a QV, com o World Health Organization Quality of Life abreviado (WHOQOL-bref). Resultados: Pacientes com PNDD apresentaram escores mais altos no IBD (12,6 ± 7,2 versus 9,9 ± 7,3; p = 0,018) e no EVA (5,0 ± 2,4 versus 2,6 ± 2,9, p < 0,001). Em relação à QV, apresentaram escores mais baixos no domínio físico (52,8 ± 15,5 versus 59,2 ± 17,0; p = 0,027) e ambiental (56,6 ± 12,3 versus 59,6 ± 13,6; p = 0,045). Conclusões: Pacientes diabéticos com PNDD apresentam pior QV nos domínios físico e ambiental do WHOQOL-bref, provavelmente devido à maior sintomatologia depressiva e gravidade de dor. Arq Bras Endocrinol Metab. 2009;53(9):1103-11 Descritores Qualidade de vida; depressão; neuropatia diabética; dor neuropática ABSTRACT Objective: To investigate the impact of depressive symptoms and neuropathic pain in the quality of life (QL) of diabetic patients with diabetic distal polyneuropathy (DDP). Methods: Two hundred and four patients with type 2 diabetes mellitus were evaluated. The diagnosis of DDP was achieved using the Neuropathy Disability Score and Neuropathy Symptom Score questionnaires. The severity of neuropathic pain was assessed by means of a Visual Analogue Scale (VAS); the severity of depression, by means of the Beck Depression Inventory (BDI); and QL was assessed by means of the World Health Organization Quality of Life Instrument-bref (WHOQOLbref). Results: Patients with DDP presented significant higher scores in BDI (12.6 ± 7.2 versus 9.9 ± 7.3; p = 0.018) and in VAS (5.0 ± 2.4 versus 2.6 ± 2.9; p < 0.001). They also presented significant lower scores in the physical (52.8 ± 15.5 versus 59.2 ± 17.0; p = 0.027) and environmental domains (56.6 ± 12.3 versus 59.6 ± 13.6; p = 0,045). Conclusions: Diabetic patients with DDP presented a worse QL in the physical and environmental domains of the WHOQOL-bref, probably due to more depressive symptoms and the severity of pain. INTRODUÇÃO O diabetes melito (DM) é uma doença metabólica complexa, multifatorial e de presença global (1). É caracterizada por hiperglicemia crônica associada a distúrbios no metabolismo dos carboidratos, lipídios e proteínas, resultante de defeitos na secreção e/ou na ação da insulina (2). Cerca de 85% a 90% dos pacientes portadores de DM possuem o chamado DM tipo 2 (DMT2) (3).

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Section: Sintomas Depressivosunclassified

“…Com a evolução da doença, o paciente refere melhora da dor; persiste, porém, com déficit sensitivo. Seu tratamento é difícil e, em geral, pouco satisfatório, devido à falta de conhecimento dos exatos mecanismos fisiopatológicos de sua instalação (12) -possivelmente pela persistência do estado hiperglicê-mico que leva ao dano neural (13).…”

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Sintomas depressivos e qualidade de vida em pacientes diabéticos tipo 2 com polineuropatia distal diabética

Moreira

Amancio

Brum

et al. 2009

Arq Bras Endocrinol Metab

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“…Baseline pain severity also may affect treatment outcome. It has been reported that greater pain severity may be associated with substantial patient burden resulting from interference with daily functioning, especially in patients with suboptimal pain management (15). The objective of this analysis was to evaluate the impact of various baseline disease characteristics on the efficacy and safety of duloxetine in the management of DPNP, using pooled data from three clinical studies.…”

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confidence: 99%

Impact of Disease Characteristics on the Efficacy of Duloxetine in Diabetic Peripheral Neuropathic Pain

et al. 2007

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OBJECTIVE -To evaluate the impact of baseline disease variables related to diabetes and diabetic neuropathy severity on efficacy and safety of duloxetine in the management of diabetic peripheral neuropathic pain.RESEARCH DESIGN AND METHODS -The impact of baseline conditions was evaluated using the data from three pooled placebo-controlled studies for combined duloxetine, doses of 60 mg q.d. and 60 mg b.i.d., versus placebo. The primary efficacy measure was the weekly mean of 24-h average pain severity, and night pain was the secondary measure. Safety and tolerability were assessed.RESULTS -There were no significant (P Ͼ 0.10) interactions of treatment by age (Ͻ65 or Ն65 years), type of diabetes (type 1 or type 2), duration of diabetes (median split Ͻ9.18 or Ն9.18 years), duration of diabetic neuropathy (Ͻ2, 2 to Ͻ6, or Ն6 years), severity of diabetic neuropathy (baseline Michigan Neuropathy Screening Instrument score Ͻ5 or Ն5), baseline A1C level (median split Ͻ7.6 or Ն7.6%), or baseline insulin use (yes/no). Significant interactions for both pain measures were observed in baseline pain subgroups (Brief Pain Inventory average pain, Ն6 and Ͻ6). Duloxetine was more effective in the subgroup with more pain. No significant association was found between any other subgroups (P Ͼ 0.10). Significant interactions (P Ͻ 0.1) occurred with treatment-emergent adverse events when stratified by subgroups.CONCLUSIONS -Pain severity but not variables related to diabetes or neuropathy may predict the effects of duloxetine in diabetic peripheral neuropathic pain. The efficacy of duloxetine is related to the initial pain severity and is generalizable across a broad spectrum of diabetic patients, including those with the highest severity of diabetes or neuropathy. Diabetes Care 30:664 -669, 2007

