Is health related quality of life influenced by diabetic neuropathic pain among type II diabetes mellitus patients in Ethiopia?

Hiwot Degu, Abigiya Wondimagegnehu, Yared Mamushet Yifru, Ayele Belachew, Hiwot Degu, Abigiya Wondimagegnehu, Yared Mamushet Yifru, Ayele Belachew

Abstract

Background: Polyneuropathy is one of the commonest complications of long-standing diabetes. Progressive sensory loss can predispose patients to foot ulcer and the neuropathy oftentimes causes pain. The pain can significantly affect the quality of life of patients.

Objectives: To describes the health-related quality of life of patients with type II diabetes mellitus suffering from painful diabetic peripheral neuropathy at two referral hospitals in Addis Ababa, Ethiopia, 2017.

Methods: An institution based cross sectional study with internal comparison was conducted among a sample of 220 type II diabetes mellitus patients in a 1:1 matched ratio of those with and without diabetes associated peripheral neuropathic pain. All were having regular follow up at two hospitals in Addis Ababa, Ethiopia. The Short Form (SF-36) health-related quality of life instrument was used to collect data on quality of life while basic socio-demographic and other disease specific features were collected using a structured questionnaire. Descriptive statistics was used to examine the mean scores of health related quality of life. Cronbach's alpha coefficient and Pearson's correlation coefficient were applied to estimate the internal consistency, and the level of agreement between the different domains of SF-36, respectively. To measure association between health related quality of life domains and explanatory variables, independent T-test and ANOVA were performed followed by multiple linear regression analyses.

Results: The health related quality of life of type II diabetes mellitus patients with peripheral neuropathic pain was poorer than those without pain in all the eight domains and the two summary scores by SF-36 (p < 0.001). Higher mean score difference was observed in Mental Component Summary Score (MCS) (14.6) compared to Physical Component Score (PCS) (9.3). Among the eight domains, the largest mean difference was found with the physical one (39.1) followed by mental health (38.2) and physical functioning (30). Pain intensity had a statistically significant negative correlation with all domains as well as the two summary scores. Younger age, a higher level of education, being single, a higher monthly income, normal body mass index, HbA1c less than seven mmo/L, absence of other diabetic complications and taking only oral hypoglycemic agents were found to predict better health related quality of life.

Conclusion: The presence of diabetic peripheral neuropathic pain was found to negatively influence the health-related quality of life of type II diabetic patients; the greatest impact being on the 'role physical' and 'mental health' domains. Older age, presence of diabetes related complications, longer duration of illness negatively influenced the health-related quality of life.

Conflict of interest statement

The authors have declared that no competing interests exist.

