scholarly journals Corneal Confocal Microscopy – A Novel, Noninvasive Method to Assess Diabetic Peripheral Neuropathy

2014 ◽  
Vol 21 (4) ◽  
pp. 319-326 ◽  
Author(s):  
Georgeta Inceu ◽  
Horea Demea ◽  
Ioan Andrei Veresiu
Keyword(s):  
Peripheral Neuropathy ◽  
Confocal Microscopy ◽  
Diabetic Neuropathy ◽  
Diabetic Peripheral Neuropathy ◽  
Diabetic Patients ◽  
Noninvasive Method ◽  
Anthropometric Parameters ◽  
Perception Threshold ◽  
Peripheral Diabetic Neuropathy ◽  
Corneal Confocal Microscopy

AbstractBackground and aims. This article aims to compare corneal confocal microscopy (CCM) with acknowledged tests of diabetic peripheral neuropathy (DPN), to assess corneal nerve morphology using CCM in diabetic patients, and to underline possible correlations between clinical and biological parameters, diabetes duration and DPN severity. Material and methods. A total of 90 patients with type 2 diabetes were included in the study for whom we measured anthropometric parameters and we performed laboratory measurements (tests). The patients were assessed for diabetic peripheral neuropathy using Semmes-Weinstein Monofilament Testing (SWMT), Rapid-Current Perception Threshold (R-CPT) measurements using the Neurometer®, and CCM. We stratified the patients according to DPN severity, based on four parameters extracted after image analysis. Results. A higher percentage of patients were diagnosed with DPN using CCM (88.8%), compared with SWMT and R-CPT measurement (17.8% and 40% respectively). The incidence of DPN detected with CCM was considerable in patients with normal protective sensation and with normal R-CPT values. Conclusions. Our study showed that corneal confocal microscopy is a useful noninvasive method for diabetic neuropathy assessement in early stages. It was proven to directly quantify small fiber pathology, and to stratify neuropathic severity, and therefore can be used as a new, reliable tool in the diagnosis, clinical evaluation, and follow-up of peripheral diabetic neuropathy.

scholarly journals Prevalence in the Italian regions of pain in patients with diabetic peripheral neuropathy (NDP) and the current costs of drug treatment for principals with specific indication

2010 ◽  
Vol 11 (1) ◽  
pp. 5-11
Author(s):  
Luca Guidi
Keyword(s):  
Peripheral Neuropathy ◽  
Diabetic Neuropathy ◽  
Diabetic Peripheral Neuropathy ◽  
Diabetic Patients ◽  
Pharmacological Treatments ◽  
Peripheral Diabetic Neuropathy ◽  
Italian Regions ◽  
Prevalence Of Pain ◽  
Pain Symptoms ◽  
The Cost

The present analysis estimates the prevalence of pain in patients affected by peripheral diabetic neuropathy referring to Italian and English data published recently and the cost of pharmacological treatments related to specifically indicated drugs. 16% of diabetic patients in Italy is affected by pain symptoms during PDN (peripheral diabetic neuropathy). The corresponding prevalence is 425,168 cases annually. A little number of these patients is actually treated with specifically indicated drugs (duloxetine, pregabalin and gabapentin), anyway the increase of share of duloxetine treatments would take to significant savings due to its lower costs among the specifically indicated pharmacological options.

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

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

Peripheral Vascular and Sweat-Gland Reflexes in Diabetic Neuropathy

1973 ◽  
Vol 45 (3) ◽  
pp. 281-289 ◽  
Author(s):  
H. K. Goadby ◽  
C. B. B. Downman
Keyword(s):  
Peripheral Neuropathy ◽  
Diabetic Neuropathy ◽  
Diabetic Peripheral Neuropathy ◽  
Diabetic Patients ◽  
Peripheral Vascular ◽  
Vasomotor System ◽  
Sympathetic Function ◽  
Vasomotor Reflexes ◽  
Significant Impairment ◽  
Electrodermal Responses

1. In two groups of diabetic patients, one with and one without signs of peripheral neuropathy, reflex short vasoconstrictor responses to such stimuli as a cough, a sharp inspiration or sudden noise were recorded from a finger and both big toes by volume plethysmography. Simultaneous electrodermal responses to the same stimuli were recorded from a hand and a foot. Vasodilator responses to body warming were also recorded. 2. Significant impairment of these vasomotor reflexes in diabetic patients with neuropathy indicates that the sympathetic vasomotor system can be involved in diabetic peripheral neuropathy. 3. Loss of the reflex electrodermal responses is also evidence of impairment of another sympathetic function in such patients. 4. Because stimuli vary in their effectiveness in causing responses in both groups of subjects, it is suggested that changes of central nervous conductivity also occur in diabetes.