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“…Bel ağrılı çoğu hastada ağrı köken olarak nöropatik mekanizmalıdır ve bu tip ağrı %10-19'dur (30,31). Nöropatik ağrının suboptimal tedavisine, hastanın hastalığı katkıda bulunur (32,33). Bununla birlikte nöropatik ağrı için sırasıyla uygulanan ilaç tedavileri mevcuttur; sırasıyla antidepresan, tramadol, opioid ve değişik antiepileptik ilaçlar önerilmiştir.…”

Section: Discussionunclassified

Pregabalinin lomber interlaminar epidural kortikosteroid enjeksiyonu uygulaması sonrası vizüel analog skala değerlerine etkisi

Yektaş¹,

Gümüş²,

Kerem³

et al. 2014

Ege Tıp Dergisi

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Amaç: İnterlaminar lomber epidural kortikosteroid enjeksiyonu (İLEKE) bel ağrısında kullanılan minimal invaziv bir tedavi yöntemidir. Bu çalışmada radikülopatisi olan disk hernili hastalarda İLEKE uygulamasında pregabalinin VAS değerlerine etkisini incelemeyi amaçladık.Gereç ve Yöntem: Polikliniğimize başvuran ve İLEKE uygulanan 100 hastaya ait kayıtların retrospektif olarak incelenerek hastaların pregabalin alan Grup P ve almayan Grup Z olarak iki gruba ayrılmasıyla gerçekleştirildi. Vizüel analog skala (VAS) değerleri 1. hafta, 1-6. ay ve 1. yıl da değerlendirildi. Bulgular:Grup P ve Grup Z de başlangıç VAS değerlerine göre 1. hafta, 1-6. ay ve 1. yılda VAS değerleri istatistiksel olarak anlamlı düşüktü. Grup P ile Grup Z karşılaştırıldığında 1-6. ay ve 1. yıl VAS değerleri Grup P de istatistiksel olarak anlamlı düşüktü. Grup P de işlem sonrası hasta memnuniyeti Grup Z ye göre istatistiksel olarak anlamlı yüksekti.Sonuç: Pregabalin, İLEKE uygulanan radikülopatili hastalarda VAS değerlerini uzun dönemde de anlamlı olarak düşürmekte, İLEKE uygulama sayısını azaltmakta ve işlem sonrası hasta memnuniyetini arttırmaktadır.Anahtar Sözcükler: Disk hernisi, radikülopati, interlaminar lomber epidural kortikosteroid enjeksiyonu, pregabalin. Summary Aim: Inter-laminar lumbar epidural corticosteroid injection (ILECI) is a minimally invasive treatment method that is used in low-back pain. In this study, we aimed at investigating the effect of pregabalin administration on VAS values in patients with radiculopathy who have a disk hernia following administration of ILECI. Materials and Methods:The records pertaining to 100 patients who presented to our outpatient clinic were retrospectively examined; the patients were divided into two groups: Group P, the patients who received pregabalin and Group Z, the patients who did not receive pregabalin. The visual analogue scale (VAS) scores were assessed in week 1, months 1-6 and year 1. Results:The VAS scores of Group P and Group Z in week 1, and year 1 were lower than the baseline VAS scores at a statistically significant level. Based on a comparison between Group P and Group Z, it was seen that the VAS scores in months 1-6 and year 1 were lower for Group P at a statistically significant level. The postadministration patient satisfaction in Group P was higher than Group Z at a statistically significant level. Conclusion: Pregabalin significantly reduces the VAS scores in patients with radiculopathy who have received ILECI, it also decreases the frequency of ILECI administration and increases post-administration patient satisfaction.

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Painful diabetic neuropathy: a cross-sectional survey of health state impairment and treatment patterns

Cited by 183 publications

References 36 publications

Sintomas depressivos e qualidade de vida em pacientes diabéticos tipo 2 com polineuropatia distal diabética

Sintomas depressivos e qualidade de vida em pacientes diabéticos tipo 2 com polineuropatia distal diabética

Impact of Disease Characteristics on the Efficacy of Duloxetine in Diabetic Peripheral Neuropathic Pain

Pregabalinin lomber interlaminar epidural kortikosteroid enjeksiyonu uygulaması sonrası vizüel analog skala değerlerine etkisi

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