Department of Diabetes, Nutrition and Metabolic Diseases, Iuliu Haţieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.
Worwag Pharma Romania SRL, Cluj-Napoca, Romania.
Int J Clin Pract. 2021 Jun;75(6):e14076. doi: 10.1111/ijcp.14076. Epub 2021 Feb 12.
To evaluate the changes in quality of life (QOL), diabetic neuropathy (DN) and amputations over 4 years in patients with diabetes.
In 2012, 25,000 Romanian-translated Norfolk QOL-DN self-administered questionnaires were distributed during a cross-sectional study. Between March-December 2016, all patients identified from the 2012 cohort and enrolled in this follow-up study completed the Norfolk QOL-DN questionnaire; amputations suffered since 2012 were recorded. The influence of age and duration of diabetes (DD) on delta QOL scores (defined as the differences between 2012 and 2016 scores) and of sex, age, diabetes type, DD and declared DN on amputations was explored using multivariate linear and logistic regression, respectively.
The mean (standard deviation) age of the 1865 participants was 60.6 (10.3) years. Mean total QOL-DN score increased from 2012 to 2016 by 4.39% (P = .079). Both DD (b = 0.39, 95% confidence interval [CI] 0.21-0.57, P < .001) and age (b = 0.25, 95% CI 0.13-0.36, P < .001) were significantly correlated with total QOL-DN score. Delta total QOL was higher in patients whose statement about having DN changed since 2012. Over 4 years, 36 patients suffered amputations. Male sex (OR = 3.11, 95% CI 1.46-6.62, P = .003), physical functioning/large-fibre neuropathy subscale score (OR = 1.04, 95% CI 1.001-1.09, P = .047), autonomic neuropathy subscale score (OR = 0.78, 95% CI 0.64-0.94, P = .011) and small-fibre neuropathy subscale score (OR = 1.21, 95% CI 1.05-1.40, P = .007) were significant predictors of amputations. Delta total QOL-DN score was 10 times higher in patients who suffered amputation(s) compared with their amputation-free counterparts.
QOL deteriorates with age and DD. Norfolk QOL-DN subscale scores can predict amputations.
评估 4 年内糖尿病患者生活质量（QOL）、糖尿病周围神经病变（DN）和截肢的变化。
2012 年，在一项横断面研究中，罗马尼亚语翻译的诺福克 QOL-DN 自我管理问卷共发放了 25000 份。2016 年 3 月至 12 月，从 2012 年队列中确定的所有患者并纳入本随访研究的患者均完成了诺福克 QOL-DN 问卷；记录了 2012 年以来发生的截肢。使用多元线性和逻辑回归分别探讨年龄和糖尿病持续时间（DD）对 QOL 评分差值（定义为 2012 年和 2016 年评分之间的差异）的影响，以及性别、年龄、糖尿病类型、DD 和声明的 DN 对截肢的影响。
1865 名参与者的平均（标准差）年龄为 60.6（10.3）岁。2012 年至 2016 年，总 QOL-DN 评分平均增加 4.39%（P=.079）。DD（b=0.39，95%置信区间[CI]0.21-0.57，P<.001）和年龄（b=0.25，95%CI0.13-0.36，P<.001）与总 QOL-DN 评分显著相关。自 2012 年以来，声明患有 DN 的患者的总 QOL 差值更高。4 年来，36 名患者截肢。男性（OR=3.11，95%CI1.46-6.62，P=.003）、生理功能/大纤维神经病亚量表评分（OR=1.04，95%CI1.001-1.09，P=.047）、自主神经病亚量表评分（OR=0.78，95%CI0.64-0.94，P=.011）和小纤维神经病亚量表评分（OR=1.21，95%CI1.05-1.40，P=.007）是截肢的显著预测因子。与无截肢者相比，截肢患者的总 QOL-DN 评分差值高 10 倍。
QOL 随年龄和 DD 而恶化。诺福克 QOL-DN 亚量表评分可预测截肢。
