Endocrine Abstracts

Introduction: Diabetic peripheral neuropathy (DPN) is one of the most common and early manifested complication in adults with type 2 diabetes leading to severe repercussions including foot ulcers, amputations and chronic pain. Furthermore painful diabetic neuropathy can also negatively impact a wide range of key human physiological processes including sleep disturbance [1]. The aim of our study was to determine the effect of neuropathic pain on sleep component.

Materials: This is a cross-sectional study conducted in 100 patients with diabetes. The DN4 questionnaire was used to identify neuropathic pain. Sleep quality was evaluated using the Pittsburgh sleep quality index (PSQI) in its arabic-validated version [2]. It consists of 19 items grouped into seven subscales: self-reported sleep quality (C1), sleep latency (C2), sleep duration (C3), habitual sleep efficiency (4), sleep disturbance (C5), use of sleep medications (C6), and daytime dysfunction (C7). Higher scores in each dimension indicate poorer quality and the sum of components provides a global PSQI score. Scores >5 defined poor quality sleepers.

Results: Mean age was 54.45±7.13 years with a sex ratio (F/M) of 2.57. Mean diabetes duration was 12.67±7.35 years. Mean BMI was 29.49±4.97 Kg/m², 32% of our patients were overweight and 49% were obese. Mean glycated hemoglobin and mean fast blood glucose were respectively 9.69±2.02 % and 11.63±4.80 mmol/l. More than half of our population was insulin-dependent (79%) and only 20% reported hypoglycemia. Peripheral neuropathy was found in 27 % of our sample. Eighteen percent among these patients were treated with pregabalin. Mean DN4 score was 1.82±1.65 with extremes ranging from 0 to 6. The mean PSQI score was 7.89±3.69 and 69% of our patients had poor sleep quality. Poor quality sleepers had higher DN4 scores (2.06±1.74 vs 1.17±1.21; P=0.017). When analyzing sleep components, DN4 score showed correlations with sleep efficiency (P=0.031; r=0.227) and sleep disturbance (P=0.027; r=0.232).

Conclusion: The findings from our study validate earlier research in the literature, highlighting the impact of neuropathy on sleep quality in individuals with diabetes, further exacerbating the impact of this complication.

References: 1. Herrero Babiloni A, De Koninck BP, Beetz G, De Beaumont L, Martel MO, Lavigne GJ. Sleep and pain: recent insights, mechanisms, and future directions in the investigation of this relationship. J Neural Transm 2020; 127:647– 60. 2. Suleiman KH, yates BC, Berger AM, Pozehl B, Meza J. Translating the Pittsburgh Sleep Quality Index into Arabic. West J Nurs Res 2010; 32:250– 68.