Clinical Characteristics And Risk Factors Of Painful Diabetic Peripheral Neuropathy

Objective Painful diabetic peripheral neuropathy(pDPN)is one of the most serious complications of diabetes,which brings serious physiological and psychological burden to diabetic patients.At present,the early diagnosis rate of pDPN is low,and the treatment is limited.Therefore,the purpose of this study is to explore the clinical characteristics and related risk factors of pDPN in order to provide theoretical basis for early prevention,early identification and early treatment of the disease.Methods A total of 447 patients with diabetic peripheral neuropathy((Diabetic peripheral neuropathy,DPN)who were admitted to our hospital from December 2017 to June2019 were selected through the medical record system.The demographic,clinical and laboratory data of the 447 patients were collected and investigated with the neuropathic pain questionnaire(DN4 questionnaire).Taking the score ? 4 of the DN4 questionnaire as the inclusion criteria of the pDPN group,a total of 200 patients were enrolled in the painful diabetic peripheral neuropathy group(pDPN group).The other 247 patients with non-painful diabetic peripheral neuropathy served as control group(DPN group).The general clinical data,laboratory data and clinical concomitant diseases in pDPN group were described,and the differences between pDPN group and DPN group were statistically analyzed,and the possible risk factors of pDPN were analyzed.Results pDPN accounts for 45% of DPN,and the age is concentrated between 45 and64 years old.The ratio of male to female is 7%.It often occurs in patients with type 2 diabetes who are overweight.The incidence of pDPN increased with the progression of diabetes.73.5% of the patients developed pain symptoms 5 years after the diagnosis of diabetes.Pain was most common in both lower limbs,such as burning and acupuncture pain at night.The rate of early diagnosis of pDPN is low,and only 20% of patients are treated for pain within 1year.40% of pDPN patients had a history of smoking and 26.5% of them had a history of drinking.50% of pDPN patients are overweight and complicated with hyperlipidemia.90% of pDPN patients have poor blood glucose control,and most of them are complicated with diabetic retinopathy,diabetic nephropathy,hypertension and coronary heart disease.Compared with DPN group,pDPN group showed higher proportion of male,higher proportion of type 2 diabetes,longer course of disease,longer history of smoking,higher level of hemoglobin,more serious electrophysiological damage and more likely to be complicated with abnormal renal function and diabetic nephropathy and diabetic retinopathy.The most important risk factors for pDPN were long duration of diabetes(OR=17.12,95% CI=3.89-75.45),followed by diabetic retinopathy(OR=2.90,95%CI=1.79-4.71),high glycosylated hemoglobin level(OR=2.15,95% CI=1.12-4.11)smoking history of more than 400 years(OR=2.08,95%CI=1.09-3.94)and male patients(OR=1.91,95% CI=1.25-2.92).Conclusion 1.PDPN accounts for 45% of DPN,which is most common in male patients and has a high incidence between 45 to 64 years old,The longer the course of diabetes,the higher the prevalence of pDPN.2.Male,course of disease more than 10 years,smoking history more than 400,high glycosylated hemoglobin level and diabetic retinopathy may be risk factors for pDPN. retinopathy.