Diffculties and ways to overcome them in selection of therapy for pain syndromes in patients with diabetes mellitus

2021 ◽  
pp. 25-30
Author(s):  
K. A. Makhinov ◽  
P. R. Kamchatnov
Keyword(s):  
Diabetes Mellitus ◽  
Nervous System ◽  
Pain Syndrome ◽  
Neurological Complications ◽  
Neuropathic Pain Syndrome ◽  
Peripheral Nerve Damage ◽  
Pain Syndromes ◽  
Patients With Diabetes ◽  
Therapeutic Possibilities ◽  
Selection Of

Diabetes mellitus (DM) causes damage to various body systems, including the peripheral nervous system. The main variants of peripheral nerve damage in diabetes mellitus are considered. Information on the development of this kind of lesion, in particular, on the formation of neuropathic pain syndrome, is given. The therapeutic possibilities of drugs from various pharmacological groups for the treatment of patients with neurological complications of diabetes are analyzed.

scholarly journals The sensitivity of electromyoneurography in the diagnosis of diabetic polyneuropathy

2011 ◽  
Vol 64 (1-2) ◽  
pp. 11-14
Author(s):  
Milan Cvijanovic ◽  
Miroslav Ilin ◽  
Petar Slankamenac ◽  
Sofija Banic-Horvat ◽  
Zita Jovin
Keyword(s):  
Diabetes Mellitus ◽  
Nervous System ◽  
Early Diagnosis ◽  
Diabetic Polyneuropathy ◽  
Peripheral Neurons ◽  
Peripheral Nerve Damage ◽  
Clinical Syndromes ◽  
Patients With Diabetes ◽  
Tendon Reflexes

Diabetic polyneuropathy is a complex set of clinical syndromes, which deplete various regions of the nervous system. The process leading to diabetic neuropathy is multi-factorial. Its symptoms are paresthesia, dysesthesia and pain. The signs of damage to the peripheral neurons are hypoesthesia, hypoalgesia, hyperesthesia and hyperalgesia, decreased tendon reflexes, and, possibly, weakness and muscle atrophy. There is no universal classification. Electromyoneurography is indispensable in the diagnosis of diabetic polyneuropathy. However, there is no agreement on the most sensitive parameter for an early diagnosis. One hundred patients with diabetes mellitus were examined in order to investigate the sensitivity of different electromyographic parameters. Electromyographic techniques proved to be entirely sensitive for the early diagnosis of diabetic polyneuropathy. Some of the parameters are more suitable for an early detection of peripheral nerve damage, and others, which are not so sensitive but easy to use and stable, are suitable to follow up the course of diabetic polyneuropathy.

scholarly journals Optimization of the method for diagnostics of cardial autonomic neuropathy in diabetes mellitus 2 types

2021 ◽  
pp. 178-183
Author(s):  
L. S. Moshkhoeva ◽  
A. N. Barinov
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Nervous System ◽  
Autonomic Neuropathy ◽  
Parasympathetic Nervous System ◽  
Diagnostic Technique ◽  
Pain Syndrome ◽  
Cardiac Autonomic Neuropathy ◽  
Neuropathic Pain Syndrome

Introduction. Early diagnosis of cardiac autonomic neuropathy is the basis for the risk of heart disease and premature death in patients with type 2 diabetes mellitus (type 2 diabetes). All patients with type 2 diabetes and prediabetes should undergo annual screening, including history taking and neurophysiologic evaluation, for early diabetic autonomic neuropathy. This article describes a modern diagnostic technique based on changes in heart rate variability, which allows early detection of damage to the parasympathetic nervous system and timely prescribing disease-modifying treatment in patients with type 2 diabetes.Materials and methods. The study included 50 patients with type 2 diabetes (cf. Age 56.5 ± 13.5 years) and 30 healthy subjects (cf. Age 58 ± 10 years), matched by sex and age. according to the NSC questionnaire, the severity of neurological deficit - according to the NIS-LL scale, neuropathic pain syndrome - according to the TSS scale.Results. In the study group of patients with type 2 diabetes, severe CAN was detected in 13.3%, moderate CAN in 40% of patients, in 46.6% of patients, CAN was not detected. In the group of healthy volunteers, disorders of the autonomic nervous system of moderate were detected in 3.3%, in the remaining 96.7% of autonomic disorders were not accepted.Conclusion. The results of pulse oximetric tests with deep breathing are comparable to the results of the QAT device Case-4 (p < 0.001). The method of pulse oximetric diagnostics is more practical to use in comparison with the hardware QAT.

