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Diabetic Neuropathy Testing

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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

and a significant increase was observed after FREMS therapy in those tested. These improvements persisted up to the final follow-up at 4 months. No significant differences were observed after placebo treatment. At 4-month follow-up, there were significant improvements in quality of life (SF-36). Strengths and limitations Randomised double-blind design. Funded in part by a research grant from Lorenz Biotech (the original manufacturer). Aptiva for painful diabetic neuropathy (MIB119) © NICE 2018. All rights (...) 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

2017 National Institute for Health and Clinical Excellence - Advice

3. Neuropad for detecting preclinical diabetic peripheral neuropathy

Neuropad to detect preclinical diabetic peripheral neuropathy is not supported by the evidence. Neuropad detects sub-normal sweating in patients with diabetes but the clinical importance of this in current NHS care pathways is poorly defined. There is insufficient evidence to support the use of Neuropad in patients in whom 10 g monofilament testing for diabetic peripheral neuropathy is not possible. 1.2 Cost modelling is uncertain because of the limited clinical-effectiveness evidence. Using Neuropad (...) instead of 10 g monofilament testing would likely increase costs because Neuropad has a lower specificity for detecting diabetic peripheral neuropathy. Further research is needed on the benefits and consequences of detecting preclinical diabetic peripheral neuropathy. 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 4 of 142 2 The technology

2018 National Institute for Health and Clinical Excellence - Medical technologies

4. VibraTip for testing vibration perception to detect diabetic peripheral neuropathy

VibraTip for testing vibration perception to detect diabetic peripheral neuropathy Vibr VibraTip for testing vibr aTip for testing vibration perception ation perception to detect diabetic peripher to detect diabetic peripheral neuropath al neuropathy y Medical technologies guidance Published: 31 December 2014 nice.org.uk/guidance/mtg22 © 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 (...) of implementing NICE recommendations wherever possible. VibraTip for testing vibration perception to detect diabetic peripheral neuropathy (MTG22) © NICE 2019. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 2 of 27Contents Contents 1 Recommendations 4 2 The technology 5 Description of the technology 5 Current management 6 3 Clinical evidence 7 Summary of clinical evidence 7 4 NHS considerations 13 System impact 13 5 Cost considerations

2015 National Institute for Health and Clinical Excellence - Medical technologies

5. The Necessity of the Simple Tests for Diabetic Peripheral Neuropathy in Type 2 Diabetes Mellitus Patients without Neuropathic Symptoms in Clinical Practice Full Text available with Trip Pro

The Necessity of the Simple Tests for Diabetic Peripheral Neuropathy in Type 2 Diabetes Mellitus Patients without Neuropathic Symptoms in Clinical Practice Early recognition and appropriate management of diabetic peripheral polyneuropathy (DPNP) is important. We evaluated the necessity of simple, non-invasive tests for DPNP detection in clinical practice. We enrolled 136 randomly-chosen patients with type 2 diabetes mellitus and examined them with the 10-g Semmes-Weinstein monofilament (...) examination, the 128-Hz tuning-fork, ankle-reflex, and pinprick tests; the Total Symptom Score and the 15-item self-administered questionnaire of the Michigan Neuropathy Screening Instrument. Among 136 patients, 48 had subjective neuropathic symptoms and 88 did not. The abnormal-response rates varied depending on the methods used according to the presence of subjective neuropathic symptoms (18.8% vs. 5.7%, P<0.05; 58.3% vs. 28.4%, P<0.005; 81.3% vs. 54.5%, P<0.005; 12.5% vs. 5.7%, P=0.195; 41.7% vs. 2.3

2018 Diabetes & metabolism journal

6. 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

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. Easier operation and similar power of 10 g monofilament test for screening diabetic peripheral neuropathy Full Text available with Trip Pro

Easier operation and similar power of 10 g monofilament test for screening diabetic peripheral neuropathy Objective The 10 g Semmes-Weinstein monofilament evaluation (SWME) of 4 sites on each foot is recommended for distal symmetric polyneuropathy screening and diagnosis. A similar method has been proposed to diagnose 'high-risk' (for ulceration) feet, using 3 sites per foot. This study compared the effectiveness of SWME for testing 3, 4 and 10 sites per foot to identify patients with diabetic (...) neuropathy. Methods We included 3497 subjects in a SWME of 10 sites; records from the 10-site SWME were used for a SWME of 3 and 4 sites. Neuropathy symptom scores and neuropathy deficit scores were evaluated to identify patients with diabetic peripheral neuropathy. Results The sensitivities of the 10 g SWME for 3, 4 and 10 sites were 17.8%, 19.0% and 22.4%, respectively. The Kappa coefficients for the SWME tests of 3, 4 and 10 sites were high (range: 0.78-0.93). Conclusions There were no significant

2018 The Journal of international medical research

9. Comparing the Diagnostic Accuracy of Simple Tests to Screen for Diabetic Peripheral Neuropathy: Protocol for a Cross-Sectional Study Full Text available with Trip Pro

