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 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 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.

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.

scholarly journals MR Micro-Neurography and a Segmentation Protocol Applied to Diabetic Neuropathy

2017 ◽  
Vol 2017 ◽  
pp. 1-7 ◽  
Author(s):  
P. F. Felisaz ◽  
G. Maugeri ◽  
V. Busi ◽  
R. Vitale ◽  
F. Balducci ◽  
...  
Keyword(s):  
Peripheral Neuropathy ◽  
Diabetic Neuropathy ◽  
Healthy Volunteers ◽  
Diabetic Peripheral Neuropathy ◽  
Structural Changes ◽  
Ultrastructural Changes ◽  
Diabetic Patients ◽  
Tissue Segmentation ◽  
Cross Sectional ◽  
Imaging Protocol

The aim of this study was to assess with MRI morphometric ultrastructural changes in nerves affected by diabetic peripheral neuropathy (DPN). We used an MR micro-neurography imaging protocol and a semiautomated technique of tissue segmentation to visualize and measure the volume of internal nerve components, such as the epineurium and nerve fascicles. The tibial nerves of 16 patients affected by DPN and of 15 healthy volunteers were imaged. Nerves volume (NV), fascicles volume (FV), fascicles to nerve ratio (FNR), and nerves cross-sectional areas (CSA) were obtained. In patients with DPN the NV was increased and the FNR was decreased, as a result of an increase of the epineurium (FNR in diabetic neuropathy 0,665; in controls 0,699, p=0,040). CSA was increased in subjects with DPN (12,84 mm2 versus 10,22 mm2, p=0,003). The FV was increased in patients with moderate to severe DPN. We have demonstrated structural changes occurring in nerves affected by DPN, which otherwise are assessable only with an invasive biopsy. MR micro-neurography appears to be suitable for the study of microscopic changes in tibial nerves of diabetic patients.

scholarly journals Thioctic Acid and Vitamin B Complex Improves Clinical Sings in Diabetic Peripheral Neuropathy

2019 ◽  
Vol 70 (10) ◽  
pp. 3614-3617
Keyword(s):  
Peripheral Neuropathy ◽  
Diabetic Neuropathy ◽  
Diabetic Peripheral Neuropathy ◽  
Prospective Observational Study ◽  
Vitamin B ◽  
Thioctic Acid ◽  
Peripheral Diabetic Neuropathy ◽  
Therapeutic Protocol ◽  
Peripheral Polyneuropathy

Diabetic neuropathy is the most common cause of neuropathy worldwide and it is estimated to affect about half of people with diabetes. The goal of our study is to compare the effectiveness of thioctic acid treatment alone versus the efficacy of thioctic acid plus vitamin B complex in patients with diabetic peripheral polyneuropathy (DPN). We conducted a prospective, observational study staring from October 2017 to December 2018, in which we included 56 DPN patients. Depending on the Michigan neuropathic screening instrument (MNSI) we divided the patients into two subgroups: patients with MNSI <7 and patients whose MNSI did not decrease sufficiently during the therapeutic protocol. 36 patients (64.2%) of the total patients enrolled in the study had an MNSI <7 at one of the follow-up meetings. These patients were also divided according to the therapeutic protocol applied in a group of patients who were treated with only thioctic acid (TA group) and in a group of patients who were treated with thioctic acid plus vitamin B complex (TA + B group). We noticed a greater proportion of patients who had a MNSI <7 in the TA + B group. This study revealed that the treatment of peripheral diabetic neuropathy with thioctic acid plus Vitamin B complex compared to thioctic acid alone was superior in terms of improving clinical features. Keywords: diabetes mellitus, thioctic acid, Vitamin B complex, diabetic peripheral neuropathy

scholarly journals Vitamin D Deficiency in Patients with Diabetic Peripheral Neuropathy

2019 ◽  
Vol 7 (4) ◽  
pp. 291-294
Author(s):  
Hameedullah Khan ◽  
Ihsanullah Rajar ◽  
Abdul Rauf Memon ◽  
Nadeem Naeem
Keyword(s):  
Vitamin D ◽  
Peripheral Neuropathy ◽  
Diabetic Neuropathy ◽  
Vitamin D Deficiency ◽  
Diabetic Peripheral Neuropathy ◽  
Cross Sectional Study ◽  
Key Words Diabetes ◽  
Cross Sectional ◽  
Peripheral Diabetic Neuropathy ◽  
Diabetes Peripheral Neuropathy

Objective: To determine the frequency of vitamin D deficiency in patients presenting with diabetic peripheral neuropathyPatients and Methods: This cross sectional study was carried out in Department of Medicine and Neurology Indus Medical College, Tando Muhammad khan. from March 2017 to August 2017. Total 74 cases of Diabetes Mellitus presenting with peripheral diabetic neuropathy were selected for the study. Evolution of degree of Neuropathy was based on TCSS score as: {no neuropathy: ≤5, severe: ≥12, moderate: 9-11 and mild: 6-8}. Vitamin D level was categorized as (deficiency (0-20 ng/ml), insufficiency (21-30 ng/ml) sufficiency (>30 ng/ml), excess (>50 ng/ml) and toxicity (>100 ng/ml). All the data was entered in SPSS.Results: Total 74 patients with diabetic neuropathy were studied. Vast majority of patients 36(48.6%) were found in age group 51-60 years, Majority were males 45(60.8%). Most of the cases 35(47.3%) were with 1-3 years duration of neuropathy. Majority of patients 42(56.8%) were found with Mild peripheral neuropathy. Vitamin-D deficiency was present in 2(43.2%) cases and insufficiency was observed in 27(36.5%) cases. No significant association was found between vitamin D deficiency and severity of neuropathy.Conclusion: Vitamin D deficiency was found (43.2%) in patients of diabetic peripheral neuropathy. Vitamin screening and intake of supplement is necessary, will help to decrease the complication of peripheral neuropathy in Diabetic cases. Key words: Diabetes, Peripheral neuropathy, Vitamin D

Pharmacological Treatment of Diabetic Peripheral Neuropathy: An Update

2021 ◽  
Vol 20 ◽  
Author(s):  
Mohamed Rafiullah ◽  
Khalid Siddiqui
Keyword(s):  
Peripheral Neuropathy ◽  
Pharmacological Treatment ◽  
Diabetic Peripheral Neuropathy ◽  
Pharmacological Therapy ◽  
Line Treatment ◽  
Pharmacological Treatments ◽  
First Line ◽  
Short Term ◽  
Disease Modifying Agents ◽  
Third Line

: Neuropathy is the most common complication of diabetes. 50% of adults with diabetes will develop neuropathy in their lifetime. Diabetic peripheral neuropathy (DPN) is the major form of neuropathy found in 75% of diabetic neuropathy incidences. Pharmacological treatments are recommended for pain management in DPN. Anticonvulsants like pregabalin and gabapentin are the preferred first-line treatment, followed by amitriptyline, duloxetine, and venlafaxine. Topical agents like capsaicin and isosorbide dinitrate are also useful in treating the DPN and may be considered for the second or third-line treatment. Opioids and related drugs are suggested for short-term use during the acute exacerbation of pain. Combination therapy may be beneficial in patients who do not respond to monotherapy. However, currently, there is no compelling evidence to suggest any specific combination of agents. Disease-modifying agents such as alpha-lipoic acid and epalrestat appear to improve the disease state but are not recommended by any guideline. This review discusses the available pharmacological therapy for treating DPN. Also, we highlight the recommendations from different guidelines about the pharmacological treatment of DPN.

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