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Handbook of Clinical Neurology 2014Diabetes mellitus is the commonest cause of an autonomic neuropathy in the developed world. Diabetic autonomic neuropathy causes a constellation of symptoms and signs... (Review)
Review
Diabetes mellitus is the commonest cause of an autonomic neuropathy in the developed world. Diabetic autonomic neuropathy causes a constellation of symptoms and signs affecting cardiovascular, urogenital, gastrointestinal, pupillomotor, thermoregulatory, and sudomotor systems. Several discrete syndromes associated with diabetes cause autonomic dysfunction. The most prevalent of these are: generalized diabetic autonomic neuropathy, autonomic neuropathy associated with the prediabetic state, treatment-induced painful and autonomic neuropathy, and transient hypoglycemia-associated autonomic neuropathy. These autonomic manifestations of diabetes are responsible for the most troublesome and disabling features of diabetic peripheral neuropathy and result in a significant proportion of the mortality and morbidity associated with the disease.
Topics: Animals; Autonomic Nervous System Diseases; Diabetes Mellitus; Diabetic Neuropathies; Humans
PubMed: 25410215
DOI: 10.1016/B978-0-444-53480-4.00006-0 -
Current Diabetes Reviews 2021Painful Diabetic Neuropathy (PDN) is a devastating condition affecting one in three people with diabetes. (Review)
Review
BACKGROUND
Painful Diabetic Neuropathy (PDN) is a devastating condition affecting one in three people with diabetes.
INTRODUCTION
Keeping in mind the unceasingly escalating prevalence of diabetes mellitus worldwide, the number of PDN patients is also expected to rise with a reduced quality of life in patients and a staggering increase in healthcare costs. Despite relentless efforts and continuous research, the commercially available medications for relieving diabetic neuropathy pain are only partially effective with substantial side effects. This is, in part, due to our partial awareness of the underlying complexities causing PDN. The pathogenesis of PDN remains elusive because of the difficulty in obtaining damaged nerve samples and the absence of non-invasive methods to investigate the pathogenesis at different stages of disease progression. The purpose of this review was to describe pathogenesis, clinical manifestations and treatment options for PDN.
METHODS
The keywords relevant to the scope of this paper were put in electronic databases (PubMed and Google Scholar) to fetch the relevant data. The data were then analyzed and compiled.
RESULTS
A simplified overview of PDN for researchers new to the field has been provided in an attempt to clarify common confusions. The changes in skin structure and functions in response to diabetes, diabetic neuropathy and painful diabetic neuropathy are also discussed. The unavailability of an efficacious pain reliever for PDN stresses on the need for identifying the microenvironmental factors that are altered in PDN and manipulate them to tailor targeted theranostics.
CONCLUSION
In the end, we proposed to consider the altered skin structure, function and microenvironmental factors in the diabetic population for devising smart, targeted, stimuli-responsive treatment options to attain maximum pain relief with minimum side effects.
Topics: Diabetes Mellitus; Diabetic Neuropathies; Humans; Pain; Pain Management; Quality of Life
PubMed: 33143631
DOI: 10.2174/1573399816666201103142521 -
Continuum (Minneapolis, Minn.) Feb 2012Diabetes is the most common cause of peripheral neuropathy in the world. More than half of patients with diabetes have neuropathy, and half of patients with neuropathy... (Review)
Review
PURPOSE OF REVIEW
Diabetes is the most common cause of peripheral neuropathy in the world. More than half of patients with diabetes have neuropathy, and half of patients with neuropathy have diabetes. Diabetic neuropathy is a major cause of disability and health care expense. This article reviews the various forms of diabetic neuropathy with a focus on diagnosis and treatment.
RECENT FINDINGS
Diabetes causes a wide variety of peripheral nerve problems. These can be divided into chronic neuropathies, of which distal symmetric polyneuropathy is the most common, and acute neuropathies, such as diabetic amyotrophy. There is growing evidence suggesting that prediabetic levels of hyperglycemia and other consequences of obesity and dyslipidemia contribute to neuropathy risk. Evolving literature suggests that many of the acute diabetic neuropathies are related to inflammatory mechanisms. An important exception is treatment-related neuropathy, previously known as "insulin neuritis".
