Diabetic neuropathy is counted among most prevalent long-term disorder. It is the debilitating consequence of diabetes, which is characterized by diffuse damage to the peripheral nerve fibers. This painful diabetic neuropathy (PDN) has a tremendous negative impact on psychosocial functioning, which is expressed by increased levels of depression and anxiety. However, how these pain-related fears affect patient's health is yet to be probed.

Therefore, scientists conducted a questionnaire-based cross-sectional study specifying diabetes and its pain-related fears. The evaluation was done among 154 PDN patients with mean age of 65.7 ± 6.6 years. The correlation analysis was performed for age, gender, pain duration, pain intensity and insulin treatment to determine the relation of kinesiophobia, fear of pain, hypoglycaemia, fear of falling, fear of negative evaluation, fear of fatigue, quality of life and disability. Every factor was measured differently. The kinesiophobia by TSK (Tampa Scale of Kinesiophobia), fear of pain by PASS-20 (Pain Anxiety Symptom Scale), hypoglycaemia by HFS (Hypoglycaemia Fear Survey), fear of falling by FES-I (Falls Efficacy Scale-I), fear of negative evaluation by BFNE (Brief Fear of Negative Evaluation Scale), fear of fatigue by TSF (Tampa Scale of Fatigue), quality of life by  Norfolk Quality of Life Questionnaire, Diabetic Neuropathy Version (QoL-DN) and  disability by  Pain Disability Index (PDI).

The univariate analyses were done in which all the fears were independently related with QOL-DN and PDI (p<0.001). Further, the linear regression models of all concern and confounders demonstrated that QOL-DN was significantly associated with pain duration, pain intensity and FES-I. The PDI showed a relation with male gender, pain intensity and FES-I. However, after controlling for confounders, duration of pain, fear of falling and pain intensity levels showed a negative relation with QoL. Although, male gender, fear of falling and pain intensity showed a positive relationship with disability. 

Therefore, it is clear from the study that PDN patients indeed suffer from various fears. The knowledge about these fears and its association with PDN is very beneficial. It enables scientists to identify potential targets for behavioral interventions and design a treatment strategy. Also, it helps to improve physical and psycho-social well-being in PDN patients.