scholarly journals Corneal confocal microscopy for the diagnosis of diabetic peripheral neuropathy: A systematic review and meta‐analysis

2021 ◽  
Author(s):  
Hoda Gad ◽  
Ioannis N. Petropoulos ◽  
Adnan Khan ◽  
Georgios Ponirakis ◽  
Ross MacDonald ◽  
...  
Keyword(s):  
Systematic Review ◽  
Peripheral Neuropathy ◽  
Confocal Microscopy ◽  
Diabetic Peripheral Neuropathy ◽  
Meta Analysis ◽  
Corneal Confocal Microscopy

scholarly journals Using corneal confocal microscopy to compare Mecobalamin intramuscular injections vs oral tablets in treating diabetic peripheral neuropathy: a RCT

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Yuanjin Zhang ◽  
Dongsheng Fan ◽  
Yixuan Zhang ◽  
Shuo Zhang ◽  
Haikun Wang ◽  
...  
Keyword(s):  
Peripheral Neuropathy ◽  
Confocal Microscopy ◽  
Nerve Fibre ◽  
Diabetic Peripheral Neuropathy ◽  
Controlled Study ◽  
Oral Tablet ◽  
Injection Treatment ◽  
Intramuscular Injections ◽  
Corneal Confocal Microscopy ◽  
Corneal Nerve

AbstractThis randomized controlled study used corneal confocal microscopy (CCM) to compare the efficacy of Mecobalamin intramuscular injections vs oral tablets in treating mild to moderate diabetic peripheral neuropathy (DPN) by detecting early nerve fiber repair. Enrolled patients were randomized approximately 1:1 to receive Mecobalamin intramuscular injections (0.5 mg/day, 3 times/week) or Mecobalamin oral tablets (1.5 mg/day) for 8 weeks. Primary outcome was change of inferior whorl length (IWL) from baseline. Secondary outcomes included changes of corneal nerve fibre length (CNFL), corneal nerve fibre density (CNFD), corneal nerve branch density (CNBD) and the Survey of Autonomic Symptoms (SAS). 15 (93.75%) patients in the injection group and 17 (89.47%) patients in the tablet group completed the study. The injection treatment significantly improved patients’ IWL from baseline (21.64 ± 3.00 mm/mm2 vs 17.64 ± 4.83 mm/mm2, P < 0.01) while the tablet treatment didn’t. Additionally, the injection treatment led to significantly improved CNFL, CNBD and SAS from baseline (all P < 0.05) while the tablet treatment did not. No patient experienced any adverse events. In conclusion, CCM is sensitive enough to detect the superior efficacy of 8-week Mecobalamin intramuscular injection treatment for DPN compared to the oral tablet treatment.ClinicalTrials.gov registration number: NCT04372316 (30/04/2020).

Systematic Review and Meta-Analysis of Pharmacological Therapies for Painful Diabetic Peripheral Neuropathy

Pain Practice ◽  
2013 ◽  
Vol 14 (2) ◽  
pp. 167-184 ◽  
Author(s):  
Sonya J. Snedecor ◽  
Lavanya Sudharshan ◽  
Joseph C. Cappelleri ◽  
Alesia Sadosky ◽  
Sonam Mehta ◽  
...  
Keyword(s):  
Systematic Review ◽  
Peripheral Neuropathy ◽  
Diabetic Peripheral Neuropathy ◽  
Meta Analysis ◽  
Painful Diabetic Peripheral Neuropathy

scholarly journals Application of the Ipswich Touch Test for diabetic peripheral neuropathy screening: a systematic review and meta-analysis

BMJ Open ◽  
2021 ◽  
Vol 11 (10) ◽  
pp. e046966
Author(s):  
Nan Zhao ◽  
Jingcan Xu ◽  
Qiuhong Zhou ◽  
Xinyi Li ◽  
Jiarui Chen ◽  
...  
Keyword(s):  
Systematic Review ◽  
Peripheral Neuropathy ◽  
Sensitivity And Specificity ◽  
Diabetic Peripheral Neuropathy ◽  
Tuning Fork ◽  
Meta Analysis ◽  
Biomedical Literature ◽  
Cochrane Library ◽  
Traditional Methods ◽  
Registration Number

ObjectiveDiabetic peripheral neuropathy (DPN) is one of the most important risk factors of diabetic foot ulcers, and early screening and treatment of DPN are crucial. The Ipswich Touch Test (IPTT) is a new method for screening for DPN and, compared with traditional methods, is more simple to operate and requires no equipment. However, the screening accuracy of IPTT in patients with DPN has not been well characterised. We aim to conduct a systematic review and meta-analysis to characterise the sensitivity and specificity of IPTT compared with traditional methods and to understand the potential screening value of IPTT.DesignSystematic review and meta-analysis.Data sourcesPubMed, Embase, Cochrane Library, Web of Science, China National Knowledge Infrastructure, Wanfang, Chinese Biomedical Literature Database up to 16 April 2020.MethodsStata V.15.1 software was used for analysis, and the screening value of IPTT in DPN was described using 10 g monofilament (10g-MF), neuropathy disability scores (NDS), Pin prick, 128 Hz tuning fork, and ankle reflex as reference standards. Sensitivity, specificity and other measures of accuracy of IPTT for screening DPN were pooled based on a quality effects model. The protocol was registered with PROSPERO (42020168420).ResultsOf the 441 records retrieved, 7 studies were evaluated for the screening value of IPTT. Five studies with 10g-MF as the reference standard were included in the meta-analysis, and the pooled sensitivity and specificity were 0.77 (95％CI 0.69–0.84) and 0.96(95％CI 0.93–0.98), respectively, and the area under curve was 0.897. Compared with vibration perception threshold, IPTT showed a sensitivity between 0.76 and 1, and a specificity between 0.90 and 0.97. Compared with NDS, IPTT showed a sensitivity between 0.53 and 1, and a specificity between 0.90 and 0.97. Compared with Pin prick, IPTT showed a sensitivity and specificity of 0.8 and 0.88, respectively. Compared with 128 Hz tuning fork, IPTT showed a sensitivity and specificity of 0.4 and 0.27, respectively. Compared with ankle reflex, IPTT had a sensitivity of 0.2 and a specificity of 0.97.ConclusionsIPTT shows a high degree of agreement with other commonly used screening tools for DPN screening. It can be used clinically, especially in remote areas and in primary medical institutions, and by self-monitoring patients. More high-quality studies are needed to assess and promote more effective screening practices.PROSPERO registration numberRegistration Number is CRD (42020168420).

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