title: Importance of pain evaluation for more accurate diagnosis of painful diabetic polyneuropathy.
abstract: Pain is a common problem in diabetic neuropathy, but relatively little has been published regarding the extent to which it needs to be addressed in clinical practice.
  
  
  OBJECTIVE
  To assess neuropathic pain profile and its association with quantitative sensory testing in painful diabetic polyneuropathy.
  
  
  METHODS
  Altogether, 61 consecutive diabetic inpatients with symmetric neuropathic complaints were enrolled. Clinical neurological examination and quantitative sensory testing (QST) were performed. Patients were interviewed using the Neuropathic Pain Scale (NPS) and filled in the McGill Pain Questionnaire (MPQ).
  
  
  RESULTS
  Of all patients, 49 (80.3%) had clinical diabetic polyneuropathy. Only 17 of these patients complained of lower extremity pain on an initial interview, while 27 marked it in the MPQ. The intensity of deep and superficial pain did not differ, but patients rated deep pain as more unpleasant than superficial (6.27±2.37 vs. 4.30±1.42 on the NPS, P=0.034). Superficial pain NPS items tended to correlate with QST results, while deep pain items did not. Only female gender (OR=7.87) and lower glycosylated hemoglobin level (OR=0.65) were predictive of pain in case of diabetic neuropathy.
  
  
  CONCLUSIONS
  Standard pain questionnaires were useful in identifying pain sufferers. At the same intensity, deep neuropathic pain was more unpleasant than superficial. Pain manifestation was associated with female gender and lower level of glycosylated hemoglobin.
authors.affiliation: Department of Neurology, Medical Academy, Lithuanian University of Health Sciences, Eivenių 2, Kaunas, Lithuania. kestutispetrikonis@yahoo.com
authors.forename: Kęstutis
authors.initials: K
authors.lastname: Petrikonis
authors.forename: Arūnas
authors.initials: A
authors.lastname: Sčiupokas
authors.forename: Gintautė
authors.initials: G
authors.lastname: Samušytė
authors.forename: Jolita
authors.initials: J
authors.lastname: Janušauskaitė
authors.forename: Rita
authors.initials: R
authors.lastname: Sulcaitė
authors.forename: Antanas
authors.initials: A
authors.lastname: Vaitkus
mesh_terms: D003929:Diabetic Neuropathies / Q000175:diagnosis / Q000503:physiopathology*; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D008297:Male; D008875:Middle Aged; D009460:Neurologic Examination; D010146:Pain; D010147:Pain Measurement; D058748:Pain Perception; D012737:Sex Factors
chemical_list: D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human