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Diabetic Neuropathy

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1. Diabetic neuropathy

Diabetic neuropathy Diabetic neuropathy - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Diabetic neuropathy Last reviewed: February 2019 Last updated: April 2018 Summary Hyperglycaemia contributes to the pathogenesis of neuropathy in both type 1 and type 2 diabetes. Other metabolic and vascular factors, particularly hypertriglyceridaemia, are important. The clinical presentation comprises a broad constellation (...) of symptoms and deficits, involving sensory, motor, and autonomic nerve fibres, and multiple organ systems. Diabetic peripheral neuropathy is the most common chronic complication of diabetes, characterised by the presence of peripheral nerve dysfunction, diagnosed after the exclusion of other causes. Pain is the outstanding complaint in most patients, but many patients are completely asymptomatic. Treatment has traditionally focused on control of hyperglycaemia as a means of slowing progression

2018 BMJ Best Practice

2. Aptiva for painful diabetic neuropathy

Aptiva for painful diabetic neuropathy Aptiva for painful diabetic neuropath Aptiva for painful diabetic neuropathy y Medtech innovation briefing Published: 13 September 2017 nice.org.uk/guidance/mib119 pathways Summary Summary The technology technology described in this briefing is Aptiva. It uses a frequency rhythmic electrical modulation system (FREMS) to treat painful diabetic neuropathy. The inno innovativ vative aspect e aspect of the technology is that it is designed to be a non-drug (...) option for treating painful diabetic neuropathy, with a novel mechanism of action. The intended place in ther place in therap apy y is uncertain. It could be used in addition to, or in place of, current drug treatment options. The main points from the e main points from the evidence vidence summarised in this briefing are from 4 non-UK-based studies, consisting of 1 randomised controlled trial, 2 randomised double-blind crossover studies and 1 case–control study. The studies include 151 adult

2017 National Institute for Health and Clinical Excellence - Advice

4. Neuropad for detecting preclinical diabetic peripheral neuropathy

Neuropad for detecting preclinical diabetic peripheral neuropathy Neuropad for detecting preclinical Neuropad for detecting preclinical diabetic peripher diabetic peripheral neuropath al neuropathy y Medical technologies guidance Published: 10 September 2018 nice.org.uk/guidance/mtg38 © NICE 2019. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and-conditions#notice-of- rights).Y Y our responsibility our responsibility This guidance represents the view of NICE (...) possible. Neuropad for detecting preclinical diabetic peripheral neuropathy (MTG38) © NICE 2019. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 2 of 14Contents Contents 1 Recommendations 4 2 The technology 5 Description of the technology 5 Current management 5 3 Evidence 7 Summary of clinical evidence 7 EAC's analysis of the clinical evidence 7 Summary of economic evidence 7 EAC's analysis of the economic evidence 8 4 Committee

2018 National Institute for Health and Clinical Excellence - Medical technologies

5. Preventing complications and treating symptoms of diabetic peripheral neuropathy

Preventing complications and treating symptoms of diabetic peripheral neuropathy Preventing complications and treating symptoms of diabetic peripheral neuropathy Preventing complications and treating symptoms of diabetic peripheral neuropathy Dy SM, Bennett WL, Sharma R, Zhang A, Waldfogel JM, Nesbit SA, Yeh H, Chelladurai Y, Feldman D, Wilson LM, Robinson KA Record Status This is a bibliographic record of a published health technology assessment. No evaluation of the quality of this assessment (...) has been made for the HTA database. Citation Dy SM, Bennett WL, Sharma R, Zhang A, Waldfogel JM, Nesbit SA, Yeh H, Chelladurai Y, Feldman D, Wilson LM, Robinson KA. Preventing complications and treating symptoms of diabetic peripheral neuropathy. Rockville: Agency for Healthcare Research and Quality (AHRQ). Comparative Effectiveness Review No. 187. 2017 Authors' objectives To assess benefits and harms of interventions for preventing diabetic peripheral neuropathy (DPN) complications and treatment

