De Sola Helena, Dueñas María, Failde Inmaculada, Palomo-Osuna Jenifer, Naranjo Cristina, Salazar Alejandro
Observatory of Pain, University of Cádiz, Cádiz, Spain.
Biomedical Research and Innovation Institute of Cádiz (INiBICA), Research Unit, Puerta del Mar University Hospital, University of Cadiz, Cádiz, Spain.
J Diabetes Investig. 2025 Aug;16(8):1495-1506. doi: 10.1111/jdi.70089. Epub 2025 May 31.
AIMS/INTRODUCTION: To identify subgroups of patients with diabetic neuropathic pain according to their phenotypic characteristics and factors associated with belonging to each of these groups.
A multicenter cross-sectional study carried out in patients with DM-type2 and diabetic neuropathy. We recorded sociodemographic and clinical data, intensity of pain, pain phenotypes, mood disorders, sleep quality, social support, and health-related quality of life. A hierarchical cluster analysis was carried out to find groups according to their phenotype. The factors associated with belonging to these groups were assessed with a multinomial logistic regression model.
Four phenotypic groups were found: G1 with longer pain duration, predominance of pain provoked by brushing or pressure, and sensation of pins/needles and tingling; G2 characterized by stabbing, pins and needles, and electric shocks; G3 with lower scores in all the NPSI items; and G4 with low-moderate scores in almost all the items, but showing some level of pins and needles and tingling. Intensity and duration of pain, and level of anxiety were the factors associated with belonging to G1, G2, and G4 with respect to G3, although the magnitude of the risk was slightly different among them.
Specific treatment strategies should be developed for the different profiles found, with special attention to those with more pain and anxiety levels, including cognitive-behavioral therapies or mindfulness-based interventions.
目的/引言:根据糖尿病性神经病理性疼痛患者的表型特征以及与各分组相关的因素来识别亚组。
对2型糖尿病和糖尿病性神经病变患者开展一项多中心横断面研究。我们记录了社会人口学和临床数据、疼痛强度、疼痛表型、情绪障碍、睡眠质量、社会支持以及健康相关生活质量。进行分层聚类分析以根据表型找出分组。使用多项逻辑回归模型评估与这些分组相关的因素。
发现了四个表型组:G1组疼痛持续时间更长,以刷擦或按压诱发的疼痛为主,伴有针刺感和刺痛感;G2组的特征为刺痛、针刺感和电击感;G3组在所有神经病理性疼痛量表(NPSI)项目中得分较低;G4组在几乎所有项目中得分低至中等,但有一定程度的针刺感和刺痛感。与G3组相比,疼痛强度和持续时间以及焦虑水平是与属于G1、G2和G4组相关的因素,尽管它们之间风险程度略有不同。
应针对所发现的不同特征制定具体治疗策略,尤其要关注疼痛和焦虑程度较高的患者,包括认知行为疗法或基于正念的干预措施。