Principles of Treatment of Patients with Diabetic Polyneuropathy in the COVID-19 Pandemic

Patients with COVID-19 may develop various neurological disorders of the central and peripheral nervous systems. It is known that diabetes mellitus (DM) type 1 or 2, cardiovascular diseases, obesity, old age and old age, male gender are risk factors for a severe course and complications of COVID-19. Currently, the COVID-19 pandemic is ongoing, and patients with the listed risk factors are recommended to follow a regime of social restriction or self-isolation. Outpatient treatment is most appropriate for this category of patients. Patients with diabetes who have undergone COVID-19 are at risk of developing or progressing diabetic polyneuropathy (DPN). It seems relevant to develop the principles of effective treatment of patients with DM and DPN in outpatient settings. Glycemic level correction, diet, weight normalization, therapy of combined cardiovascular diseases, an increase of physical activity, sleep normalization, maintenance of normal psychological state are the main principles of treatment of patients with DM and DPN in COVID-19 pandemic conditions. Pathogenetic therapy of DPN continues to be discussed, in our country the preparations of B vitamins, alpha-lipoic acid are widely used. B-group vitamin preparations can be used in the form of tablets or solutions for intramuscular injections. The effectiveness of B vitamins (B1, B6, B12) in the treatment of a severe course of COVID- 19, prevention of complications of COVID-19, especially in elderly patients and with diabetes is discussed.

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Management of patients with painful diabetic neuropathy: clinical case report

Medical Council ◽

10.21518/2079-701x-2020-21-78-83 ◽

2021 ◽

pp. 78-83

Author(s):

V. A. Golovacheva ◽

A. A. Golovacheva

Keyword(s):

Case Report ◽

Drug Therapy ◽

Cardiovascular Diseases ◽

Clinical Case ◽

Control Diet ◽

Neurological Complication ◽

Combination Drug ◽

Adherence To Medication ◽

Patients With Diabetes ◽

Pathogenetic Therapy

Diabetic polyneuropathy is the most common neurological complication of diabetes mellitus (DM) and may affect about half of all patients with diabetes. Timely diagnosis and treatment of DPN can prevent such serious complications as limb numbness, severe pain during the day and night, foot ulceration and suppuration, amputation of the foot or toes, disability and even death. The combined approach to the treatment of DPN is the most effective and includes glycemic control, diet, optimal hypoglycemic therapy, management of cardiovascular diseases, educational conversations with patients, psychological support in the form of consultations with a psychologist or psychotherapy, and sufficient pathogenetic and symptomatic drug therapy of DPN. A clinical case of managing a patient with T2DM, DPN and cardiovascular diseases is described in detail. The interdisciplinary approach was used to treat the patient, which included the use of drug and non-drug therapies. The drug therapy of diabetes was adjusted, and medications to treat cardiovascular diseases were prescribed. Pathogenetic therapy of DPN remains a highly controversial issue. Among the drugs that affect the pathogenetic mechanisms of DPN, careful consideration was given to B vitamins and alpha lipoic acid. In the presented clinical case report, the patient was prescribed a combination drug containing vitamins B1, B6 and B12 as a pathogenetic therapy of DPN. A high priority in the treatment of DM and DPN is placed on raising awareness among patients about the causes and prognosis of the disease. Most patients with diabetes and DPN have psychological problems, symptoms of anxiety and depression about the disease, catastrophization of existing symptoms, poor adherence to medication due to feelings of despair and thoughts of the disease as incurable. In view of above factors, psychological methods appear as effective in the treatment of patients with diabetes and DPN. The cognitive behavioural therapy was used in the described clinical case as a psychological method. The use of CBT improved the patient’s emotional state, increased his adherence to medications and lifestyle recommendations. A positive effect in the form of decreased severity of neuropathic and autonomic symptoms of DPN was observed in as little as 10 days after treatment. At follow-up Week 12, the patient’s condition continued to improve and his work capacity increased.

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Pathogenesis, evaluation and pathogenetic therapy of diabetic polyneuropathy

Neurology neuropsychiatry Psychosomatics ◽

10.14412/2074-2711-2021-3-99-106 ◽

2021 ◽

Vol 13 (3) ◽

pp. 99-106

Author(s):

I. A. Strokov ◽

V. V. Oganov

Keyword(s):

Diabetes Mellitus ◽

Diabetic Polyneuropathy ◽

Late Complications ◽

Common Type ◽

Randomized Controlled ◽

High Prevalence ◽

Patients With Diabetes ◽

Pathogenetic Therapy ◽

Modifying Effect ◽

Cellular Pathology

The increase in the number and life expectancy of patients with diabetes mellitus (DM) worldwide determines the high prevalence of late complications of diabetes, including diabetic polyneuropathy (DPN), the most common type of polyneuropathy. Oxidative stress is considered the main reason for the cellular pathology development in diabetes mellitus, which determines the use of antioxidants for the DPN treatment. Alpha-lipoic acid (ALA), a natural fat-soluble antioxidant, is the most effective drug for reducing DPN symptoms. Furthermore, the symptom-modifying effect of ALA has been shown in numerous randomized controlled trials. The article discusses the possible disease-modifying effect of ALA.