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).

scholarly journals Artificial Intelligence–Based Classification of Diabetic Peripheral Neuropathy From Corneal Confocal Microscopy Images

Diabetes Care ◽  
2021 ◽  
pp. dc202012
Author(s):  
Tooba Salahouddin ◽  
Ioannis N. Petropoulos ◽  
Maryam Ferdousi ◽  
Georgios Ponirakis ◽  
Omar Asghar ◽  
...  
Keyword(s):  
Artificial Intelligence ◽  
Peripheral Neuropathy ◽  
Confocal Microscopy ◽  
Diabetic Peripheral Neuropathy ◽  
Corneal Confocal Microscopy ◽  
Microscopy Images

scholarly journals Rapid Automated Diagnosis of Diabetic Peripheral Neuropathy With In Vivo Corneal Confocal Microscopy

2014 ◽  
Vol 55 (4) ◽  
pp. 2071 ◽  
Author(s):  
Ioannis N. Petropoulos ◽  
Uazman Alam ◽  
Hassan Fadavi ◽  
Andrew Marshall ◽  
Omar Asghar ◽  
...  
Keyword(s):  
Peripheral Neuropathy ◽  
Confocal Microscopy ◽  
Diabetic Peripheral Neuropathy ◽  
Automated Diagnosis ◽  
Corneal Confocal Microscopy

Flow Motion in Peripheral Diabetic Neuropathy

1995 ◽  
Vol 88 (2) ◽  
pp. 191-196 ◽  
Author(s):  
S. J. Benbow ◽  
D. W. Pryce ◽  
K. Noblett ◽  
I. A. MacFarlane ◽  
P. S. Friedmann ◽  
...  
Keyword(s):  
Blood Flow ◽  
Peripheral Neuropathy ◽  
Confidence Interval ◽  
Diabetic Neuropathy ◽  
Diabetic Peripheral Neuropathy ◽  
Relative Amplitude ◽  
Diabetic Patients ◽  
Flow Motion ◽  
Hands And Feet ◽  
Motion Amplitude

1. Flow motion is the cyclical variation in blood flow owing to the rhythmical opening and closing of arterioles. Previous studies have suggested that cutaneous flow motion may be altered in diabetic neuropathy but have not been consistent in their findings. 2. In order to assess the effect of diabetic peripheral neuropathy on flow motion, we have examined the frequency and amplitude of flow motion in 12 patients with diabetic peripheral neuropathy, 10 age-matched diabetic patients without peripheral neuropathy and 10 age-matched non-diabetic controls. 3. Peripheral neuropathy was diagnosed by a history of foot ulceration or chronic painful neuropathy, clinical examination and abnormal peroneal nerve conduction velocities. Blood flow, using laser Doppler flowmetry, was measured at four sites on the dorsum of both hands and feet. Flow motion was analysed using fast Fourier transform analysis, between 0.05 and 0.2 Hz, and displayed on a power spectral density graph. Predominant frequency and relative amplitude of flow motion were calculated. 4. Relative amplitude and frequency of flow motion were similar in the hands of all three groups, as was the frequency in the feet of the three groups. Relative amplitude was significantly smaller in the feet of diabetic patients with neuropathy (median 7.2%, 95% confidence interval 4.9–9.4%) than in diabetic patients without neuropathy (median 13.5%, 95% confidence interval 6.3–21.5%, P < 0.02) or in non-diabetic control subjects (median 10.3%, 95% confidence interval 6.9–27.4%, P < 0.02). 5. Flow motion amplitude is reduced in diabetic peripheral neuropathy. The control of flow motion amplitude appears to be at least partly under neurological control.

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