| 英文摘要 |
Objective: Diabetic neuropathy is the most common complication of type 2 diabetes mellitus. Diabetic neuropathic pain is the type of excruciatingly refractory pain with sensorimotor neuropathy which is the most common type of neuropathy. The (Chinese J. Pain purpose of this study is to examine the risk factors of diabetic neuropathic pain. Method: We studied possible risk factors for developing diabetic neuropathy in the Taiwan National Health Insurance Research Database (NHIRD). This nationwide Key Words: population based study extracted data in the Taiwan NHIRD from 1998 to 2006. A total Diabetic neuropathic pain, of 52,190 patients diagnosed with type 2 diabetic mellitus within a one-year period of diabetic neuropathy, musculoskeletal disease (MSD) in between 1998 and 2002 were included together with musculoskeletal diseases, 7,670 non-MSD patients as a comparison cohort. Cox proportional hazard regressions type 2 diabetes mellitus, were conducted to compute hazard ratios, after the adjustment for comorbid medical disorders and socio-demographic status. Results: Results indicated that 13.8% of the T2DM patients with MSD experienced a diabetic neuropathic pain episode during this 5-year period compared with 9.8% of patients in the comparison cohort. The adjusted hazard of diabetic neuropathic pain was significantly higher (1.308 times, 95% Confidence Interval 1.2101.413) for patients with MSD, relative to the comparison cohort. The association persisted in further analyses stratified by hypertension, coronary heart diseases, and age. Conclusion: MSD was identified as an independent risk factor for subsequent diabetic neuropathic pain. Therefore a comprehensive multidisciplinary approach is needed to optimize primary and secondary prevention of diabetic neuropathic pain in patients with MSD. |
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