Pragmatic Opioid Use in Painful Diabetic Neuropathy

Balhara, Yatan Pal Singh; Singh, Shalini; Kalra, Sanjay

doi:10.17925/ee.2020.16.1.21

Cited by 11 publications

(15 citation statements)

References 41 publications

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“…Painful diabetic neuropathy (PDN) is among the most common complications in a patient with chronic Diabetes Mellitus (type 1 and 2). PDN manifests with an intense pain arising as a direct consequence of the disease or lesions affecting the peripheral nervous system (PNS) [ 6 ]. Above 30% of patients with diabetes diagnosed with PDN.…”

Section: Introductionmentioning

confidence: 99%

Predicting the quality of life based on pain dimensions and psychiatric symptoms in patients with Painful diabetic neuropathy: a cross-sectional prevalence study in Iranian patients

Davoudi

Rezaei

Rajaeiramsheh

et al. 2021

Health Qual Life Outcomes

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Background This study aimed to predict the quality of life (QOL) in patients with Painful Diabetic Neuropathy (PDN) based on pain severity, pain catastrophizing, pain acceptance, depression, anxiety, and sleep disturbance. Also, this study was aimed to assess the prevalence of psychiatric symptoms in Iranian patients with PDN. Method 1120 patients (mean age, 53.6 ± 12.6 years) participated in the research. Data were collected by the Quality of life questionnaire (NeuroQoL); Beck Depression Inventory, Beck Anxiety Inventory, the visual analog scale for pain severity, Pain Catastrophizing Scale (PCS), Chronic Pain Acceptance Questionnaire (CPAQ) and Pittsburgh Sleep Quality Index (PSQI). Finally, the data were analyzed using SPSS-26 by multiple regression analysis. Results The results showed the regression models’ significance, and the dependent variables predicted 42% of total changes in the QOL. The most significant predicting factors were depression, pain catastrophizing, pain acceptance, pain severity, sleep disturbance, and anxiety in order. In patients with PDN, the prevalence of sleep disturbances, depression, and anxiety were 85.5%, 68.2%, and 62.1%, respectively. Also, comorbid depression and anxiety were found in 47% of patients. Conclusion Results demonstrated a significant relationship between pain-related and psychiatric dimensions with QOL. Thus, it is suggested to design more specific psychological-based rehabilitation interventions in which these variables are considered. They should focus on more significant variables (such as depression and pain catastrophizing) to reach better treatment outcomes. Furthermore, this research shows a high level of anxiety, depression, and sleep disturbance in Iranian patients with PDN. Thus, experts and clinicians are suggested to focus on reducing these psychiatric symptoms.

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Section: Introductionmentioning

confidence: 99%

Predicting the quality of life based on pain dimensions and psychiatric symptoms in patients with Painful diabetic neuropathy: a cross-sectional prevalence study in Iranian patients

Davoudi

Rezaei

Rajaeiramsheh

et al. 2021

Health Qual Life Outcomes

View full text Add to dashboard Cite

show abstract

“…Among the various problems in diabetic patients, painful diabetic neuropathy (PDN) needs extensive attention. Peripheral neuropathic pain is a pain that rising as a straight consequence of the disease or lesion affecting the peripheral nervous system (PNS) (6). More than 30% of diabetic patients develop PDN.…”

Section: Introductionmentioning

confidence: 99%

“…More than 30% of diabetic patients develop PDN. Patients with PDN report a stinging, burning, and keen sensation that increases at night with a loss of sensation or numbness of the involved area (6,7).…”

Section: Introductionmentioning

confidence: 99%

“…This pain occurs in varying degrees and intensi es at night. Due to its debilitating properties, neuropathic pain causes dissatisfaction, fatigue, and distress; ultimately reduces the Qol of these patients much more than diabetic patients without neuropathy (6,8).…”

Section: Introductionmentioning

confidence: 99%

“…Also, the lack of improvement in sleep problems is an obstacle to improving other symptoms in these patients (16).Overall, problems related to pain, depression, anxiety, and sleep disturbance lead to a severe decline in Qol (as a primary goal of therapeutic interventions) in patients with PDN. However, various studies have targeted a number of these symptoms in various ways (6,8,11,14).Therefore, the contribution of each one in reducing these patients' Qol has not been determined. It has been associated with limitations such as meager sample size (less than 60 people) (18,19), failure to conduct individual interviews (9), and lack of examination in psychological variables (20).…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Predicting the Quality of Life in Patients With Painful Diabetic Neuropathy (PDN) Based on Pain Severity, Pain Catastrophizing, Pain Acceptance, Depression, Anxiety, and Sleep Disturbance: Assessing the Prevalence of Psychiatric Symptoms in Iranian Patients With PDN.