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Identification of risk factors for patients with diabetes: diabetic polyneuropathy case study

BMC Medical Informatics and Decision Making ◽

10.1186/s12911-020-01215-w ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Oleg Metsker ◽

Kirill Magoev ◽

Alexey Yakovlev ◽

Stanislav Yanishevskiy ◽

Georgy Kopanitsa ◽

...

Keyword(s):

Risk Factors ◽

Diabetic Polyneuropathy ◽

Patients With Diabetes

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Apolipoprotein(a), Fibrinopeptide A and Carotid Atherosclerosis in Middle-Aged Men

Thrombosis and Haemostasis ◽

10.1055/s-0038-1648915 ◽

1994 ◽

Vol 72 (04) ◽

pp. 563-566 ◽

Cited By ~ 16

Author(s):

Tuomo Rankinen ◽

Sari Väisänen ◽

Michele Mercuri ◽

Rainer Rauramaa

Keyword(s):

Risk Factors ◽

Cardiovascular Diseases ◽

Carotid Atherosclerosis ◽

Intima Media Thickness ◽

Carotid Bifurcation ◽

Carotid Intima Media Thickness ◽

Fibrinopeptide A ◽

Carotid Imt ◽

Apolipoprotein A ◽

The Difference

SummaryThe association between apolipoprotein(a) [apo(a)], fibrinogen, fibrinopeptide A (FPA) and carotid intima-media thickness (IMT) was analyzed in Eastern Finnish men aged 50 to 60 years. Apo(a) correlated directly with carotid bifurcation (r = 0.26, p = 0.001), but not with common carotid IMT. Men in the lowest quartile of apo(a) had thinner (p = 0.013) IMT in bifurcation [1.59 mm (95% Cl 1.49; 1.68)] compared to the men in the highest [1.91 mm (95% Cl 1.73; 2.09)] apo(a) quartile. The difference remained (p=0.038) after adjusting for confounders. Plasma fibrinogen was not related to carotid IMT, whereas FPA correlated with common carotid (r = 0.21, p = 0.016) and carotid bifurcation (r = 0.21, p = 0.018) IMT. These associations abolished after adjusting for the confounders. The data suggest that apo(a) associate with carotid atherosclerosis independent of other risk factors for ischemic cardiovascular diseases.

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Associations of age-dependent IGF-1 standard deviation scores to cardiovascular diseases and risk factors: A cross-sectional study in 6,282 primary care patients

Experimental and Clinical Endocrinology & Diabetes ◽

10.1055/s-2007-972385 ◽

2007 ◽

Vol 115 (S 1) ◽

Author(s):

HJ Schneider ◽

J Klotsche ◽

H Lehnert ◽

C Sievers ◽

HU Wittchen ◽

...

Keyword(s):

Risk Factors ◽

Primary Care ◽

Standard Deviation ◽

Cardiovascular Diseases ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Age Dependent ◽

Primary Care Patients

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Association of MR-proANP with cardiovascular risk factors in middle aged patients with diabetes mellitus type 2 and non-diabetic controls

Endocrine Abstracts ◽

10.1530/endoabs.63.gp26 ◽

2019 ◽

Author(s):

Simona Chisaliita ◽

Magnus Wijkman ◽

Fredrik Nystrom ◽

Carl Johan Ostgren

Keyword(s):

Diabetes Mellitus ◽

Risk Factors ◽

Cardiovascular Risk ◽

Cardiovascular Risk Factors ◽

Diabetes Mellitus Type 2 ◽

Diabetes Mellitus Type ◽

Middle Aged ◽

Aged Patients ◽

Patients With Diabetes

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Vitamin D supplementation and dynamics of LDF skin microcirculation in patients with diabetes mellitus and diabetic polyneuropathy

Endocrine Abstracts ◽

10.1530/endoabs.63.gp122 ◽

2019 ◽

Author(s):

Anna Stepanova ◽

Tatiana Karonova ◽

Mikhail Galagoudza ◽

Edvard Jude

Keyword(s):

Diabetes Mellitus ◽

Vitamin D ◽

Diabetic Polyneuropathy ◽

Vitamin D Supplementation ◽

Skin Microcirculation ◽

Patients With Diabetes

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Digital risk analysis of cardiovascular diseases: new opportunities for the patients

Orvosi Hetilap ◽

10.1556/oh.2008.28353 ◽

2008 ◽

Vol 149 (15) ◽

pp. 677-684 ◽

Cited By ~ 1

Author(s):

Csaba Arnold ◽

Zoltán Englert ◽

Csaba Szabadhegyi ◽

Csaba Farsang

Keyword(s):

Risk Factors ◽

Cardiovascular Diseases ◽

Risk Analysis ◽

Effective Treatment ◽

Medical History ◽

Vascular Diseases ◽

Coronary Risk ◽

Risk Status ◽

Long Period ◽

Graphic Presentation

Authors constructed a software helping the prevention programme of coronary and vascular diseases as the classical risk factors are used for graphic presentation of coronary risk as compared to “normal” risk. By repeated estimation alterations in coronary risk status can be compared to previous ones and thereby help evaluating the changes. This programme is highlighted by the presentation of changes in coronary risk of a patient during a 4-year-long period of her medical history. It is also shown how graphic presentation of risk can support the more effective treatment and patient care.

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