title: The impact of neuropathic pain and other comorbidities on the quality of life in patients with diabetes.
abstract: BACKGROUND
  Diabetic polyneuropathy (DPN) is one of the most common complications of diabetes and can exist with or without neuropathic pain. We were interested in how neuropathic pain impairs the quality of life in diabetic patients and what is the role of comorbidities in this condition.
  
  
  METHODS
  The study included 80 patients with painful DPN (group "P") and 80 patients with DPN, but without neuropathic pain (group "D"). Visual analogue scale (VAS) and Leeds assessment of neuropathic symptoms and signs (LANSS) pain scale were used for assessment of neuropathic pain, SF-36 standardized questionnaire for assessment of the quality of life and BDI questionnaire for assessment of depression.
  
  
  RESULTS
  Subjects in group P had statistically significantly lower values compared to group D in all 8 dimensions and both summary values of the SF-36 scale. We ascribe the extremely low results of all parameters of SF-36 scale in group P to painful diabetic polyneuropathy with its complications. The patients in group D showed higher average values in all dimension compared to group P, but also somewhat higher quality of life compared to general population of Croatia in 4 of 8 dimensions, namely vitality (VT), social functioning (SF), role-emotional (RE) and mental health (MH), which was unexpected result. Clinically, the most pronounced differences between two groups were noted in sleeping disorders and problems regarding micturition and defecation , which were significantly more expressed in group P. The similar situation was with walking distance and color-doppler sonography of carotid arteries, which were significantly worse in group P. Consequently, subjects in group P were more medicated than the patients in group D, particularly with tramadol, antiepileptics and antidepressants.
  
  
  CONCLUSIONS
  Painful DPN is a major factor that influences various aspects of quality of life in diabetic patients. Additionally, this study gives an overview of diabetic population in the Republic of Croatia, information that could prove useful in future studies.
authors.affiliation: Department of Diabetic Complication, Clinical Hospital Merkur, University Clinic Vuk Vrhovac, Dugi dol 4a, 10000, Zagreb, Croatia. vesna.djermanovic.dobrota@zg.t-com.hr.
authors.forename: Vesna
authors.initials: V
authors.lastname: Dermanovic Dobrota
authors.affiliation: Croatian Institute for Brain Research, School of Medicine, University of Zagreb, Salata 12, Zagreb, Croatia. phrabac@hiim.hr.
authors.forename: Pero
authors.initials: P
authors.lastname: Hrabac
authors.affiliation: Department of Internal Medicine, Clinical Hospital Merkur, Zajčeva 19, 10000, Zagreb, Croatia. dinko.skegro@kb-merkur.hr.
authors.forename: Dinko
authors.initials: D
authors.lastname: Skegro
authors.affiliation: Department of Diagnostic and Interventional Radiology, University hospital Center Zagreb, Kišpatićeva 12, 10000, Zagreb, Croatia. rtg.smiljanic@gmail.com.
authors.forename: Ranko
authors.initials: R
authors.lastname: Smiljanic
authors.affiliation: Department of Diagnostic and Interventional Radiology, University hospital Center Zagreb, Kišpatićeva 12, 10000, Zagreb, Croatia. savko.dobrota@zg.t-com.hr.
authors.forename: Savko
authors.initials: S
authors.lastname: Dobrota
authors.affiliation: Department of Internal Medicine, Clinical Hospital Merkur, Zajčeva 19, 10000, Zagreb, Croatia. ingrid.prkacin@gmail.com.
authors.forename: Ingrid
authors.initials: I
authors.lastname: Prkacin
authors.affiliation: Department of Diabetic Complication, Clinical Hospital Merkur, University Clinic Vuk Vrhovac, Dugi dol 4a, 10000, Zagreb, Croatia. n.brkljacic@gmail.com.
authors.forename: Neva
authors.initials: N
authors.lastname: Brkljacic
authors.affiliation: Department of Diabetic Complication, Clinical Hospital Merkur, University Clinic Vuk Vrhovac, Dugi dol 4a, 10000, Zagreb, Croatia. kperos@idb.hr.
authors.forename: Kristijan
authors.initials: K
authors.lastname: Peros
authors.affiliation: Department of Diabetic Complication, Clinical Hospital Merkur, University Clinic Vuk Vrhovac, Dugi dol 4a, 10000, Zagreb, Croatia. martina.tomic@idb.hr.
authors.forename: Martina
authors.initials: M
authors.lastname: Tomic
authors.affiliation: Department of Physiology, School of Medicine, University of Zagreb, Salata 3, 10000, Zagreb, Croatia. vesnas@mef.hr.
authors.forename: Vesna
authors.initials: V
authors.lastname: Lukinovic-Skudar
authors.affiliation: University Department of Neurology, University hospital Center " Sestre milosrdnice", Vinogradska 29, 10000, Zagreb, Croatia. vanjakes@net.hr.
authors.forename: Vanja
authors.initials: V
authors.lastname: Basic Kes
mesh_terms: D000368:Aged; D015897:Comorbidity; D017523:Croatia / Q000453:epidemiology; D003863:Depression / Q000523:psychology; D003929:Diabetic Neuropathies / Q000453:epidemiology / Q000523:psychology*; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D009437:Neuralgia / Q000453:epidemiology / Q000523:psychology*; D010147:Pain Measurement / Q000379:methods*; D011788:Quality of Life / Q000523:psychology*; D012720:Severity of Illness Index; D012893:Sleep Wake Disorders / Q000523:psychology; D011795:Surveys and Questionnaires