Comparison of Neuropathic Pain Course in Long-Term Oral Antidiabetic and Insulin Use

Öz

Objective: It was aimed to compare neuropathic pain with other risk factors in patients with type 2 diabetes mellitus using long-term oral antidiabetic and insulin. Materials and Methods: According to the American Diabetes Society criteria, 100 patients with Type 2 diabetes mellitus were included in the study. Patients underwent neurological examination, Leeds Assesment of Neuropatic Symptoms and Signs (LANSS) and McGill Melzack Pain Questionnaire Form were applied. Patients were divided into two groups as Neuropathic Pain group (LANSS ≥12) and Non-neuropathic Pain group (LANSS <12). Groups were compared in terms of demographic characteristics, duration of diabetes, antidiabetic therapy, serum glucose and HbA1c values, presence of hyperlipidemia and hypertension. Results: Neuropathic pain was detected in 51% of the patients. Advanced age , long diabetes duration, high serum glucose and HbA1c levels, presence of hypertension in the Neuropathic Pain group, compared with the Non-neuropathic Pain group significant difference was found. (P<0.05) There was no significant difference between the groups in terms of gender, presence of hyperlipidemia, and antidiabetic therapy. (P> 0.05) Neuropathic pain localization was most commonly distal to the lower and upper extremities, pattern was paroxysmal and spontaneous, the most commonly used phrases in the definition was 'warmth', 'thorn bumps' and the most common trigger was anxiety. Conclusion: In the development of neuropathic pain with type 2 diabetes mellitus; advanced age, long diabetes duration, poor glycemic control and presence of hypertension play an important role. Gender, presence of hyperlipidemia, and antidiabetic therapy don’t make difference in the development of neuropathic pain.

Anahtar Kelimeler

• Neuropathic Pain
• Diabetes Mellitus
• Insulin
• Oral Antidiabetic

Uzun Dönem Oral Antidiyabetik ve İnsülin Kullanımında Nöropatik Ağrı Seyrinin Karşılaştırılması

Öz

Amaç: Bu çalışmada uzun dönem oral antidiyabetik ve insülin kullanan tip 2 diyabetes mellituslu hastalarda nöropatik ağrının diğer risk faktörleri ile birlikte karşılaştırılması amaçlanmıştır. Gereç ve Yöntem: Amerikan Diyabet Cemiyeti kriterlerine göre Tip 2 diyabetes mellitus olan 100 hasta çalışmaya alındı. Hastalara nörolojik muayene yapılıp, LANSS (Leeds Assesment of Neuropatic Symptoms and Signs) ve McGill Melzack Ağrı Sorgu Formu uygulandı. LANSS ≥12 olan hastalar Nöropatik Ağrılı gurup ve LANSS <12 olan hastalar Nöropatik Ağrısız gurup olarak ayrıldı. Guruplar demografik özellikler, diyabet süresi, kullanılan antidiyabetik tedavi, serum glukoz ve HbA1c değerleri, hipertansiyon ve hiperlipidemi varlığı açısından karşılaştırıldı. Bulgular: Hastaların %51’inde nöropatik ağrı saptandı. Nöropatik Ağrılı gurupta ileri yaş, uzun diyabet süresi, yüksek serum glukoz ve HbA1c düzeyleri, hipertansiyon varlığı Nöropatik Ağrısız gurupla karşılaştırıldığında anlamlı fark bulundu. (P<0.05) Her 2 gurup arasında cinsiyet, hiperlipidemi varlığı, kullanılan antidiyabetik tedavi açısından anlamlı bir fark bulunmadı (P>0.05). Hastalarda nöropatik ağrı lokalizasyonu en sık alt ve üst ekstremite distalinde, paterni paroksismal ve spontan, tanımında en sık kullanılan ifadeler ‘sıcaklık veren’ ‘diken diken’ ve en sık tetikleyen faktör anksiyeteydi. Sonuç: Tip 2 diyabetes mellitus hastalarında nöropatik ağrı gelişiminde; ileri yaş, uzun diyabetes mellitus süresi, kötü glisemik kontrol ve hipertansiyon varlığı önemli rol oynamaktadır. Cinsiyet, hiperlipidemi varlığı, kullanılan antidiyabetik tedavi ise nöropatik ağrı gelişiminde farklılık yaratmamaktadır.

Anahtar Kelimeler

• Nöropatik ağrı
• diyabetes mellitus
• insülin
• oral antidiyabetik

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