Comparing the Diagnostic Accuracy of Simple Tests to Screen for Diabetic Peripheral Neuropathy: Protocol for a Cross-Sectional Study Various tests are used to detect diabetic peripheral neuropathy by assessing sense perception in the feet. Tests vary in terms of time and resources required. Simple tests are those that can be conducted quickly and easily in primary care without laboratory equipment. There are some limitations to these simple tests, an example being the variable amplitude (...) of the 128 Hz tuning fork. A new test, VibraTip (McCallan Medical, UK), might be a valuable alternative as it emits a consistent amplitude and may offer improved diagnostic accuracy.The aims of this study are to estimate the diagnostic accuracy of the VibraTip device for diabetic peripheral neuropathy against the reference standard of sural nerve conduction velocity measurement, and to assess whether the VibraTip offers superior diagnostic accuracy to other routine tests based on vibration or touch.The

2018 JMIR Research Protocols

10. 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

) as a screening test for the diagnosis of diabetic neuropathy in patients in primary care. (...) 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

2018 Medicine

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

) 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 (...) 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

2018 PLoS ONE

12. Combination of Ewing test, heart rate variability, and heart rate turbulence analysis for early diagnosis of diabetic cardiac autonomic neuropathy. Full Text available with Trip Pro

Combination of Ewing test, heart rate variability, and heart rate turbulence analysis for early diagnosis of diabetic cardiac autonomic neuropathy. The aim of this study was to compare and analyze Ewing test, heart rate variability (HRV), and heart rate turbulence (HRT) in the diagnosis of cardiac autonomic neuropathy (CAN) in diabetic patients.Ninety diabetic patients (age 18-78) and 20 nondiabetic control subjects were studied. Standard Ewing test and 24-hour Holter was performed in all (...) participants to evaluate CAN. Patients with Ewing score ≥2 were classified as CAN+.The rate of CAN+ in diabetic patients [44.4% (40/90)] was higher than that in the controls [5% (1/20)] (P < .05). Using the HRV analysis and HRT analysis, rates of CAN+ in diabetic patients were 56.67% (51/90) and 52.22% (47/90), respectively. SD of all normal-to-normal (NN) intervals (SDNN), SD of the average NN intervals calculated over 5-minute periods of the entire recording (SDANN), low frequency power (LF

2017 Medicine

13. 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

14. The association of metformin use with vitamin B12 deficiency and peripheral neuropathy in Saudi individuals with type 2 diabetes mellitus. Full Text available with Trip Pro

The association of metformin use with vitamin B12 deficiency and peripheral neuropathy in Saudi individuals with type 2 diabetes mellitus. To compare the prevalence of vitamin B12 deficiency and peripheral neuropathy between two groups of type 2 diabetes mellitus (T2DM) patients treated with or without metformin, and to determine factors associated with vitamin B12 deficiency therapy and dietary intake of vitamin B12.In this retrospective study, we recruited 412 individuals with T2DM: 319 (...) taking metformin, and 93 non-metformin users. Demographics, dietary assessment for vitamin B12 intakes, and medical history were collected. Participants were assessed for peripheral neuropathy. Blood specimens were collected and checked for serum vitamin B12 levels. The differences between the two groups were analyzed using an independent t-test for continuous data, and the Chi-squared or Fisher's exact test was used for categorical data. The relationship of vitamin B12 deficiency with demographics

2018 PLoS ONE

15. The prevalence of cardiovascular autonomic neuropathy and its influence on post induction hemodynamic variables in patients with and without diabetes; A prospective cohort study. Full Text available with Trip Pro

diabetes undergoing surgery. We further studied its relation to changes in post-induction hemodynamic variables.We prospectively included 82 adult patients, 55 with DM, 27 without DM, scheduled for major abdominal or cardiac surgery. Patients performed four autonomic function tests on the day before surgery. Primary outcomes were the prevalence of CAN and the relation between CAN and severe post-induction hypotension, defined as mean arterial pressure (MAP) < 50 mmHg or ≥ 50% decrease from baseline (...) The prevalence of cardiovascular autonomic neuropathy and its influence on post induction hemodynamic variables in patients with and without diabetes; A prospective cohort study. Cardiovascular autonomic neuropathy (CAN) is a known complication of diabetes, but is also diagnosed in patients without diabetes. CAN may be related to perioperative hemodynamic instability. Our objective was to investigate if patients with diabetes would have a higher prevalence of CAN compared to patients without

2018 PLoS ONE

16. Mediators and moderators of change in mindfulness-based stress reduction for painful diabetic peripheral neuropathy. (Abstract)

