Abstract：
OBJECTIVE: Painful diabetic peripheral neuropathy (DPN) is a common complication in patients with diabetes. It is associated with a poor quality of life and high costs of care. This study investigated the impact of painful DPN on healthcare costs and resource utilization.
METHODS: This was a retrospective analysis of administrative claims of adult patients with diabetes (type 1 or 2) from Optum\'s de-identified Clinformatics® Data Mart Database. Patients were assigned to four cohorts by presence of DPN and pain severity, based on diagnoses and prescription patterns in a one-year baseline. All-cause and diabetes-associated costs were calculated for the year following the index DPN diagnosis. Risk factors associated with presence of severely painful DPN were evaluated.
RESULTS: Relative to those without DPN, patients who had DPN without pain, painful DPN (PDPN), or severe PDPN incurred respective increases of $3,093, $9,349, and $20,887 in average annual all-cause costs. More than half of costs from painful/severe DPN were for prescriptions and inpatient hospitalization. Severe PDPN was associated with elevated odds of diabetic amyotrophy (OR: 8.09; 95% CI: 6.84-9.56), diabetic foot ulcers (OR: 6.54, 95% CI: 6.32-6.76), and loss of mobility (OR: 2.54, 95% CI: 2.48-2.60), among other complications.
CONCLUSIONS: Painful DPN is associated with higher healthcare costs and resource utilization, and a greater risk of debilitating conditions that limit quality of life. Future research should focus on better treatment options and more aggressive pain management strategies to reduce the negative impacts of DPN.
METHODS: This was a retrospective analysis of administrative claims of adult patients with diabetes (type 1 or 2) from Optum\'s de-identified Clinformatics® Data Mart Database. Patients were assigned to four cohorts by presence of DPN and pain severity, based on diagnoses and prescription patterns in a one-year baseline. All-cause and diabetes-associated costs were calculated for the year following the index DPN diagnosis. Risk factors associated with presence of severely painful DPN were evaluated.
RESULTS: Relative to those without DPN, patients who had DPN without pain, painful DPN (PDPN), or severe PDPN incurred respective increases of $3,093, $9,349, and $20,887 in average annual all-cause costs. More than half of costs from painful/severe DPN were for prescriptions and inpatient hospitalization. Severe PDPN was associated with elevated odds of diabetic amyotrophy (OR: 8.09; 95% CI: 6.84-9.56), diabetic foot ulcers (OR: 6.54, 95% CI: 6.32-6.76), and loss of mobility (OR: 2.54, 95% CI: 2.48-2.60), among other complications.
CONCLUSIONS: Painful DPN is associated with higher healthcare costs and resource utilization, and a greater risk of debilitating conditions that limit quality of life. Future research should focus on better treatment options and more aggressive pain management strategies to reduce the negative impacts of DPN.
摘要：
目的：痛性糖尿病周围神经病变（DPN）是糖尿病患者常见的并发症。它与生活质量差和护理费用高有关。这项研究调查了痛苦的DPN对医疗保健成本和资源利用的影响。
方法：这是从Optum的去识别的Clinformatics®DataMart数据库中对成年糖尿病患者（1型或2型）的行政索赔进行的回顾性分析。根据DPN的存在和疼痛的严重程度，将患者分为四个队列。基于一年基线的诊断和处方模式。计算指数DPN诊断后一年的全因和糖尿病相关费用。评估了与严重疼痛性DPN相关的危险因素。
结果：相对于没有DPN的结果，没有疼痛的DPN患者，疼痛性DPN（PDPN），或严重的PDPN分别增加了3,093美元、9,349美元和20,887美元的平均年度所有原因成本。疼痛/严重DPN的一半以上的费用用于处方和住院。严重的PDPN与糖尿病性肌萎缩的几率升高相关(OR:8.09;95%CI:6.84-9.56),糖尿病足溃疡（OR：6.54，95%CI：6.32-6.76），和流动性丧失(OR：2.54，95%CI：2.48-2.60)，在其他并发症中。
结论：痛苦的DPN与更高的医疗保健成本和资源利用率有关，以及限制生活质量的衰弱状况的更大风险。未来的研究应该集中在更好的治疗方案和更积极的疼痛管理策略上，以减少DPN的负面影响。
方法：这是从Optum的去识别的Clinformatics®DataMart数据库中对成年糖尿病患者（1型或2型）的行政索赔进行的回顾性分析。根据DPN的存在和疼痛的严重程度，将患者分为四个队列。基于一年基线的诊断和处方模式。计算指数DPN诊断后一年的全因和糖尿病相关费用。评估了与严重疼痛性DPN相关的危险因素。
结果：相对于没有DPN的结果，没有疼痛的DPN患者，疼痛性DPN（PDPN），或严重的PDPN分别增加了3,093美元、9,349美元和20,887美元的平均年度所有原因成本。疼痛/严重DPN的一半以上的费用用于处方和住院。严重的PDPN与糖尿病性肌萎缩的几率升高相关(OR:8.09;95%CI:6.84-9.56),糖尿病足溃疡（OR：6.54，95%CI：6.32-6.76），和流动性丧失(OR：2.54，95%CI：2.48-2.60)，在其他并发症中。
结论：痛苦的DPN与更高的医疗保健成本和资源利用率有关，以及限制生活质量的衰弱状况的更大风险。未来的研究应该集中在更好的治疗方案和更积极的疼痛管理策略上，以减少DPN的负面影响。
