Health-related quality of life and management routine in painful and painless diabetic polyneuropathy (PREDIP study)

Aims This non-interventional, prospective, multicenter registry study aimed to assess the real-world management routine and the impact of the severity of neuropathic pain on health-related quality of life in people with diabetic sensorimotor polyneuropathy (DSPN). Methods Participants with possible/probable DSPN (n = 617) from practices or clinics were classified by the numerical pain rating scale into severe/moderate painful DSPN (Group 1;n = 262), mild painful DSPN (Group 2;n = 210), and painless DSPN (Group 3;n = 145). Mandatory assessment of DSPN included pain scales/questionnaires and the Short Form 12 Health Survey (SF-12), while optional assessment comprised point-of-care screening tools. Results In Group 1, 42% of participants received any pharmacotherapy and 28% received analgesic pharmacotherapy for DSPN. Three different DSPN screening tools were used in 77%, 54%, and 28% of the participants. In multivariate analyses, decreased scores of the physical and mental SF-12 components were most consistently associated with both severe/moderate and mild painful DSPN compared to painless DSPN (P < 0.05). Severe/moderate painful DSPN was also associated with female sex, higher BMI, and longer diabetes duration (P < 0.05). Conclusions Although not only severe/moderate but also mild neuropathic pain are powerful risk factors of reduced health-related quality of life, painful DSPN still remains undertreated, whilst screening tools are underutilized in real-world practice.