Rezaei

Rajaeiramsheh

Davoudi

et al. 2020

Preprint

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Background: This study aimed to predict the quality of life in patients with Painful Diabetic Neuropathy (PDN) based on pain severity, pain catastrophizing, pain acceptance, depression, anxiety, and sleep disturbance. Also, assessing the prevalence of psychiatric symptoms in Iranian patients with PDN.Method: In this descriptive correlational study, 1500 MTBI patients admitted to the diabetes centers in Tehran, Iran, from November 2019, to August 2020 were selected using the convenient sampling method. One thousand one hundred twenty patients (mean age, 53.6± 12.6 years) participated in the research. Data were collected using the Quality of life (NeuroQol) questionnaire (as a dependent variable); Beck Depression Inventory, Beck Anxiety Inventory, 10-cm visual analog scale (pain severity), Pain Catastrophizing Scale (PCS), Chronic Pain Acceptance Questionnaire (CPAQ) and Pittsburgh Sleep Quality Index (PSQI). Finally, the data were analyzed in SPSS‑26 by multiple regression analysis.Results: The study results showed that the regression model was significant (P < 0.5), in which variables predicted 42% of total changes in the quality of life in patients. Predicting factors from the most significant to the lowest include depression, pain catastrophizing, pain acceptance, pain severity, sleep disturbance, and finally, anxiety. Also, in patients with PDN, the prevalence rates of sleep disturbances, depression, and anxiety are 85.5%, 68.2%, and 62.1%, respectively. Also, comorbid depression and anxiety were found in 47% of patients.Conclusion: The findings of this study show a considerable relationship between these factors and quality of life. Thus, it is suggested to design more specific psychological‑based rehabilitation programs concerning these variables to improve these patients' quality of life, focusing on stronger variables (depression and pain catastrophizing) for reaching better treatment outcomes. Furthermore, according to the findings of this research, which shows a high level of anxiety, depression, and sleep disturbance in Iranian patients with PDN, all experts and clinicians must focus on these psychiatric symptoms to reduce disease problems.

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First‐in‐Human Single‐Ascending‐Dose, Multiple‐Dose, and Food Interaction Studies of NRD.E1, an Innovative Nonopioid Therapy for Painful Diabetic Peripheral Neuropathy

Tiecke¹,

Rainisio²,

Guentert³

et al. 2022

Clinical Pharm in Drug Dev

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Painful diabetic peripheral neuropathy is characterized by burning, stabbing, or electric shock-type pain, which severely impacts day-to-day functioning and quality of life. Here, we report the results of 3 phase I studies with NRD135S.E1 (referred to as NRD.E1), a new, orally available chemical entity, presently developed for the treatment of painful diabetic peripheral neuropathy. The first study was a first-in-human, randomized, placebo-controlled, single-ascending-dose study, where NRD.E1 was administered to healthy male subjects in single dosages ranging from 300 to 1200 mg. The second study was a randomized,placebo-controlled multiple-dose study,where healthy male subjects received 300 mg of NRD.E1 once daily for 5 consecutive days. The third study was an open-label food interaction study in healthy men and women following a crossover design, where NRD.E1 was administered under fed and fasted conditions at 40 mg. The studies revealed dose-dependent absorption, increased exposure to NRD.E1 when administered with food, and no relevant accumulation after once-daily administration. All 3 phase I studies consistently showed rapid absorption of orally administered NRD.E1 followed by fast elimination, mainly via metabolization (glucuronidation), and small secondary increases in plasma concentrations. NRD.E1 was well tolerated, with no subject discontinuation due to treatment-emergent adverse events in any study.

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Pragmatic Opioid Use in Painful Diabetic Neuropathy

Cited by 11 publications

References 41 publications

Predicting the quality of life based on pain dimensions and psychiatric symptoms in patients with Painful diabetic neuropathy: a cross-sectional prevalence study in Iranian patients

Predicting the quality of life based on pain dimensions and psychiatric symptoms in patients with Painful diabetic neuropathy: a cross-sectional prevalence study in Iranian patients

Predicting the Quality of Life in Patients With Painful Diabetic Neuropathy (PDN) Based on Pain Severity, Pain Catastrophizing, Pain Acceptance, Depression, Anxiety, and Sleep Disturbance: Assessing the Prevalence of Psychiatric Symptoms in Iranian Patients With PDN.

First‐in‐Human Single‐Ascending‐Dose, Multiple‐Dose, and Food Interaction Studies of NRD.E1, an Innovative Nonopioid Therapy for Painful Diabetic Peripheral Neuropathy

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