scholarly journals A Review on Diabetic Peripheral Neuropathy

2021 ◽  
Vol 11 (2-S) ◽  
pp. 121-125
Author(s):  
Jasaswi Ray ◽  
Chinmaya Keshari Sahoo ◽  
Rajashree Mohanty ◽  
Rakesh Sahoo ◽  
Rajashree Dalai
Keyword(s):  
Peripheral Neuropathy ◽  
Diabetic Peripheral Neuropathy ◽  
Diabetic Patients ◽  
Pharmacological Management ◽  
Noradrenaline Reuptake ◽  
Limb Proprioception

Diabetic peripheral neuropathy (DPN) is a common complication of both type 1 and type 2 diabetes affecting over 90% of the diabetic patients. Due to the toxic effects of hyperglycemia there is development of this complication. It is typically characterized by significant deficits in tactile sensitivity, vibration sense, lower-limb proprioception, and kinesthesia. Painful DPN has been shown to be associated with significant reductions in overall quality of life, increased levels of anxiety and depression, sleep impairment, and greater gait variability. Hence DPN is often inadequately treated, and the role of improving glycaemic control in diabetes. Major international clinical guidelines for the management of DPN recommend several symptomatic treatments. First-line therapies include tricyclic antidepressants, serotonin–noradrenaline reuptake inhibitors, and anti-consultants that act on calcium channels. Other therapies include opioids and topical agents such as capsaicin and lidocaine. The objectives of this paper are to review current guidelines for the pharmacological management of DPN. Keywords: DPN, hyperglycemia, depression, lidocaine

Diabetic neuropathy: Epidemiological, pathogenetic, and clinical aspects with special emphasis on type 2 diabetes mellitus

1983 ◽  
Vol 104 (4_Suppl) ◽  
pp. S89-S94
Author(s):  
E. Matikainen ◽  
J. Juntunen
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Peripheral Neuropathy ◽  
Diabetic Control ◽  
Clinical Aspects ◽  
Type 2 Diabetics ◽  
Insulin Dependent

ABSTRACT. Peripheral neuropathy is a frequent complication of diabetes mellitus. Alterations of the peripheral nervous system in diabetics have been studied in numerous investigations. There are many factors known to participate in the development of this complication, e.g. the age of the patient, duration of the diabetes, quality of the diabetic control etc. The role of different types of diabetes in development of neuropathy is still largely unclear since investigations on this aspect are few. It seems, however, that peripheral neuropathy in type 2 (non-insulin dependent) diabetes is common but often mild. The differential diagnosis of the peripheral neuropathy in type 2 diabetics is more difficult than in type 1 (insulin dependent) diabetics, since these patients tend to be older and also may have other concomitant disorders. In this paper the clinical features and pathogenetic mechanisms of neuropathy in type 2 diabetes are briefly discussed.

scholarly journals Albumin-Creatinine Ratio is More Diagnostic Sensitive than Cystatin-C in Assessment of Diabetic Peripheral Neuropathy

2018 ◽  
Vol 1 (3) ◽  
Keyword(s):  
Diabetes Mellitus ◽  
Peripheral Neuropathy ◽  
Cystatin C ◽  
Early Treatment ◽  
Diabetic Peripheral Neuropathy ◽  
Diabetic Patients ◽  
Creatinine Ratio ◽  
Serum Cystatin C ◽  
Albumin Creatinine Ratio

Background: Diabetic Peripheral neuropathy is one of the most common cardiovascular complications among diabetes mellitus patients and occurs in more than half of the population of diabetic patients world-wide. It is a common cause of foot ulcer, gangrene and amputation among diabetics. Thus, its prevention or early treatment can improve the quality of life of diabetic patients. In a bid to reduce it, various biochemical markers have been evaluated to enable early treatment and amelioration of diabetic neuropathy among diabetes mellitus patients. Aim: Evaluation of the diagnostic relevance of Cystatin-C versus Albumin-creatinine ratio in assessment of Peripheral neuropathy in diabetic type 2 subjects. Method: 102 type 2 DM subjects (66 females and 36 males) and 100 control subjects of same age range (40 – 80 years) were recruited for this study which includes 51 subjects with peripheral neuropathy and 51 subjects without peripheral neuropathy. Serum Cystatin-C, Microalbuminuria, Urine creatinine and HBA1c were analysed with standard methods. Results: Cystatin-C, Microalbuminuria, Albumin-creatinine ratio and Glycated haemoglobin were significantly elevated (P<0.05) in diabetic subjects compared to the control. Cystatin-C (ng/ml), microalbuminuria (mg/l), albumin creatinine ratio (mg/mmol) and HBA1c (%) is [105.52 ± 45.11; 90.07±20.29; 10.48 ± 4.82; 6.9±1.7] respectively. Microalbuminuria, albumin creatinine ratio showed significant increase (P<0.05) in subjects with peripheral neuropathy compared to those subjects without [92.11± 22.82; 35.70±16.35; 2.61±1.1; 6.38±1.79]. The ROC curve shows that Albumin-creatinine ratio showed significant (P<0.05) sensitivity to peripheral neuropathy [AUC=0.714] while Cystatin-C showed no significant (P<0.05) sensitivity to peripheral neuropathy complication [AUC=0.553]. Conclusion: Cystatin-C was found to be deranged in diabetics. However, Albumin-creatinine ratio showed more diagnostic sensitivity for peripheral neuropathy than Cystatin-C.

scholarly journals Diabetic Peripheral Neuropathy: Epidemiology, Physiopathology, Diagnosis and Treatment