Mediators and moderators of change in mindfulness-based stress reduction for painful diabetic peripheral neuropathy. Painful diabetic peripheral neuropathy (PDPN) is a chronic pain condition with modest response to pharmacotherapy. Participation in mindfulness-based stress reduction (MBSR) leads to improvements in pain-related outcomes but the mechanisms of change are unknown. The present study examined the mediators and moderators of change in 62 patients with PDPN who participated (...) in a randomized controlled trial comparing MBSR to waitlist. Changes in mindfulness and pain catastrophizing were tested simultaneously as mediators. Increased mindfulness mediated the association between participation in MBSR and improved pain severity, pain interference, and the physical component of health-related quality of life (HRQoL) 3 months later. The mediation effect of pain catastrophizing was not significant. Linear moderated trends were also found. Post-hoc moderated mediation analyses suggested

2019 Journal of behavioral medicine Controlled trial quality: uncertain

17. Comparison of topical capsaicin and topical turpentine Oil for treatment of painful diabetic neuropathy. (Abstract)

Comparison of topical capsaicin and topical turpentine Oil for treatment of painful diabetic neuropathy. Diabetes Mellitus is a pandemic of the modern era owing to our rapidly deteriorating lifestyle. Painful diabetic neuropathy is one of the costliest and disabling complications of diabetes mellitus. No single treatment exists to prevent or reverse neuropathic changes or to provide total pain relief. Topical Capsaicin and Turpentine Oil are found to be effective in treatment of painful (...) diabetic neuropathy.Patients of either gender with ages between 18 and 70 years having painful diabetic neuropathy already taking one oral drug for painful neuropathy and treatment for diabetes mellitus and an HbA1C less than 8.5% were included while Pregnant or lactating mothers, patients with chronic liver disease and patients with renal insufficiency (creatinine >3.0 mg/dl) and peripheral arterial disease were excluded from study. Patients were randomly divided into two groups (A & B) using computer

2019 Journal of Ayub Medical College, Abbottabad : JAMC Controlled trial quality: uncertain

18. Combined exercise and visual gaze training improves stepping accuracy in people with diabetic peripheral neuropathy. Full Text available with Trip Pro

tests, 8 patients with DPN, 11 patients with diabetes but no neuropathy (D) and 10 healthy controls (C). Accuracy of stepping was measured pre- and post-intervention as participants walked along an irregularly arranged stepping walkway. Participants attended a one-hour session, once a week, for sixteen weeks, involving high-load resistance exercise and visual-motor training.Patients who took part in the intervention improved stepping accuracy (DPN: +45%; D: +36%) (p < 0.05). The diabetic non (...) Combined exercise and visual gaze training improves stepping accuracy in people with diabetic peripheral neuropathy. Patients with diabetes and diabetic peripheral neuropathy (DPN) place their feet with less accuracy whilst walking, which may contribute to the increased falls-risk. This study examines the effects of a multi-faceted intervention on stepping accuracy, in patients with diabetes and DPN.Forty participants began the study, of which 29 completed both the pre and post-intervention

2019 Journal of diabetes and its complications Controlled trial quality: uncertain

19. Augmented corneal nerve fiber branching in painful compared to painless diabetic neuropathy. (Abstract)

Augmented corneal nerve fiber branching in painful compared to painless diabetic neuropathy. It remains enigmatic which factors determine the development of diabetic sensorimotor polyneuropathy (DSPN) as a painful or painless entity.We hypothesized that corneal nerve pathology could be more pronounced in painful DSPN indicating predominant small nerve fiber damage.In this cross-sectional study we assessed 53 patients with painful DSPN, 63 with painless DSPN, and 46 glucose tolerant volunteers (...) by corneal confocal microscopy (CCM), nerve conduction (NC), and quantitative sensory testing. DSPN was diagnosed according to modified Toronto Consensus criteria. A cutoff at 4 points on the 11-point numerical rating scale was used to differentiate between painful and painless DSPN.After adjustment for age, sex, BMI, and smoking, corneal nerve fiber density (CNFD), corneal nerve fiber length (CNFL), and corneal nerve branch density (CNBD) were reduced both in patients with painful and painless DSPN

2019 Journal of Clinical Endocrinology and Metabolism

20. Impaired Amino Acid and TCA Metabolism and Cardiovascular Autonomic Neuropathy Progression in Type 1 Diabetes. Full Text available with Trip Pro

Impaired Amino Acid and TCA Metabolism and Cardiovascular Autonomic Neuropathy Progression in Type 1 Diabetes. While diabetes is characterized by hyperglycemia, nutrient metabolic pathways like amino acid and tricarboxylic acid (TCA) cycle are also profoundly perturbed. As glycemic control alone does not prevent complications, we hypothesized that these metabolic disruptions are responsible for the development and progression of diabetic cardiovascular autonomic neuropathy (CAN). We performed (...) standardized cardiovascular autonomic reflex tests and targeted fasting plasma metabolomic analysis of amino acids and TCA cycle intermediates in subjects with type 1 diabetes and healthy control subjects followed for 3 years. Forty-seven participants with type 1 diabetes (60% female and mean ± SD age 35 ± 13 years, diabetes duration 13 ± 7 years, and HbA1c 7.9 ± 1.2%) had lower fumarate levels and higher threonine, serine, proline, asparagine, aspartic acid, phenylalanine, tyrosine, and histidine levels

2019 Diabetes

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