scholarly journals Dinamics of somatosensory generated potentials in myofascial pain syndromes

2001 ◽  
Vol 82 (5) ◽  
pp. 336-340
Author(s):  
G. A. Ivanichev ◽  
A. V. Ovchinnikov
Keyword(s):  
Nervous System ◽  
Myofascial Pain ◽  
Pain Syndrome ◽  
Myofascial Pain Syndromes ◽  
Pain Syndromes ◽  
Antinociceptive System

In pronounced pain syndrome the most important functional shifts (the generators of pathologically increased excitement) by recording somatosensory generated potentials arc revealed at higher levels than in slight tenderness. At the same time in slight painfulness tenderness a great number of the generators of mild activity arc found, showing insufficient activity of antinociceptive system. After treatment a number of the generators of pathologically increased excitement decrease, at the same time the migration to the caudal parts of nervous system occurs. The neurophysiologic basis for possible worsening myofascial pain syndromes is created.

scholarly journals Analgetic effect of ozone therapy: myths of reality?

2020 ◽  
Author(s):  
Iryna Vladimirovna Baranova ◽  
Yurii A. Bezsmertnyi ◽  
Halyna V. Bezsmertnaya ◽  
Kateryna P. Postovitenko ◽  
Iryna A. Iliuk ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Musculoskeletal System ◽  
Chronic Back Pain ◽  
Pain Syndrome ◽  
Neurological Complications ◽  
Potential Effect ◽  
Intervertebral Disk ◽  
Ozone Therapy ◽  
Pain Syndromes ◽  
Innovative Techniques

Introduction: Administration of an oxygen-ozone mixture is one of the innovative techniques used in single-drug or complex therapeutic schemes for treatment of many degenerative-dystrophic pathologies of the musculoskeletal system and related neurological complications. Aim: The aim was to determine the mechanisms of physiological action of the oxygen-ozone mixture in order to substantiate its efficacy for treatment of chronic pain syndrome with underlying degenerative-dystrophic pathologies of the musculoskeletal system. Material and methods: The article covers biochemical and pathomorphological studies that explain the mechanism of the pain syndrome and the potential effect of the ozone therapy. Results and discussion: The treatment schemes and benefits of different routes of ozone administration (intramuscularly, intravenously, intradiscally and intraarticularly) were analyzed. Diverse research data demonstrated influence on the causes of chronic pain, pathophysiological phases, and possible complications. The prospects of further studies for development of the most effective techniques for treatment of various pain syndromes were assessed. Conclusions: Ozone therapy is one of the alternative rehabilitation methods with a substantial pain relieving effect. As of today, the possibility of using the oxygen-ozone mixture for treatment of chronic back pain related to intervertebral disk hernia and fibromyalgia has been substantially confirmed.

scholarly journals Anti-Diabetic Drugs in Cardiovascular Disease

2021 ◽  
Vol 96 (2) ◽  
pp. 85-91
Author(s):  
Se-Eun Kim ◽  
Byung-Su Yoo
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Cardiovascular Disease ◽  
Antidiabetic Drugs ◽  
Cardiovascular Safety ◽  
Safety And Efficacy ◽  
Cardiovascular Outcome Trials ◽  
Patients With Diabetes ◽  
Cardiovascular Stability ◽  
Selection Of

Diabetes is one of the important risk factors in cardiovascular disease associated with atherosclerosis, and cardiovascular disease is the leading cause of death in patients with diabetes mellitus. Recent randomized placebo-controlled cardiovascular outcome trials of all new antidiabetic drugs have linked SGLT-2 inhibitors and GLP1-agonists to not only increased cardiovascular stability but significant reduction of cardiovascular disease. These results have led to preferential selection of the most effective and beneficial antidiabetic drugs with the evidence of cardiovascular safety and efficacy. Herein, we address cardiovascular stability and the effectiveness of antidiabetic drugs, focusing on recently developed ones.

scholarly journals Neurological complications of alcoholic disease and ways of their correction

