It is well-recognized that painful symptomatology, and also neuropathic deficits, might have an adverse effect on the QoL in diabetic neuropathy (21,22). It is increasingly recognized that QoL, rather than being a mere rating of health status, is actually a uniquely personal experience, representing the way that individuals perceive and react to their health status (23). This increasing recognition emphasizes the need to address the patient's perspective, rather than the researchers' views when measuring QoL.
Until recently, the studies which reported that neuropathy can have a negative impact on the functioning and QoL relied upon generic instruments, which do not describe the condition-specific features of neuropathy. Thus, Vileikyte et al. (24) developed the first neuropathy-specific QoL instrument, NeuroQoL, which investigates the impact of symptoms and/or foot ulceration as a consequence of neuropathy on QoL. The results of this study demonstrated that patients experiencing neuropathic symptoms reported severe restrictions in activities of daily living (e.g., leisure, daily tasks), problems with interpersonal relationships, and changes in self perception. It therefore appears that neuropathic pain and changes in self perception as a result of foot complications have the most devastating effect on the individual's QoL. Finally, recent research suggests that not only do painful neuropathic symptoms have an effect on qualify of life, but also generate symptoms of anxiety (23).
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