Detection of undisclosed neuropathy and assessment of its impact on quality of life: a survey in 25,000 Romanian patients with diabetes.
OBJECTIVE
The objective of this cross-sectional survey was to capture undiagnosed neuropathy in Romanian patients with self-reported diabetes using Norfolk QoL-DN as a screening tool and to assess its impact on quality of life (QoL).


METHODS
25,000 Romanian-translated, validated Norfolk QoL-DN questionnaires were distributed between June and December 2012. 21,261 patients who self-reported diabetes and answered questions related to neuropathy, ulceration, gangrene and amputation were included in the analysis.


RESULTS
52% of diabetic patients (n = 6615) who answered "no" to the question "Do you have neuropathy?" had total QoL scores above the cut-off, suggesting the presence of diabetic neuropathy. 13,854 (65.2%) patients answered "yes" to the question "Do you have neuropathy?" and 3,150 (14.8%) reported at least one episode of ulceration, gangrene or amputation. Total QoL score was 3-fold higher (worse) for patients who answered "yes" to the question "Do you have neuropathy?" than for those who answered "no" (38.39 vs. 13.71; p < 0.001) and 1.4-fold worse for patients who reported ulceration, gangrene or amputation than for those who did not report any of these (50.38 vs. 34.87; p < 0.001).


CONCLUSIONS
We found a high prevalence of undisclosed diabetic neuropathy in this population and showed that neuropathy severity has an increasing impact on total QoL and its domains.
Iuliu Hațieganu University of Medicine and Pharmacy Cluj-Napoca, Department of Diabetes, Nutrition and Metabolic Diseases, 4-6 Clinicilor Street, Cluj-Napoca, Romania.
Andrei I
AI
Veresiu
Iuliu Hațieganu University of Medicine and Pharmacy Cluj-Napoca, Department of Medical Informatics and Biostatistics, 6 Pasteur Street, Cluj-Napoca, Romania. Electronic address: cosmina_ioana@yahoo.com.
Cosmina I
CI
Bondor
Iuliu Hațieganu University of Medicine and Pharmacy Cluj-Napoca, 8 Victor Babes Street, IMOGEN Research Center, Cluj-Napoca, Romania.
Bogdan
B
Florea
Eastern Virginia Medical School, Strelitz Diabetes Center, 855 West Brambleton Avenue, Norfolk, VA, USA.
Etta J
EJ
Vinik
Eastern Virginia Medical School, Neuroendocrine Unit, 855 West Brambleton Avenue, Norfolk, VA, USA.
Aaron I
AI
Vinik
Wörwag Pharma GmbH&Co.KG, Romanian Representative Office, Society of Diabetic Neuropathy, 11 Fagului Street, Cluj-Napoca, Romania.
Norina A
NA
Gâvan
D000368:Aged; D000671:Amputation, Surgical / Q000009:adverse effects; D017281:Cost of Illness; D003430:Cross-Sectional Studies; D057210:Delayed Diagnosis; D003928:Diabetic Nephropathies / Q000175:diagnosis* / Q000503:physiopathology; D005260:Female; D005734:Gangrene / Q000209:etiology / Q000601:surgery; D006306:Health Surveys; D006801:Humans; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D015995:Prevalence; D011788:Quality of Life; D012383:Romania / Q000453:epidemiology; D057566:Self Report; D012720:Severity of Illness Index; D014456:Ulcer / Q000209:etiology / Q000601:surgery
Diabetes mellitus; Diabetic neuropathy; Neuropathy severity; Quality of life; Undisclosed neuropathy