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Cluster analysis of neuropathic symptoms in subjects with diabetic peripheral neuropathy


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Background: Diabetic peripheral neuropathy (DPN) is characterized by complex neuropathy-related pain, discomfort with daily activities, sleep disturbance, and decreased QOL rather than pain per se. Thus, a comprehensive approach regarding the impact of DPN on these health-related issues is needed.  Aim: To identify subgroups of DPN patients according to a composite of sensory symptoms and the clinical impacts on pain severity, sleep disturbance, and QOL Method: A hierarchical cluster analysis was performed to identify relevant subgroups of patients with DPN (n = 1,338) from the Korean Diabetes Association Neuropathy Study (2010). The scores on the Michigan Neuropathy Screening Instrument (MNSI) questionnaire, Brief Pain Inventory-Short Form, visual analogue scale, Medical Outcomes Study Sleep Scale, and EuroQol were used as variables. Results: Patients with DPN were divided into three clusters: asymptomatic (Cluster 1, n = 448, 33.5%), moderate symptoms with disturbed sleep (Cluster 2, n = 562, 42.0%) and severe symptoms with decreased quality of life (Cluster 3, n = 328, 24.5%). Patients in Cluster 3, compared with Clusters 1 and 2, were characterised by higher levels of HbA1c, more prevalent retinopathy and nephropathy, and more severe pain and mental and physical impairments. Patients in Cluster 2 had moderate pain levels but disturbed sleep patterns comparable to those of the patients in Cluster 3. The symptoms on the MNSI showed a similar distribution pattern but different severities among the three clusters. Discussion: Cluster analysis endorsed the use of symptomatic and comprehensive subgrouping to individualise the evaluation and treatment of patients with DPN.


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© Copyright 2019 Morressier GmbH.
All rights reserved.