SUMMARY
While disease-altering therapy continues to prove elusive, our understanding of basic disease mechanisms is improving, and new diagnostic and research tools will hopefully lead to novel therapies for distal symmetric diabetic polyneuropathy.
Topics: Adult; Aged; Diabetes Mellitus; Diabetic Neuropathies; Female; Humans; Male; Middle Aged; Young Adult
PubMed: 22810070
DOI: 10.1212/01.CON.0000411568.34085.3e -
Revue Medicale Suisse Jun 2022Diabetic neuropathy is a heterogeneous entity, grouping multiple disorders, of which the most classic form is distal symmetric polyneuropathy (DSPN). Its diagnosis is... (Review)
Review
Diabetic neuropathy is a heterogeneous entity, grouping multiple disorders, of which the most classic form is distal symmetric polyneuropathy (DSPN). Its diagnosis is based in most cases on a compatible history and clinical examination. Screening for DSPN, to allow the implementation of preventive measures against its complications, remains the cornerstone of management, in the absence of specific treatment. In this article, we propose a review of the different forms of diabetic neuropathy and their management.
Topics: Diabetes Mellitus; Diabetic Neuropathies; Humans; Physical Examination; Polyneuropathies
PubMed: 35647748
DOI: 10.53738/REVMED.2022.18.784.1106 -
Neurologic Clinics Aug 1997The most common form of diabetic neuropathy is chronic, distal symmetrical sensorimotor, or predominantly sensory neuropathy; the latter is invariably associated with... (Review)
Review
The most common form of diabetic neuropathy is chronic, distal symmetrical sensorimotor, or predominantly sensory neuropathy; the latter is invariably associated with some degree of autonomic dysfunction. There are, however, other neuropathic patterns in diabetes mellitus that are uncommon but are important to recognize, since they may mimic many other non-neurologic diseases. This article discusses a variety of forms of mononeuropathies and diabetic proximal motor neuropathy, commonly known as diabetic amyotropy.
Topics: Autonomic Nervous System Diseases; Diabetic Neuropathies; Diagnosis, Differential; Humans; Motor Neuron Disease; Neurologic Examination
PubMed: 9227953
DOI: 10.1016/s0733-8619(05)70334-0 -
Diabetes/metabolism Research and Reviews Jan 2019Diabetes impairs the bone marrow (BM) architecture and function as well as the mobilization of immature cells into the bloodstream and number of potential regenerative... (Review)
Review
Diabetes impairs the bone marrow (BM) architecture and function as well as the mobilization of immature cells into the bloodstream and number of potential regenerative cells. Circadian regulation of bone immature cell migration is regulated by β-adrenergic receptors, which are expressed on haematopoietic stem cells, mesenchymal stem cells, and osteoblasts in the BM. Diabetes is associated with a substantially lower number of sympathetic nerve terminal endings in the BM; thus, diabetic neuropathy plays a critical role in BM dysfunction. Treatment with mesenchymal stem cells, BM mononuclear cells, haematopoietic stem cells, and stromal cells ameliorates the dysfunction of diabetic neuropathy, which occurs, in part, through secreted neurotrophic factors, growth factors, adipokines, and polarizing macrophage M2 cells and inhibiting inflammation. Inflammation may be a therapeutic target for BM stem cells to improve diabetic neuropathy. Given that angiogenic and neurotrophic effects are two major barriers to effective diabetic neuropathy therapy, targeting BM stem cells may provide a novel approach to develop these types of treatments.