2017 Health Technology Assessment (HTA) Database.

6. Ameliorative Effects Of N-Acetylcysteine As Adjunct Therapy On Symptoms Of Painful Diabetic Neuropathy Full Text available with Trip Pro

Ameliorative Effects Of N-Acetylcysteine As Adjunct Therapy On Symptoms Of Painful Diabetic Neuropathy Painful diabetic neuropathy (PDN) is a variant of diabetic peripheral neuropathy which is highly prevalent and distressing in diabetic patients. Despite its high burden, the optimal treatment of PDN has remained a clinical challenge. To explain the emergence and maintenance of PDN, increasing attention has been focused on dimensions of inflammation and oxidative toxic stress (OTS). Accordingly (...) a time period of 8 weeks, adjuvant NAC is more efficacious in improving neuropathic pain associated with diabetic neuropathy than placebo. Ameliorative effects of NAC on OTS biomarkers demonstrated that NAC may alleviate painful symptoms of diabetic neuropathy, at least in part by its antioxidant effects.© 2019 Heidari et al.

2020 EvidenceUpdates

7. Prevention of Plantar Ulcers in People With Diabetic Peripheral Neuropathy Using Pressure-Sensing Shoe Insoles

Prevention of Plantar Ulcers in People With Diabetic Peripheral Neuropathy Using Pressure-Sensing Shoe Insoles Prevention of Plantar Ulcers in People With Diabetic Peripheral Neuropathy Using Pressure-Sensing Shoe Insoles | CADTH.ca CADTH Document Viewer Prevention of Plantar Ulcers in People With Diabetic Peripheral Neuropathy Using Pressure-Sensing Shoe Insoles Table of Contents Search this document Prevention of Plantar Ulcers in People With Diabetic Peripheral Neuropathy Using Pressure (...) -Sensing Shoe Insoles June 2017 Summary The SurroSense Rx system is a set of pressure-sensing shoe insoles that connect wirelessly to a proprietary smartwatch and is intended for people with diabetes who have mild to moderate sensory loss associated with diabetic peripheral neuropathy, or nerve damage. By providing real-time alerts about plantar pressure distributions, or the area of pressure between the foot and the surface supporting it, users of the SurroSense Rx system can alter their activities

2017 CADTH - Issues in Emerging Health Technologies

8. Prevention of Plantar Ulcers in People With Diabetic Peripheral Neuropathy Using Pressure-Sensing Shoe Insoles

Prevention of Plantar Ulcers in People With Diabetic Peripheral Neuropathy Using Pressure-Sensing Shoe Insoles Prevention of Plantar Ulcers in People With Diabetic Peripheral Neuropathy Using Pressure-Sensing Shoe Insoles | CADTH.ca CADTH Document Viewer Prevention of Plantar Ulcers in People With Diabetic Peripheral Neuropathy Using Pressure-Sensing Shoe Insoles Table of Contents Search this document Prevention of Plantar Ulcers in People With Diabetic Peripheral Neuropathy Using Pressure (...) -Sensing Shoe Insoles June 2017 Summary The SurroSense Rx system is a set of pressure-sensing shoe insoles that connect wirelessly to a proprietary smartwatch and is intended for people with diabetes who have mild to moderate sensory loss associated with diabetic peripheral neuropathy, or nerve damage. By providing real-time alerts about plantar pressure distributions, or the area of pressure between the foot and the surface supporting it, users of the SurroSense Rx system can alter their activities

2017 CADTH - Issues in Emerging Health Technologies

9. Automated symptom and treatment side effect monitoring for improved quality of life among adults with diabetic peripheral neuropathy in primary care: a pragmatic, cluster, randomized, controlled trial Full Text available with Trip Pro

