Assessment of pain and treatment satisfaction in patients with painful diabetic peripheral neuropathy.

INTRODUCTION: Painful diabetic peripheral neuropathy (DPN) is a common complication of diabetes mellitus and can have debilitating consequences with a significant impact on quality of life. This study was done to evaluate treatment satisfaction and to describe pain experienced from DPN by patients at our Center. METHODS: Patients > or = 18 years of age with a diagnosis of diabetes, were offered a self-administered questionnaire by their health-care provider. In addition to information related to their diabetes, patients were asked if they experienced nerve pain, the characteristics of the nerve pain, impact on activitylevel, sleep, quality of life, and satisfaction with current therapy. RESULTS: A total of 98 patients, 53.1% female, met the inclusion criteria and were included in the analysis. Thirty-one patients (31.6%) reported neuropathic pain, with 83.3% having experienced nerve pain for > or = one year and the majority (67.7%) reporting nerve pain primarily in their feet. Impact of nerve pain on quality of life was noted by 61.3% of patients although 64.5% of patients reported that nerve pain did not cause them to avoid activities. CONCLUSION: Painful DPN is a complication of diabetes mellitus and has a significant impact on quality of life. The results of our questionnaire found about a third of patients with long-standing diabetes have DPN of which about two thirds reported that it affected their quality of life. Surprisingly, almost half of the patients reported being satisfied with their treatment despite severe nerve pain.

Effect of zoledronic acid on bone density and markers of bone turnover in a community clinic.

OBJECTIVE: This study aims to document the efficacy of zoledronic acid by comparing bone densities and markers of bone turnover, in patients with osteoporosis. METHODS: Bone mineral density (BMD) and urinary N-telopeptide, a marker of bone turnover, were compared before and after treatment with intravenous zoledronic acid. RESULTS: 52 participants had atleast two doses of zoledronic acid over 36 months. Significant increases in BMD were found in the spine (t=4.38, P<0.01) and decrease in bone turnover marker N-telopeptide (t=3.30, P=0.002). Small but significant correlations were determined between prior steroid use and change in BMD in the spine (r=0.35, P<0.05), and family history of osteoporosis and change in BMD in the right femur (r=0.38, P<0.05). CONCLUSION: Annual infusions of zoledronic acid for at least two years, revealed a significant increase in bone density at the spine and a decrease in urinary N-telopeptide in patients treated at our center.