Topics: Bone Marrow; Bone Marrow Cells; Diabetic Neuropathies; Humans; Inflammation
PubMed: 30289199
DOI: 10.1002/dmrr.3083 -
Nature Clinical Practice. Neurology Jun 2007Diabetic neuropathy is the most common neuropathy in industrialized countries, and it is associated with a wide range of clinical manifestations. The vast majority of... (Review)
Review
Diabetic neuropathy is the most common neuropathy in industrialized countries, and it is associated with a wide range of clinical manifestations. The vast majority of patients with clinical diabetic neuropathy have a distal symmetrical form of the disorder that progresses following a fiber-length-dependent pattern, with sensory and autonomic manifestations predominating. This pattern of neuropathy is associated with a progressive distal axonopathy. Patients experience pain, trophic changes in the feet, and autonomic disturbances. Occasionally, patients with diabetes can develop focal and multifocal neuropathies that include cranial nerve involvement and limb and truncal neuropathies. This neuropathic pattern tends to occur after 50 years of age, and mostly in patients with long-standing diabetes mellitus. Length-dependent diabetic polyneuropathy does not show any trend towards improvement, and either relentlessly progresses or remains relatively stable over a number of years. Conversely, the focal diabetic neuropathies, which are often associated with inflammatory vasculopathy on nerve biopsies, remain self-limited, sometimes after a relapsing course.
Topics: Diabetic Neuropathies; Humans; Peripheral Nerves
PubMed: 17549059
DOI: 10.1038/ncpneuro0504 -
Advances in Experimental Medicine and... 2012Diabetic neuropathy (DN) is the most common, most neglected and difficult to treat diabetic complication. It affects the whole body, and presents with diverse clinical... (Review)
Review
Diabetic neuropathy (DN) is the most common, most neglected and difficult to treat diabetic complication. It affects the whole body, and presents with diverse clinical pictures. The most important outcome of somatic and autonomic DN are the development of diabetic foot followed by diabetic ulceration and possible amputation. In this chapter the definition, epidemiology, pathophysiology and classification of somatic DN will be discussed. Attention will be given to various practical aspects of somatic DN of different types with their specific clinical presentation, diagnostic approaches and treatment options, including the usually rarely discussed gender differences. DN remains a problem in diabetology, compared to other micro- and macrovascular complications. The disease is rarely investigated, although simple testing devices for somatic nerve impairment exist, and remains difficult to treat because ofthe complex pathogenetic mechanisms. The main prevention/progression delaying measure for the progression of DN is the tight glycaemic control. Painful DN is common and need appropriate symptomatic relieving drugs. Future investigations must be targeted on new treatment options.
Topics: Diabetic Neuropathies; Humans; Prevalence; Severity of Illness Index
PubMed: 23393678
DOI: 10.1007/978-1-4614-5441-0_14 -
Wiener Klinische Wochenschrift May 2019These are the guidelines for diagnosis and treatment of diabetic neuropathy and diabetic foot. Diabetic neuropathy comprises a number of mono- and polyneuropathies,... (Review)
Review
These are the guidelines for diagnosis and treatment of diabetic neuropathy and diabetic foot. Diabetic neuropathy comprises a number of mono- and polyneuropathies, plexopathies, radiculopathies and autonomic neuropathy.The position statement summarizes characteristic clinical symptoms and techniques for diagnostic assessment of diabetic neuropathy, including the complex situation of the diabetic foot syndrome. Recommendations for the therapeutic management of diabetic neuropathy, especially for the control of pain in sensorimotor neuropathy, are provided. The needs to prevent and treat diabetic foot syndrome are summarized.
Topics: Diabetic Foot; Diabetic Neuropathies; Diagnostic Techniques, Neurological; Humans; Neurologic Examination; Pain; Pain Management; Practice Guidelines as Topic; Syndrome
PubMed: 30980143
DOI: 10.1007/s00508-019-1487-4 -
Seminars in Vascular Surgery Mar 2003
Review
Topics: Capillaries; Diabetic Foot; Diabetic Neuropathies; Disease Progression; Glycation End Products, Advanced; Humans; Hyperglycemia; Peripheral Nerves; Physical Examination
PubMed: 12644973
DOI: 10.1053/svas.2003.50004