scholarly journals Autonomic Diabetic Polyneuropathy Variants: Possible Correction

Doctor Ru ◽  
2021 ◽  
Vol 20 (2) ◽  
pp. 60-66
Author(s):  
A.V. Zilov ◽  
◽  
Keyword(s):  
Diabetes Mellitus ◽  
Autonomic Neuropathy ◽  
Lipoic Acid ◽  
Diabetic Polyneuropathy ◽  
Clinical Aspects ◽  
Diabetic Patients ◽  
Slowing Down ◽  
Key Points ◽  
Delayed Complications ◽  
Clinical Interest

Objective of the Review: To analyse the incidence of polyneuropathy in diabetic patients focusing on autonomic neuropathy. Key Points. Polyneuropathy is one of the most common delayed complications of diabetes mellitus (DM); the condition has numerous clinical aspects. Major polyneuropathy studies focus on assessment, prevention and management of pain caused by sensory and sensory-and-motor defects, prevention of ulceration and Charcot foot. At the same time, various autonomic neuropathy variants in diabetic patients have either been studied not thoroughly enough, or are outside of clinical interest. Still, prevention and pathogenic effect from autonomic neuropathy are similar to those used in other types of diabetic neuropathy. We describe major pathogenic links in nerve fibre damaging and clinical forms of autonomic neuropathy. Major studies of the use of α-lipoic acid in DM are presented. Conclusion. α-lipoic acid medications are efficient in slowing down various forms of autonomic neuropathy. Dose-dependent action of these medications, adequate therapy duration (at least 3 months as a course of medication), improved glycaemic control in patients with DM are essential for autonomic neuropathy prevention and slowing down. Keywords: diabetes mellitus; diabetic polyneuropathy; diabetic autonomic polyneuropathy; α-lipoic acid.

scholarly journals Diabetic polyneuropathy: diagnosis, prevention, and treatment

2020 ◽  
Vol 12 (4) ◽  
pp. 113-118
Author(s):  
V. A. Golovacheva ◽  
I. A. Strokov
Keyword(s):  
Diabetes Mellitus ◽  
Clinical Trials ◽  
Nervous System ◽  
Lipoic Acid ◽  
Diabetic Polyneuropathy ◽  
Patient Treatment ◽  
Alpha Lipoic Acid ◽  
Sensorimotor Polyneuropathy ◽  
Chronic Hyperglycemia ◽  
Prevention And Treatment

The most common form of peripheral nervous system damage in diabetes mellitus is distal symmetric sensorimotor polyneuropathy (DSSMPN). Chronic hyperglycemia, dyslipidemia, and impaired microcirculation are considered to be the key mechanisms for the development of DSSMPN, but its pathogenesis is still unclear and continues to be studied. The paper analyzes the issues of diagnosis of DSSMPN and the effective principles of patient treatment. It also discusses the use of alpha-lipoic acid (ALA) as a drug for the pathogenetic treatment of DSSMPN and describes the results of clinical trials of its treatment with ALA preparations.

scholarly journals Associations between Fatty Acid-Binding Protein 4–A Proinflammatory Adipokine and Insulin Resistance, Gestational and Type 2 Diabetes Mellitus

Cells ◽  
2019 ◽  
Vol 8 (3) ◽  
pp. 227 ◽  
Author(s):  
Marcin Trojnar ◽  
Jolanta Patro-Małysza ◽  
Żaneta Kimber-Trojnar ◽  
Bożena Leszczyńska-Gorzelak ◽  
Jerzy Mosiewicz
Keyword(s):  
Diabetes Mellitus ◽  
Insulin Resistance ◽  
Fatty Acid ◽  
Fatty Acid Binding Protein ◽  
Binding Protein ◽  
Clinical Aspects ◽  
Diabetic Patients ◽  
Fatty Acid Binding ◽  
Acid Binding Protein

There is ample scientific evidence to suggest a link between the fatty acid-binding protein 4 (FABP4) and insulin resistance, gestational (GDM), and type 2 (T2DM) diabetes mellitus. This novel proinflammatory adipokine is engaged in the regulation of lipid metabolism at the cellular level. The molecule takes part in lipid oxidation, the regulation of transcription as well as the synthesis of membranes. An involvement of FABP4 in the pathogenesis of obesity and insulin resistance seems to be mediated via FABP4-dependent peroxisome proliferator-activated receptor γ (PPARγ) inhibition. A considerable number of studies have shown that plasma concentrations of FABP4 is increased in obesity and T2DM, and that circulating FABP4 levels are correlated with certain clinical parameters, such as body mass index, insulin resistance, and dyslipidemia. Since plasma-circulating FABP4 has the potential to modulate the function of several types of cells, it appears to be of extreme interest to try to develop potential therapeutic strategies targeting the pathogenesis of metabolic diseases in this respect. In this manuscript, representing a detailed review of the literature on FABP4 and the abovementioned metabolic disorders, various mechanisms of the interaction of FABP4 with insulin signaling pathways are thoroughly discussed. Clinical aspects of insulin resistance in diabetic patients, including women diagnosed with GDM, are analyzed as well.

scholarly journals Alpha-lipoic Acid: Effects on the Beat-to-Beat Vectorcardiographic Parameters in Type 2 Diabetes Mellitus Patients with Cardiac Autonomic Neuropathy