Automated symptom and treatment side effect monitoring for improved quality of life among adults with diabetic peripheral neuropathy in primary care: a pragmatic, cluster, randomized, controlled trial To evaluate the effectiveness of automated symptom and side effect monitoring on quality of life among individuals with symptomatic diabetic peripheral neuropathy.We conducted a pragmatic, cluster randomized controlled trial (July 2014 to July 2016) within a large healthcare system. We randomized (...) 1834 primary care physicians and prospectively recruited from their lists 1270 individuals with neuropathy who were newly prescribed medications for their symptoms. Intervention participants received automated telephone-based symptom and side effect monitoring with physician feedback over 6 months. The control group received usual care plus three non-interactive diabetes educational calls. Our primary outcomes were quality of life (EQ-5D) and select symptoms (e.g. pain) measured 4-8 weeks after

2019 EvidenceUpdates

10. triterpenes for diabetic neuropathy: a randomized, double-blind, placebo-controlled, pilot clinical study. (Abstract)

triterpenes for diabetic neuropathy: a randomized, double-blind, placebo-controlled, pilot clinical study. Diabetic neuropathy (DN), a common complication of diabetes mellitus, results from hyperglycemia, poor microcirculation and attendant nerve damage. Currently available treatments relieve symptoms, but do not modify the neurodegeneration underlying DN. Centella asiatica (CA) triterpenes improved microcirculation in earlier clinical studies, and showed neurotropic effects in preclinical (...) models suggesting a potential disease modifying effect in DN. This 52-week, randomized, double-blind, placebo-controlled trial examined the effects of CAST, a standardized CA extract containing triterpenes, on neuropathy symptoms in Type II diabetic subjects.The study enrolled patients with a history of Type II diabetes, with evidence of symptomatic symmetrical DN with total symptom score (TSS) ≥4, and stable HbA1c level <8. The primary outcome measure was TSS, which assessed intensity and frequency

2018 Esperienze dermatologiche Controlled trial quality: predicted high

11. Greater corneal nerve loss at the inferior whorl is related to the presence of diabetic neuropathy and painful diabetic neuropathy Full Text available with Trip Pro

Greater corneal nerve loss at the inferior whorl is related to the presence of diabetic neuropathy and painful diabetic neuropathy We assessed whether a measure of more distal corneal nerve fibre loss at the inferior whorl(IW) region is better than proximal measures of central corneal nerve damage in relation to the diagnosis of diabetic peripheral neuropathy(DPN), painful DPN and quality of life(QoL). Participants underwent detailed assessment of neuropathy, QoL using the SF36 questionnaire (...) DPN compared to controls. IWL(p = 0.001), ANFL(p = 0.01) and TNFL(p = 0.02) were significantly lower in patients with painful compared to painless DPN. The VAS score correlated with IWL(r = -0.36, P = 0.004), ANFL(r = -0.32, P = 0.01) and TNFL(r = -0.32, P = 0.01) and QoL correlated with CNFL(r = 0.35, P = 0.01) and IWL(r = 0.4, P = 0.004). Corneal nerve fibre damage is more prominent at the IW, lower in patients with painful compared to painless neuropathy and relates to their QoL. IWL may

2018 Scientific reports

12. Feasibility and effectiveness of electrochemical dermal conductance measurement for the screening of diabetic neuropathy in primary care. DECODING Study (Dermal Electrochemical Conductance in Diabetic Neuropathy). Rationale and design. Full Text available with Trip Pro

Feasibility and effectiveness of electrochemical dermal conductance measurement for the screening of diabetic neuropathy in primary care. DECODING Study (Dermal Electrochemical Conductance in Diabetic Neuropathy). Rationale and design. Diabetes mellitus is the leading cause of polyneuropathy in the Western world. Diabetic neuropathy is a frequent complication of diabetes and may have great clinical transcendence due to pain and possible ulceration of the lower extremities. It is also a relevant (...) cause of morbidity and mortality in patients with diabetes. Although the cause of polyneuropathy in patients with diabetes is only partially known, it has been associated with chronic hyperglycemia suggesting the possible etiopathogenic implication of advanced glycosylation end products. The strategy of choice in the medical management of diabetic neuropathy is early detection since glycaemic control and the use of certain drugs may prevent or slow the development of this disease. Diabetic

