Associations between stages of diabetic polyneuropathy and quality of life, neuropathic pain, and well-being: A multicenter, cross-sectional analysis based on electroneuromyographic findings

This study aimed to investigate the relationship between electrophysiological findings of diabetic neuropathy (DN) and patients' quality of life, neuropathic pain levels, and well-being. A cross-sectional study was conducted in 12 centers in Turkey. DN patients were categorized into four stages based on electrophysiological findings using the Baba classification. Scales such as Short Form-36 (SF-36), Douleur Neuropathique 4-Questions (DN4), Brief Pain Inventory (BPI), and WHO-5 Well-Being (WHO-5 WB) were used to assess quality of life, pain, and well-being. Additional factors like HbA1c levels and diabetes duration were analyzed. Among 323 DN patients, 90 were in stage 1, 84 in stage 2, 72 in stage 3, and 77 in stage 4. There were no significant differences in age or gender between the stages. Diabetes duration and HbA1c levels were significantly lower in stage 1 compared to later stages. SF-36 and WHO-5 WB scores declined, while DN4 and BPI pain interference scores increased in the later stages. These findings persisted after adjusting for confounders such as age, BMI, comorbidities, and diabetes duration. Patients with advanced-stage DN experienced a poorer quality of life, greater pain, and more frequent comorbidities compared to early-stage patients. Electrophysiological findings should be considered in the clinical management of DN.