2019 ◽  
Vol 11 (3) ◽  
pp. 124-128 ◽  
Author(s):  
A. Yu. Emelyanova ◽  
O. E. Zinovyeva ◽  
S. R. Fedoseev ◽  
E. V. Misyuryaeva
Keyword(s):  
Nervous System ◽  
Skeletal Muscles ◽  
Clinical Presentation ◽  
Alcohol Intoxication ◽  
Neurological Complications ◽  
Nerve Fibers ◽  
Therapeutic Action ◽  
Peripheral Nerve Damage ◽  
B Complex Vitamins ◽  
Alcoholic Disease

The problem of alcohol abuse and its social and medical consequences has remained relevant for many years. Damage to the nervous system is one of the most common manifestations of alcoholic disease. The effect of ethanol and its metabolites results in damage to all parts of the nervous system and skeletal muscles. The paper provides a brief overview of Russian and foreign literature on the neurological manifestations of chronic alcohol intoxication. It considers modern ideas about the pathogenesis of alcoholic neuropathy (APN). It also discusses differences in the clinical presentation, course, and developmental mechanisms of the main (chronic toxic and acute/subacute) forms of APN associated with thiamine deficiency. The paper notes difficulties in diagnosing peripheral nerve damage, especially in the early stages of the disease and describes modern methods for objectifying damage to thin nerve fibers in chronic APN. It presents approaches to treating alcohol-induced damage to the peripheral nervous system, by taking into account the leading mechanisms of pathogenesis. Special attention is paid to B-complex vitamins and alpha-lipoic acid preparations frequently used in this disease, to the mechanisms of their therapeutic action, and to the evaluation of their efficacy in APN.

scholarly journals Supplementation with 0.1% and 2% vitamin e in diabetic rats: analysis of myenteric neurons immunostained for myosin-V and nNOS in the jejunum

2012 ◽  
Vol 49 (4) ◽  
pp. 284-290 ◽  
Author(s):  
Eleandro Aparecido Tronchini ◽  
Aline Rosa Trevizan ◽  
Cristiano Massao Tashima ◽  
Renata Virginia Ferreira Pereira ◽  
Jacqueline Nelisis Zanoni
Keyword(s):  
Diabetes Mellitus ◽  
Nervous System ◽  
Vitamin E ◽  
Enteric Nervous System ◽  
Neurological Complications ◽  
Diabetic Rats ◽  
Diabetic Group ◽  
Diabetic Patients ◽  
Myosin V ◽  
Gastric Stasis

CONTEXT: Diabetes mellitus is a disease characterized by hyperglycemia that, when allowed to progress long-term untreated, develops vascular and neurological complications, which are responsible for the development of alterations in the enteric nervous system in diabetic patients. In the gastrointestinal tract, diabetes mellitus promotes motor and sensory changes, and in the reflex function of this system, causing gastroparesis, diarrhea, constipation, megacolon, slow gastrointestinal transit, gastric stasis and dilation with decreased or increased peristaltic contractions. Several studies have shown that oxidative stress is the main responsible for the vascular and neurological complications affecting the enteric nervous system of diabetics. OBJECTIVE: The effects of 0.1% and 2% vitamin E on myosin-V- and nNOS-immunoreactive neurons in the jejunum of diabetic rats were investigated. METHODS: Thirty rats were divided into the groups: normoglycemic, normoglycemic treated with 0.1% vitamin E, normoglycemic treated with 2% vitamin E, diabetic, diabetic treated with 0.1% vitamin E, and diabetic treated with 2% vitamin E. The neuronal density and areas of neuron cell bodies were determined. RESULTS: Diabetes (diabetic group) significantly reduced the number of myosin-V-immunoreactive neurons compared with the normoglycemic group. The diabetic treated with 0.1% vitamin E and diabetic treated with 2% vitamin E groups did not exhibit a greater density than the D group (P>0.05). Nitrergic density did not change with diabetes (P>0.05). The areas of myosin-V- and nNOS-immunoreactive neurons significantly increased in the normoglycemic treated with 2% vitamin E and diabetic groups compared with the normoglycemic group. CONCLUSION: Supplementation with 2% vitamin E had a neurotrophic effect only in the area of myosin-V-immunoreactive neurons compared with the diabetic group.

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