2018 Medicine

13. Administration of CORM-2 inhibits diabetic neuropathy but does not reduce dyslipidemia in diabetic mice. Full Text available with Trip Pro

Administration of CORM-2 inhibits diabetic neuropathy but does not reduce dyslipidemia in diabetic mice. The antinociceptive effects of the carbon monoxide-releasing molecule tricarbonyldichlororuthenium (II) dimer (CORM-2) during chronic pain are well documented, but most of its possible side-effects remain poorly understood. In this work, we examine the impact of CORM-2 treatment on the lipoprotein profile and two main atheroprotective functions attributed to high-density lipoprotein (HDL (...) ) in a mouse model of type 1 diabetes while analyzing the effect of this drug on diabetic neuropathy. Streptozotocin (Stz)-induced diabetic mice treated with CORM-2 (Stz-CORM-2) or vehicle (Stz-vehicle) were used to evaluate the effect of this drug on the modulation of painful diabetic neuropathy using nociceptive behavioral tests. Plasma and tissue samples were used for chemical and functional analyses, as appropriate. Two main antiatherogenic properties of HDL, i.e., the ability of HDL to protect low

2018 PLoS ONE

14. Functional magnetic resonance imaging reveals differences in brain activation in response to thermal stimuli in diabetic patients with and without diabetic peripheral neuropathy. Full Text available with Trip Pro

Functional magnetic resonance imaging reveals differences in brain activation in response to thermal stimuli in diabetic patients with and without diabetic peripheral neuropathy. Diabetes affects both the peripheral and central nervous systems. The aim of this study was to explore the changes in brain activity in response to thermal stimuli in diabetic patients with and without diabetic peripheral neuropathy (DPN) using functional magnetic resonance imaging (fMRI).A total of 36 right-handed (...) caudate nucleus, frontal gyrus, and cingulate cortex), but also in the cognition-related cerebral areas (right temporal lobe, left hippocampus, and left fusiform gyrus). Activation of vermis 1-3 was greater in NDPN patients than in HV in response to 0°C stimulation.fMRI may be useful for the early detection of central nervous system impairment caused by DPN. Our results indicate that central nervous system impairment related to diabetic neuropathy may not be limited to motion- and sensation-related

2018 PLoS ONE

15. Correction: Using time series analysis approaches for improved prediction of pain outcomes in subgroups of patients with painful diabetic peripheral neuropathy. Full Text available with Trip Pro

Correction: Using time series analysis approaches for improved prediction of pain outcomes in subgroups of patients with painful diabetic peripheral neuropathy. [This corrects the article DOI: 10.1371/journal.pone.0207120.].

2019 PLoS ONE

16. Evaluation of combined radiofrequency and chemical blockade of multi-segmental lumbar sympathetic ganglia in painful diabetic peripheral neuropathy Full Text available with Trip Pro

Evaluation of combined radiofrequency and chemical blockade of multi-segmental lumbar sympathetic ganglia in painful diabetic peripheral neuropathy Painful diabetic peripheral neuropathy (PDPN) is one of the most common complications of diabetes. PDPN seriously affects the quality of life and is difficult to treat; therefore, there is an urgent need for new cost-effective treatment methods for PDPN.To investigate the efficacy and safety of radiofrequency thermocoagulation (RF) combined

