Detection of undisclosed neuropathy and assessment of its impact on quality of life: a survey in 25,000 Romanian patients with diabetes

J Diabetes Complications. 2015 Jul;29(5):644-9. doi: 10.1016/j.jdiacomp.2015.04.001. Epub 2015 Apr 9.


Aims: The objective of this cross-sectional survey was to capture undiagnosed neuropathy in Romanian patients with self-reported diabetes using Norfolk QoL-DN as a screening tool and to assess its impact on quality of life (QoL).

Methods: 25,000 Romanian-translated, validated Norfolk QoL-DN questionnaires were distributed between June and December 2012. 21,261 patients who self-reported diabetes and answered questions related to neuropathy, ulceration, gangrene and amputation were included in the analysis.

Results: 52% of diabetic patients (n = 6615) who answered "no" to the question "Do you have neuropathy?" had total QoL scores above the cut-off, suggesting the presence of diabetic neuropathy. 13,854 (65.2%) patients answered "yes" to the question "Do you have neuropathy?" and 3,150 (14.8%) reported at least one episode of ulceration, gangrene or amputation. Total QoL score was 3-fold higher (worse) for patients who answered "yes" to the question "Do you have neuropathy?" than for those who answered "no" (38.39 vs. 13.71; p < 0.001) and 1.4-fold worse for patients who reported ulceration, gangrene or amputation than for those who did not report any of these (50.38 vs. 34.87; p < 0.001).

Conclusions: We found a high prevalence of undisclosed diabetic neuropathy in this population and showed that neuropathy severity has an increasing impact on total QoL and its domains.

Keywords: Diabetes mellitus; Diabetic neuropathy; Neuropathy severity; Quality of life; Undisclosed neuropathy.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Amputation / adverse effects
  • Cost of Illness*
  • Cross-Sectional Studies
  • Delayed Diagnosis
  • Diabetic Nephropathies / diagnosis*
  • Diabetic Nephropathies / physiopathology
  • Female
  • Gangrene / etiology
  • Gangrene / surgery
  • Health Surveys
  • Humans
  • Male
  • Mass Screening
  • Middle Aged
  • Prevalence
  • Quality of Life*
  • Romania / epidemiology
  • Self Report
  • Severity of Illness Index
  • Ulcer / etiology
  • Ulcer / surgery