Phenotypic characteristics of diabetic neuropathic pain and factors associated in patients with Diabetes Mellitus-type 2.

Objective: To identify subgroups of patients with diabetic neuropathic pain according to their phenotypic characteristics and factors associated with belonging to each of these groups.

Methods: 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.

Results: 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.

Conclusions: 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.