Automatic Corneal Nerves Recognition for Earlier Diagnosis and Follow-Up of Diabetic Neuropathy

2010 ◽  
pp. 60-69 ◽  
Author(s):  
Ana Ferreira ◽  
António Miguel Morgado ◽  
José Silvestre Silva
Keyword(s):  
Diabetic Neuropathy ◽  
Corneal Nerves

scholarly journals Effect of Inhibition or Deletion of Neutral Endopeptidase on Neuropathic Endpoints in High Fat Fed/Low Dose Streptozotocin-Treated Mice

2016 ◽  
Vol 75 (11) ◽  
pp. 1072-1080 ◽  
Author(s):  
Matthew S. Yorek ◽  
Alexander Obrosov ◽  
Bao Lu ◽  
Craig Gerard ◽  
Randy H. Kardon ◽  
...  
Keyword(s):  
Diabetic Neuropathy ◽  
Neutral Endopeptidase ◽  
Neural Function ◽  
High Fat ◽  
Multiple Endpoints ◽  
Active Peptides ◽  
Corneal Nerves ◽  
Intervention Protocol ◽  
Prevention Protocol ◽  
Corneal Nerve

Previously we demonstrated that a vasopeptidase inhibitor of angiotensin converting enzyme and neutral endopeptidase (NEP), a protease that degrades vaso- and neuro-active peptides, improves neural function in diabetic rodent models. The purpose of this study was to determine whether inhibition or deletion of NEP provides protection from neuropathy caused by diabetes with an emphasis on morphology of corneal nerves as a primary endpoint. Diabetes, modeling type 2, was induced in C57Bl/6J and NEP deficient mice through a combination of a high fat diet and streptozotocin. To inhibit NEP activity, diabetic C57Bl/6J mice were treated with candoxatril using a prevention or intervention protocol. Twelve weeks after the induction of diabetes in C57Bl/6J mice, the existence of diabetic neuropathy was determined through multiple endpoints including decrease in corneal nerves in the epithelium and sub-epithelium layer. Treatment of diabetic C57Bl/6J mice with candoxatril improved diabetic peripheral neuropathy and protected corneal nerve morphology with the prevention protocol being more efficacious than intervention. Unlike C57Bl/6J, mice deficient in NEP were protected from the development of neuropathologic alterations and loss of corneal nerves upon induction of diabetes. These studies suggest that NEP contributes to the development of diabetic neuropathy and may be a treatable target.

Pittsburgh Epidemiology of Diabetes Complications Study: Measuring Diabetic Neuropathy Follow-up Study Results

Diabetes Care ◽  
1992 ◽  
Vol 15 (4) ◽  
pp. 525-527 ◽  
Author(s):  
R. E. Maser ◽  
D. J. Becker ◽  
A. L. Drash ◽  
D. Ellis ◽  
L. H. Kuller ◽  
...  
Keyword(s):  
Diabetic Neuropathy ◽  
Diabetes Complications ◽  
Follow Up Study ◽  
Study Results

scholarly journals Potential Adverse Consequences of Combination Therapy with Gabapentin and Pregabalin

2021 ◽  
Vol 2021 ◽  
pp. 1-4
Author(s):  
Muhammad Nabeel Ghayur
Keyword(s):  
Adverse Effects ◽  
Diabetic Neuropathy ◽  
Gamma Aminobutyric Acid ◽  
Prescribing Practices ◽  
Pharmacy Staff ◽  
Inhibitory Neurotransmitter ◽  
Antiepileptic Medication ◽  
History Of ◽  
Impaired Awareness

Gabapentinoids comprise the medications gabapentin and pregabalin. These were designed to not only look chemically like the central inhibitory neurotransmitter gamma-aminobutyric acid (GABA) but also act like it. The prototype gabapentin was primarily introduced to be used as antiepileptic medication. Today, both chemicals are not only utilized as adjunct antiepileptics in focal (aware and impaired awareness) seizures but are also used in several neuropathic pain conditions and other clinical indications. Their use has skyrocketed in the past few years and this has brought forward more instances of adverse effects and errors in prescribing practices. We describe here a case of a female patient with a history of diabetes, diabetic neuropathy, and hypertension being prescribed both gabapentin and pregabalin concomitantly which led to adverse effects like drowsiness, dizziness, fatigue, and ataxia. Once the patient medication profile was revisited, the pharmacy staff was able to identify the therapeutic duplications (gabapentin and pregabalin). The physician was contacted and pregabalin was discontinued. This led to the disappearance of the adverse effects. The dose of the existing gabapentin was increased to control the symptoms of diabetic neuropathy. This report sheds light on the importance of responsible prescribing, efficient checking of medication profiles on the level of dispensing pharmacies, and timely follow-up to patients to keep the patients safe and their medical conditions under check.

scholarly journals Predictors of Diabetic Foot Reulceration beneath the Hallux

2019 ◽  
Vol 2019 ◽  
pp. 1-7 ◽  
Author(s):  
R. J. Molines-Barroso ◽  
J. L. Lázaro-Martínez ◽  
J. V. Beneit-Montesinos ◽  
F. J. Álvaro-Afonso ◽  
E. García-Morales ◽  
...  
Keyword(s):  
Diabetic Neuropathy ◽  
Diabetic Foot ◽  
Cox Model ◽  
Sociodemographic Factors ◽  
Hallux Limitus ◽  
Therapeutic Footwear ◽  
Custom Made ◽  
History Of ◽  
A Prospective Study

Aims. To evaluate the factors that predict reulceration beneath the hallux in people with a history of diabetic foot ulceration. Methods. A prospective study conducted between January 2012 and December 2014 was performed in a diabetic foot unit to assess the risk factors associated with hallux reulceration. Sixty patients with diabetic neuropathy and a history of previous ulcer were consecutively included. Sociodemographic factors and comorbidities plus the biomechanical and radiographic factors were obtained. Follow-up on participants was conducted every month, and they wore offloading therapeutic footwear and custom-made insoles. Hallux reulceration during the follow-up period was assessed as the main outcome measure in the study. Results. Patients were followed up during 29 (14.2-64.4) months. Twenty-nine patients (52%) developed a new ulceration: 9 patients (31%) in the hallux and 20 (69%) in other locations. Functional hallux limitus (p=0.005, 95% CI (2.097–73.128), HR 12.384) and increased body mass index (p=0.044, 95% CI (1.003-1.272), HR 1.129) were associated with the hallux ulceration-free survival time in the multivariate Cox model. Conclusions. Obesity and the presence of functional hallux limitus increase the probability of developing hallux reulceration in patients with diabetic neuropathy and a history of ulcers.

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