The Role of Comorbidity in the Clinical Course and Quality of Life of Patients With Diabetic Polyneuropathy

Abstract

The aim: To identify and substantiate the role of comorbidity in the clinical course and quality of life (QOL) of patients with diabetic polyneuropathy (DP). Materials and methods: We examined 139 patients aged from 19 to 69 years with DP occured as a consequence from type I and II diabetes mellitus (DM). The examined persons were divided into two groups: DP due to type I and II DM with comorbidity (group A,n=93) and without comorbidity (group B,n=46). For the patients was done a comprehensive clinical and neurological examination, laboratory, instrumental methods of examination. Results: We observe hypo- or areflexia much more in group A respect to reflexes on the upper and lower extremities than in group B, where the changes are more noticeable on the lower extremities. The level of QOL in group A is significantly lower than in group B. According to the McGill scale in group A, all indicators of pain characteristics are higher. Quite a high score in group A on the Pain Rating Index(PRI) – 32.17±1.57points. The lowest rates of the nerve conduction velocity (NCV) on the motor fibers were registered in group A, on the sensitive fibers of the upper extremities has got lower rates in groups A and B than in the control group, but in group A it is slightly higher. Conclusions: Clinical manifestations of DP in group A are more pronounced than in the comparison group and a wide range of comorbidity was diagnosed, including cardiovascular, which aggravates the manifestations of DP.