Diabetic peripheral neuropathy manifests diverse sensory symptoms

Patients suffering from diabetic peripheral neuropathy (DPN) experience a wide variety of sensory symptoms, reports a recent study. Such heterogeneity among patients could help direct more stratified and individualized interventions.

Researchers conducted an epidemiological data analysis of 649 DPN patients (mean age 65.8 years, 54.7 percent women). Cluster analysis was performed to establish patient subgroups in line with their symptom profiles.

The most common sensory symptom was pain in the front of the feet, which was reported by 69.9 percent (n=448) of patients. This was followed by painful sensations in the back of the feet (40.9 percent; n=262) and in the anterior leg, between the ankle and knee (approximately 20 percent). Lower extremity pain was bilaterally presenting in most patients.

Three symptom clusters emerged. The first was characterized by having more abnormal ankle reflexes and first-toe vibration sensations than the other two clusters, and had more severe symptoms with poor quality of life. This cluster included the lowest percentage of patients (18.3 percent; n=119).

Meanwhile, the second cluster was associated with more foot deformities, but with mostly sensation-less symptoms and a generally good quality of life. Majority of patients (49.0 percent; n=318) belonged to the second cluster. The third cluster of patients had moderate pain and low quality of life (31.4 percent; n=204).

“The identification of patient subtypes with distinct symptom characteristics at baseline is important and shows that heterogeneity in patients with DPN should be taken into account for a more stratified or individualized treatment approach,” the researchers said.