2021 ◽  
Vol 2 (2) ◽  
pp. 16
Author(s):  
Victoria Serhiyenko ◽  
Krystina Kozlovska ◽  
Alexandr Serhiyenko
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Autonomic Neuropathy ◽  
Lipoic Acid ◽  
Qt Dispersion ◽  
Cardiac Autonomic Neuropathy ◽  
Control Group ◽  
Alpha Lipoic Acid

Objective: Relevance of cardiac autonomic neuropathy has not been fully recognized and there is no standardized treatment protocol.Aim: To evaluate the effects of alpha-lipoic acid on the beat-to-beat vectorcardiographic parameters, namely spatial QRS-T angle, QT dispersion (QTd) and corrected QT interval (QTc) in type 2 diabetes mellitus persons with cardiac autonomic neuropathy. Research designs and methods: Our study involved 33 persons with definite stage of cardiac autonomic neuropathy and diabetes mellitus type 2, which were assigned to each of two groups: one took standard antihyperglycaemic treatmen (n=15, control group) and the other (n=18) in addition to standard therapy - 600 mg of alpha-lipoic acid daily for three months. The analysis of vectorcardiographic parameters was performed. Results: It was found out that alpha-lipoic acid contributed to decrease of the vectorcardiographic parameters, namely QRS-T angle, QTd and QTc. Conclusions: The positive influences of alpha-lipoic acid suggest the usefulness of its prescription to type 2 diabetes mellitus persons with definite stage of cardiac autonomic neuropathy. The efficacy of alpha-lipoic acid is the result of its direct effect on the parameters of vectorcardiography.

scholarly journals Alpha Lipoic Acid Influence in the Attenuation of Oxidative Stress and of Clinical Manifestations of Neuropathy in Diabetes Mellitus Patients

2018 ◽  
Vol 15 (4) ◽  
pp. 15-26
Author(s):  
Bondar Andrei Cristian ◽  
Popa Amorin Remus
Keyword(s):  
Oxidative Stress ◽  
Diabetes Mellitus ◽  
Diabetic Neuropathy ◽  
Lipoic Acid ◽  
Healthy Subjects ◽  
Microvascular Complications ◽  
Clinical Manifestations ◽  
Clinical Aspects ◽  
Alpha Lipoic Acid ◽  
Perception Threshold

AbstractAlpha lipoic acid is an antioxidant substance used for the pathogenic treatment of diabetic neuropathy, oxidative stress being a central mechanism in diabetic microvascular complications. Our study included 24 diabetes mellitus patients with diabetic neuropathy and 20 healthy subjects. Diabetes patients were given alpha lipoic acid 600 mg intravenously for 10 days and then per os for 30 days.Significant improvements were observed concerning oxidative stress evaluated by measuring serum malondyaldehide and ceruloplasmin. The clinical characteristic of neuropathy improved, both the level of pain decreased and the vibration perception threshold increased. Our study demonstrated a two times higher level of oxidative stress in patients with diabetes compared to healthy subjects, and that by influencing oxidative stress we could influence the clinical aspects of neuropathy. Further investigations need to be done to explore the pleiotropic effects of alpha lipoic acid on other mechanisms that are implicated in the pathogenies of diabetic neuropathy.

scholarly journals A Study of Cardiac Autonomic Neuropathy among Type-II Diabetic Patients

2021 ◽  
pp. 345-352
Author(s):  
B.V. Surendra ◽  
N. S. Muthiah ◽  
M. V. Sailaja ◽  
K. Prabhu
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Autonomic Neuropathy ◽  
Tertiary Care ◽  
Male Gender ◽  
Cardiac Autonomic Neuropathy ◽  
Diabetic Patients ◽  
Care Hospital ◽  
Type Ii ◽  
Duration Of Diabetes

Background: Though very common, CAN is a least understood complication of diabetes which is often under diagnosed. In diabetes mellitus patients, CAN leads to silent myocardial infarction and sudden death. So by identifying CAN early, which is asymptomatic will help to delay or arrest its progression. AIM: To find out the prevalence and the associated risk factors of Cardiac autonomic neuropathy (CAN) among type-II Diabetes Mellitus patients in a tertiary care hospital. Materials & Methods: A total of 273 type-II diabetic participants were selected after taking into consideration of inclusion & exclusion criteria. The prevalence of CAN was assessed by ewings and clarkesnon invasive cardiac autonomic neuropathy reflex tests. The association of risk                  factors with the presence of CAN was analysed by using Pearson’s chi square test.                               Data were analysed by using SPSS 16. The accepted level of significance was set below 0.05 (P<0.05). Results: The prevalence of CAN among type-II diabetic patients in this study was found to be 34%. Prevalence of CAN increased in the participants with male gender, increased age, and increased BMI, increased duration of diabetes, poor glycaemic control,dyslipidimea, smokers and hypertension and it is statistically significant. Conclusion: In this study it is observed that the prevalence of CAN increased with old age, male gender, poor glycemic control, increased duration of diabetes, Dyslipidemia, higher BMI, Hypertension & smoking. So risk factors associated with the CAN be detected and treated at an early stage to further reduce morbidity and mortality.

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