Assessment of Nerve Fibers Dysfunction Through Current Perception Threshold Measurement in Diabetic Peripheral Neuropathy

Background: Alpha-lipoic acid (ALA) was used in the treatment of diabetic peripheral neuropathy (DPN) using different routes, doses and treatment durations. The aim of this work is to assess the efficacy of oral 600mg ALA twice daily over 6 months in the treatment of patients with DPN. Methods: This is a prospective, single-center, double-blinded, placebo-controlled study conducted at the outpatient clinic of Mansoura Specialized Hospital, Mansoura University. A total of 200 patients with DPN were randomly assigned to add on treatment with either oral 600mg twice daily ALA (n=100) or placebo (n=100) for 6 months. Treatment outcome was assessed using vibration perception threshold (VPT), neurological symptom score (NSS), neurological disability score (NDS), and visual analog scale (VAS) for pain at baseline and at each visit (1, 3 and 6 months) after the start of treatment. Results: Comparison between the study groups regarding the baseline data revealed no statistically significant differences. with respect to the outcome parameters, no significant differences were found between the studied groups at baseline. However, in subsequent visits, ALA-treated patients had significantly better results regarding almost all the outcome parameters (NSS, NDS, VAS, VPT). Mild nausea was reported in 6 patients. None of the studied patients discontinued treatment. Conclusions: Oral 600mg ALA twice-daily treatment for DPN over 6 months is effective, safe and tolerable.

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Diagnostic accuracy of monofilament test to detect diabetic neuropathy

Journal of Advances in Internal Medicine ◽

10.3126/jaim.v10i1.37086 ◽

2021 ◽

Vol 10 (1) ◽

pp. 20-25

Author(s):

Sujan Shrestha ◽

Mamen Prasad Gorhaly ◽

Manil Ratna Bajracharya

Keyword(s):

Peripheral Neuropathy ◽

Positive Predictive Value ◽

Diagnostic Accuracy ◽

Negative Predictive Value ◽

Predictive Value ◽

Diabetic Peripheral Neuropathy ◽

Perception Threshold ◽

Sensitivity Specificity ◽

Vibration Perception ◽

Monofilament Test

Background Diabetic peripheral neuropathy (DPN) is a significant independent risk factor for diabetic foot, and an effective screening instrument is required to diagnose DPN early to prevent future ulceration and amputation. This study aims to determine the diagnostic accuracy of monofilament test to detect diabetic peripheral neuropathy. Methods This cross-sectional study was conducted in National Academy of Medical Sciences, Bir hospital, Mahabouddha, Kathmandu from February 2016 to January 2017. A total of 96 diabetic patients attending inpatient and outpatient Department were selected. Diabetic peripheral neuropathy was assessed by measurement of loss of protective sensation (LOPS) by monofilament test and compared with vibration perception threshold by standard biothesiometer. The sensitivity, specificity, positive predictive value and negative predictive value of monofilament test were calculated. Results The prevalence of diabetic peripheral neuropathy was 26%. The sensitivity, specificity, positive predictive value and negative predictive value of monofilament test were found to be 92.0%, 95.8%, 88.5% and 97.1% respectively. There was strong association between LOPS by monofilament and vibration perception threshold by biothesiometer. Conclusion This study showed a strong diagnostic accuracy of monofilament test to detect DPN when compared with biothesiometer. As monofilament test is a cheap, easily available, and portable, it can be used in the periphery where biothesiometer is not available.

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PENGARUH AKUPUNKTUR JIN’S 3 NEEDLE TERHADAP PENURUNAN INTENSITAS NYERI DIABETIC NEUROPATHY PERIFER

Journal of Islamic Medicine ◽

10.18860/jim.v4i1.9051 ◽

2020 ◽

Vol 4 (1) ◽

pp. 46-51

Author(s):

Leny Candra Kurniawan ◽

Ikhwan Abdullah

Keyword(s):

Peripheral Neuropathy ◽

Side Effects ◽

Diabetic Neuropathy ◽

Diabetic Peripheral Neuropathy ◽

Nerve Fibers ◽

Significance Level ◽

Peripheral Diabetic Neuropathy ◽

Study Population ◽

Sugar Levels ◽

Needle Acupuncture

Diabetic Peripheral Neuropathy is a type of nerve damagethat occurs due to diabetes. High blood sugar levels in thelong term can cause damage to nerve fibers throughout thebody, such as legs, feet, blood circulation, heart, digestivesystem, and urinary tract. Diabetic Peripheral Neuropathy isa serious complication of diabetes that often causes pain inthe limbs. Pain management Diabetic Peripheral Neuropathyis usually by administering pain medication for a long periodof time. These medicines will have side effects. The use ofacupuncture as an alternative to help reduce the intensity ofpain in peripheral diabetic neuropathy has proven to beeffective and relatively without side effects. The advantage ofacupuncture therapy is that it has relatively no side effects.The general aim of this study is to reduce the intensity of painin peripheral neuropathy. The research design usesquantitative methods. The study population was all patientswith peripheral neuropathy who visited the Harmoni HealthyClinic in March-May 2019. The sampling method used wasaccidental sampling. The benefits of this study provide analternative for DM sufferers to reduce the intensity ofneuropathic pain naturally with acupuncture without fear.side effects. From the results of this study it is known thatthere is an influence of Jin’s Three Needle acupuncture inreducing the intensity of pain in Peripheral Neuropathy.Calculations using statistical SPSS 21 with paired sample ttest obtained significant results (0.00) from the value of α(0.05), then H1 is accepted. So with a significance level of5%, it can be concluded that Jin's Three Needle acupuncturecan reduce the intensity of pain in diabetic peripheralneuropathy