2019 ◽  
Vol 7 (1) ◽  
pp. 35-48
Author(s):  
Nazma Akter
Keyword(s):  
Neuropathic Pain ◽  
Peripheral Neuropathy ◽  
Diabetic Peripheral Neuropathy ◽  
Clinical Evidence ◽  
Current Treatment ◽  
Diabetic Patients ◽  
First Line ◽  
Diabetic Neuropathic Pain ◽  
Current Treatment Regimen ◽  
Limb Proprioception

Diabetic peripheral neuropathy (DPN) is a common complication of both type 1 and type 2 diabetes. It affects over 90% of the diabetic patients. It is widely accepted that the toxic effects of hyperglycemia play an important role in the development of this complication, but several other hypotheses have been postulated. It is typically characterized by significant deficits in tactile sensitivity, vibration sense, lower-limb proprioception, and kinesthesia. Painful DPN has been shown to be associated with significant reductions in overall quality of life, increased levels of anxiety and depression, sleep impairment, and greater gait variability. DPN is often misdiagnosed and inadequately treated. Clinical recognition of DPN is imperative for allowing timely symptom management to reduce the morbidity associated with this condition. The management of diabetic neuropathic pain consists basically in excluding other causes of painful peripheral neuropathy, improving glycemic control as a prophylactic therapy and using medications to alleviate pain. First line drugs for pain relief include anticonvulsants, such as pregabalin and gabapentin and antidepressants, especially those that act to inhibit the reuptake of serotonin and noradrenaline. In addition, there is experimental and clinical evidence that opioids can be helpful in pain control, mainly if associated with first line drugs. Other agents, including for topical application, such as capsaicin cream and lidocaine patches, have also been proposed to be useful as adjuvant in the control of diabetic neuropathic pain, but the clinical evidence is insufficient to support their use. The purpose of this review is to examine proposed mechanisms of DPN, summarize current treatment regimen. A better understanding of the mechanisms underlying diabetic neuropathic pain will contribute to the search of new therapies. Delta Med Col J. Jan 2019 7(1): 35-48

Understanding and managing interferences in clinical laboratory assays: the role of laboratory professionals

2020 ◽  
Vol 58 (3) ◽  
pp. 350-356 ◽  
Author(s):  
Martina Zaninotto ◽  
Mario Plebani
Keyword(s):  
Patient Safety ◽  
Laboratory Testing ◽  
Clinical Laboratory ◽  
Careful Evaluation ◽  
The Matrix ◽  
Analytical Phase

AbstractThe recently raised concerns regarding biotin interference in immunoassays have increased the awareness of laboratory professionals and clinicians of the evidence that the analytical phase is still vulnerable to errors, particularly as analytical interferences may lead to erroneous results and risks for patient safety. The issue of interference in laboratory testing, which is not new, continues to be a challenge deserving the concern and interest of laboratory professionals and clinicians. Analytical interferences should be subdivided into two types on the basis of the possibility of their detection before the analytical process. The first (type 1) is represented by lipemia, hemolysis and icterus, and the second (type 2), by unusual constituents that are not undetectable before analysis, and may affect the matrix of serum/plasma of individual subjects. Type 2 cannot be identified with current techniques when performing the pre-analytical phase. Therefore, in addition to a more careful evaluation and validation of the method to be used in clinical practice, the awareness of laboratory professionals should be raised as to the importance of evaluating the quality of biological samples before analysis and to adopt algorithms and approaches in the attempt to reduce problems related to erroneous results due to specific or non-specific interferences.

scholarly journals The Effects of Combined Exercise Training (Resistance-Aerobic) on Serum Kinesin and Physical Function in Type 2 Diabetes Patients with Diabetic Peripheral Neuropathy (Randomized Controlled Trials)

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Seyedeh Hoda Seyedizadeh ◽  
Sadegh Cheragh-Birjandi ◽  
Mohammad Reza Hamedi Nia
Keyword(s):  
Type 2 Diabetes ◽  
Peripheral Neuropathy ◽  
Exercise Training ◽  
Physical Function ◽  
Diabetic Peripheral Neuropathy ◽  
Diabetic Patients ◽  
Combined Exercise ◽  
Combined Exercise Training ◽  
Diabetes Patients

Diabetic peripheral neuropathy is one of the most common chronic complications of diabetics which causes nerve damage and muscle strength decrease in patients. This in turn results in imbalance leading to the diabetic patients’ daily activity disparity. The present investigation was conducted to specifically study the effects of combined training (resistance-aerobic) on serum kinesin-1 and physical function in type 2 diabetes patients with diabetic peripheral neuropathy. 24 diabetic neuropathic females were randomly to be selected out and divided into two experimental and control groups. The experimental group received resistance-aerobic training for 3 sessions during eight weeks. The exercise training included resistance exercises with 2-3 sets, 6-7 exercise stations, 8-12 repetitions (reps), and 3-5 minutes of rest in between the exercises, and the aerobic exercises contained 50-65% of heart rate reserve (HRR) for 3 minutes with 30 seconds of rest interval between sets and 5-10 repetitions. Results show that the serum kinesin-1 level and aerobic endurance declined after eight weeks of combined (resistance-aerobic) exercise training, but this decrease was not significant. The upper body strength increased but it was not significant, while the lower body showed a significant strength increase. With regard to the progressive nature of diabetic peripheral neuropathy, it seems that even the little changes resulting from the combined exercise training can be useful. Nevertheless, more research is required in this area.

Sign in / Sign up

Export Citation Format

Share Document