Diabetic neuropathy and its association with anxiety disorder

Abstract

Diabetic neuropathy (DN) is a microvascular complication of diabetes mellitus. It is characterized by involvement in the nerves that produce a pain like rush, burn or stitch. This neuropathic pain has been associated with a high risk of anxiety in patients with it, thus generating a greater economic burden in patients with symptomatic DN. We aim to describe current information in the literature on the relationship between symptomatic diabetic neuropathy and the risk of concomitant anxiety disorder. We carried out a parallel search by four reviewers in the Ovid, Pubmed, SciELO and Cochrane databases. Of the 1140 articles found, 56 articles were evaluated in full text. A varied prevalence of anxious and depressive symptoms was found in patients with symptomatic DN, evaluated using different questionnaires and scales. Some studies found an association between anxiety, sleep disorders and inadequate glycemic control. Early education and the management of neuropathic pain have been reported as factors of good prognosis, the latter being the determinants of quality of life and productivity in patients with symptomatic DN. The relationship between diabetic neuropathy and anxiety disorder can be bidirectional. Given these findings, and their possible impact on the individual and on public health, opportunities arise to fill the gaps in primary prevention, early diagnosis, and treatment in this population, which should be defined in future research.