2018 EvidenceUpdates Controlled trial quality: uncertain

17. Efficacy of Botulinum Toxin A for Treating Cramps in Diabetic Neuropathy (Abstract)

Efficacy of Botulinum Toxin A for Treating Cramps in Diabetic Neuropathy Muscle cramps occur in >50% of diabetic patients and reduce the quality of life. No effective treatment is available. We evaluated the clinical effectiveness of botulinum toxin A (BTX-A) injections for treating cramps in diabetic patients with neuropathy.This single-center, double-blind, placebo-controlled perspective study investigated the efficacy and safety of BTX-A intramuscular injection for treating calf or foot (...) cramps refractory to common pharmacological drugs. Fifty diabetic patients with peripheral neuropathy and cramps were randomly assigned to 2 matched groups. BTX-A (100 or 30 units) or saline was injected on each side into the gastrocnemius or the small flexor foot muscles. Changes in pain intensity (primary outcome) and cramp frequency were evaluated over the course of 20 weeks after BTX-A administration. Cramp interference in daily life and the electrophysiological cramp threshold frequency were

2018 EvidenceUpdates

18. Type 1 diabetes-associated cognitive impairment and diabetic peripheral neuropathy in Chinese adults: results from a prospective cross-sectional study. Full Text available with Trip Pro

Type 1 diabetes-associated cognitive impairment and diabetic peripheral neuropathy in Chinese adults: results from a prospective cross-sectional study. To compare neurocognitive functioning of Type 1 diabetic mellitus (T1DM) and healthy adults, and explore risk factors of cognitive dysfunction of T1DM patients, especially the association between cognitive impairment and diabetic peripheral neuropathy (DPN).Seventy T1DM (age: 32.17 ± 9.57 yr., duration: 8.99 ± 7.02 yr) patients and 48 healthy (...) , as a diabetic complication, was identified to be associated with cognitive impairments.

2019 BMC Endocrine Disorders

19. Diabetic neuropathies influence recovery from hip-fracture surgery in older persons with diabetes. (Abstract)

Diabetic neuropathies influence recovery from hip-fracture surgery in older persons with diabetes. To explore the impact of diabetic peripheral neuropathy (DPN) on the recovery of older persons with diabetes mellitus (DM) after hip-fracture surgery.Secondary data for this study came from a clinical trial on the effectiveness of a DM-specific care model for 176 older persons (age ≥ 60) with DM over 2 years following hip-fracture surgery at a medical center in Taiwan. In the original trial (...) , the experimental group (n = 88) received DM-specific care comprising diabetes care plus subacute care, and the control group (n = 88) received only usual care.DPN was assessed using the Michigan Neuropathy Screening Instrument. Outcomes of self-care ability in activities of daily living (ADL), health-related quality of life (HRQoL), and depressive symptoms were assessed 1, 3, 6, 12, 18, 24 months following hospital discharge using the Chinese Barthel Index and Chinese-version instrumental ADL (IADL) scale

2019 Experimental Gerontology Controlled trial quality: uncertain

20. A cardiac risk score based on sudomotor function to evaluate cardiovascular autonomic neuropathy in asymptomatic Chinese patients with diabetes mellitus. Full Text available with Trip Pro

A cardiac risk score based on sudomotor function to evaluate cardiovascular autonomic neuropathy in asymptomatic Chinese patients with diabetes mellitus. Cardiac autonomic neuropathy is a common but always overlooked. More convenient diagnostic methods are needed.Cardiac autonomic neuropathy risk score evaluated by SUDOSCAN has a fine diagnostic efficacy detecting cardiac autonomic neuropathy.This is a cross-sectional study among patients with diabetes mellitus. Subjects undertook SUDOSCAN (...) tests and cardiac autonomic reflex tests, including heart rate variability due to Valsalva maneuver, heart rate response due to deep breathing and heart rate response due to standing up. Presenting 2 abnormal results was defined as cardiac autonomic neuropathy.Subjects with cardiac autonomic neuropathy has significantly higher cardiac autonomic neuropathy risk score (32.88±1.60 vs 27.64±1.24,P = 0.010). Cardiac autonomic neuropathy risk score was correlated significantly with the heart rate response

2018 PLoS ONE

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