References

    1. WHO. Definition, Diagnosis and Classification of Diabetes Mellitus and Complications. 1999, WHO/NCD/992
    1. International Diabetes Federation. IDF Diabetes Atlas,. Seventh Edition, 2015.
    1. Schlenk EA, Erlen JA, Dunbar-Jacob J, McDowell J, Engberg S, Sereika SM, et al. Health-related quality of life in chronic disorders: a comparison across studies using the MOS SF-36. Quality of Life Research. 1977; 7(1):57–65.
    1. Abbashar H, Omer El-A, Ahmmed H, Mohamed M, Hamad A, Ahmed EM, et al. The prevalence of neurological complications among Adult Sudanese diabetic patients. Sudanese Journal of Public Health, 2009; 4(3):331–4.
    1. Tessa P, Alan B, Peter M, Jackie E, Hasan B, Jen K. The Impact of Diabetes-Related Complications on Preference-Based Measures of Health-Related Quality of Life in Adults with Type I Diabetes. SAGE Medical Decision Making 2016; 36(8): 1020–1033.
    1. Reddemma S, Veera G Y, Aparna A, Prashanth K, Ashutosh K. Neuroinflammation and Oxidative Stress in DiabeticNeuropathy: Futuristic Strategies Based on These Targets. International Journal of Endocrinology, Article ID 674987:10, 2014.
    1. Khaled K, Morsy Ar, Abdelaziz El S, Said A. Peripheral neuropathy in type-II diabetic patients attending diabetic clinicsin Al-Azhar University Hospitals, Egypt. International Journal of Diabetes Mellitus, 2010; 2: 20–23.
    1. Solomon T, Loretta V, Gerry R, Søren HSp, Bruce A, Baconja M, et al. Painful diabetic peripheral neuropathy: consensus recommendations on diagnosis, assessment and management. Diabetes Metab Res Rev. 2011; 27(7):629–38. 10.1002/dmrr.1225
    1. Francisco LJ W. Neurologic Complications of Diabetes. California Medicine: 1962; 14–20.
    1. Van A K, Bouhassira D, De Bacquer D, Weiss S, Matthys K, Raemen H, et al. Prevalence and impact on quality of life of peripheral neuropathy with orwithout neuropathic pain in type 1 and type 2 diabetic patients attending hospital outpatients clinics. Diabetes Metabolism. 2009; 35(3)206–213. 10.1016/j.diabet.2008.11.004
    1. Andrew J, Mampedi B, Larry A D, Ehab Y M, Mahomed Omar KA, Ismail A T, et al. An Epidemiological Study to Assess the Prevalence of Diabetic Peripheral Neuropathic Pain Among adults with Diabetes Attending Private and Institutional Outpatient Clinics in South Africa. Journal of International Medical Research 2014;42(4)018–1028.
    1. Abdul H Z, Fayaz A S, Bashir A L, Shariq R M, Nissar A S, Farooq A D. Profile of neurological problems in Diabetes Mellitus: Retrospective analysis of data from 1294patients. Health Administrator 2009; 22(1& 2): 95–106
    1. Andrea D B, Panos K, Giovanny V F, Andre C, Tejada C A, Prdro C H, et al. Epidemiology, management, complications andcosts associated with type 2 diabetes in Brazil: a comprehensive literature review. Globalization and Health, 2003; 9:62.
    1. Cruccua G, Sommer C, Anand P, Attald N, Baron R, Garcia L, et al. EFNS guidelines on neuropathic pain assessment. European Journal of Neurology, 2004; 11:153–62.
    1. Seung H K, BongY C. Diabetic Peripheral Neuropathy in Type 2 Diabetes Mellitus in Korea. Diabetes Metab J 2012; 36:6–12. 10.4093/dmj.2012.36.1.6
    1. Annabel B, Julia A FR. Systematic and Critical Review of the Process of Translation and Adaptation of Generic Health Related Quality of life Measures in Africa,Asia, Eastern Europe, the Middle east, South America. Soc Sci Med. 2003; 57(7):1289–306.
    1. Fahad S B, Mohamed A H, Akmal S. A cross-sectional assessment of health-related quality of life among type 2 diabetic patients in Pakistan. J Pharm Bioallied Sci, 2016; 8(1) 64–68. 10.4103/0975-7406.171734
    1. Rui W W C, Yanfang Z, Xiaoyan Y, Xiuqiang M, Meijing W, Zheng G, et al. Health related quality of life measured by SF-36: a population-basedstudy in Shanghai, China. BMC Public Health, 2008; 8:292 10.1186/1471-2458-8-292
    1. Guillemin F, Bombardier C, Beaton D. Cross-Cultural Adaptation of health related quality of life measures: literature review and proposed guidelines. J Clio epidemiol, 1993; 46(12)1417–32.
    1. Vesna DD, Pero H, Dinko S, Ranko S, Savko D, Ingrid P, et al. The impact of neuropathic pain and other comorbidities on the quality of life in patients with diabetes. Health Qual Life Outcomes, 2014; 12:171 10.1186/s12955-014-0171-7
    1. Stephen J W. Sample size and power estimation for studies with health related quality of life outcomes: a comparison of four methods using theSF-36. Biomedical journal, 2004; 2:26.
    1. Stanislava Y, Guenka P, Guenka P, Milen D, Emilia N, Elina P. Comparison of health-related quality of-life measurement instruments in diabetic patients. Biotechnology & Biotechnological Equipment, 2014; 28 (4):769–74.
    1. Derege K, Atalay A, Teshome S, Alemayehu N, Neguse D, Teferra. Health related quality of life (SF-36) survey inButajira, rural Ethiopia: Normative data and evaluation of reliability and validity. Ethio Med J, 2004; (4):289–97.
    1. Kebede A, Teferi G, Ephrem E, Tsige GM. Quality of life of people living with HIV/AIDS and on highly active antiretroviral therapy in Ethiopia. African Journal of AIDS Research, 2014; 9(1)31–40.
    1. Ian G, Baron R, Troels J. Neuropathic Pain: Principles of Diagnosis and Treatment. Mayo Clinic Proceedings, 2015; 90(4)532–45. 10.1016/j.mayocp.2015.01.018
    1. John E W, Cathy D S. The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Medical Care 1992; 30 (6)473–83.
    1. John W, Kristin K S, Mark K, Barbra G. SF-36 Health Survey: Manual and Interpretation Guide. The Health Institute, New England Medical Centre, Boston Massachusetts, 1993
    1. Khaled J. Y I, Nasir A, Abdulla H, Mohammed W, Noor A, Shatha Al, et al. The effect of diabetes mellitus on quality of life. Sudanese Journal of Public Health. January (2014):9(1)4852.
    1. Rui V D, Lazaros A, Mathieu W.L P.M., Cecile C. Quality of life increases in patients with painful diabetic neuropathy following treatment with spinal cord stimulation. cross mark(Qual Life Res, 2016; 25:1771–1777.
    1. Nurten O YD, Hulusi K. Effects of Pain and Disability on Qualityof Life in Patients with DiabeticPolyneuropathy. Neuroscience & Medicine, 2015; 6: 98–106.
    1. Genga E K, Otieno C.F, Ogola E.N, Maritim M.C. Assessment of the Perceived Quality of Life of Non insulin Dependent Diabetic patients attending the Diabetes Clinic in Kenyatta National Hospital. IOSR Journal Of Pharmacy, 2014; 4(3):15–21.
    1. Andres PR, Vilma I, Andrea B, Andrea A, Carolina C. Quality of life in type 2 diabetes mellitus patients requiring insulin treatment in Buenos Aires, Argentina: a cross-sectional study. Int J Health Policy Manag, 2015; 4(7)475–480. 10.15171/ijhpm.2015.80

Source: PubMed

Sponsors et collaborateurs

Les conditions médicales

Interventions en matière de drogue

3
S'abonner