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Association between Circulating B-Type Natriuretic Peptide and Diabetic Peripheral Neuropathy: A Cross-Sectional Study of a Chinese Type 2 Diabetic Population

Journal of Diabetes Research ◽

10.1155/2020/3436549 ◽

2020 ◽

Vol 2020 ◽

pp. 1-10

Author(s):

Pijun Yan ◽

Qin Wan ◽

Zhihong Zhang ◽

Yong Xu ◽

Ying Miao ◽

...

Keyword(s):

Peripheral Neuropathy ◽

Natriuretic Peptide ◽

Diabetic Peripheral Neuropathy ◽

Ankle Brachial Index ◽

Perception Threshold ◽

Cross Sectional ◽

Potential Biomarker ◽

Increased Risk ◽

Circulating Levels

Cardiovascular disease which is associated with cardiac dysfunction, usually measured with circulating levels of B-type natriuretic peptide (BNP), has been associated with incidence and progression of diabetic peripheral neuropathy (DPN). The potential relationship of circulating physiological levels of BNP with DPN, however, has not been reported. Circulating levels of BNP were measured in 258 patients with type 2 diabetes mellitus (T2DM), and participants were divided into a DPN group ( n = 61 ) and no DPN group ( n = 197 ). The relationship between circulating physiological levels of BNP and DPN and other parameters was analyzed. Circulating levels of BNP were significantly elevated in T2DM patients with DPN compared to those without ( P = 0.001 ). Circulating levels of BNP were significantly and positively associated with systolic blood pressure ( P = 0.035 ), neutrophil-to-lymphocyte ratio ( P = 0.007 ), creatinine ( P = 0.030 ), vibration perception threshold values ( P = 0.021 ), and the prevalence of diabetic foot ulceration ( P = 0.039 ), peripheral arterial disease ( P = 0.013 ), DPN ( P = 0.032 ), and diabetic nephropathy ( P = 0.020 ) and negatively with lymphocyte count ( P = 0.003 ) and ankle-brachial index ( P = 0.038 ), irrespective of age, sex, and body mass index. Moreover, circulating levels of BNP was an independent decisive factor for the presence of DPN after multivariate adjustment (odds ratio, 1.044; 95% confidence interval, 1.006-1.084; P = 0.024 ). Additionally, the higher quartiles of circulating BNP were related significantly to an increased risk of DPN compared to the lowest quartile ( P = 0.003 ). Last but most importantly, the analysis of receiver operating characteristic curves revealed that the best cutoff value for circulating levels of BNP to predict DPN was 15.18 pg/mL (sensitivity 78.7% and specificity 48.2%). These findings suggest that high circulating physiological levels of BNP may be associated with the development of DPN and may be a potential biomarker for DPN in patients with T2DM.

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Relationship Between Glycated Hemoglobin and Vibration Perception Threshold in Diabetic Peripheral Neuropathy

The International Journal of Lower Extremity Wounds ◽

10.1177/1534734619882173 ◽

2019 ◽

Vol 19 (2) ◽

pp. 120-124 ◽

Cited By ~ 2

Author(s):

Arun G. Maiya ◽

Anche Parameshwar ◽

Manjunath Hande ◽

Vinayak Nandalike

Keyword(s):

Peripheral Neuropathy ◽

Diabetic Peripheral Neuropathy ◽

Glycated Hemoglobin ◽

Pearson Correlation ◽

Regression Result ◽

Perception Threshold ◽

Cross Sectional ◽

Vibration Perception Threshold ◽

The Relationship ◽

Vibration Perception

Foot ulcers, infections, and deformity are some of the major sources of mortality and morbidity among the diabetic population. The relationship between glycated hemoglobin (HbA1c) and diabetic peripheral neuropathy (DPN) has been well established. There is a dearth of literature on the relationship between vibration perception threshold (VPT) and HbA1c values. So, the objective of the study was to determine the strength of linear relationship between HbA1c levels and vibration perception threshold in DPN. This cross-sectional study was conducted at Kasturba Hospital, Manipal, and diabetic foot screening camps held at various parts of Udupi district. Ethical approval was obtained from the Institutional Ethics Committee, Kasturba Hospital, Manipal (IEC:281/2017). A total of 534 participants ranging from 30 to 70 years of age and were diagnosed with type 2 diabetes mellitus on medications were included in the study. Neuropathy assessment consisting of monofilament and vibration perception threshold was done using Neurotouch beta version (Yostra Labs, Bengaluru, India). HbA1c measurement was done using turbidimetric inhibition immunoassay technique (Roche Diagnostics, Mannheim, Germany). Pearson correlation coefficient showed a moderate to good correlation between HbA1c and VPT ( r = .0.753, P < .001). Linear regression result has shown a significant relationship of VPT with HbA1c (4.033 [95% confidence interval = 3.67-4.39]). The present study has concluded that there is strong relationship between HbA1c values and VPT and could be a predictor for complications in the foot following DPN.

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