General Approach to Diabetic Neuropathy

Bora Uzuner; Sertaç Ketenci; Ender Salbaş

doi:10.30565/medalanya.788960

Review

General Approach to Diabetic Neuropathy

Year 2020, Volume: 4 Issue: 3, 296 - 308, 29.10.2020

Bora Uzuner Sertaç Ketenci Ender Salbaş

https://doi.org/10.30565/medalanya.788960

Cited By: 2

Abstract

Diabetic neuropathy (DN) is the most common complication of diabetes mellitus. It causes microvascular and macrovascular damages and diagnosis can easily be overlooked by most physicians. Generally; the diagnosis of DN can be omitted by physicians dealing with diabetes treatment since it starts with non-specific findings, shows slow progression and can be confused with complaints in many diseases. It is estimated that there will be 578 million people diagnosed with DN in the world in 2030. Chronic hyperglycemia, microvascular insufficiency, oxidative and nitrosative stress, impaired neurotropism and autoimmunity are some of the factors that cause nerve destruction. Paresthesias such as tingling, burning, electrical shock-like sensations, numbness, throbbing, compression, pinpricks to the skin, complaints are the most common symptoms. There is no treatment for pathogenetic mechanisms in diabetic neuropathy that completely eliminates neuronal damage. The purposes of treatment is slowing down the progression of the disease, controlling the pain, preventing complications, quick and adequate treatment of occurred complications, maintaining the functional capacity of the patient. In this review, we aimed to comprehensively address the general approach to diabetic neuropathy, diagnosis and treatment.

Keywords

diabetes mellitus, neuropathic pain, neuropathy, diagnosis, treatment

References

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Diyabetik Nöropatiye Genel Yaklaşım

Year 2020, Volume: 4 Issue: 3, 296 - 308, 29.10.2020

Bora Uzuner Sertaç Ketenci Ender Salbaş

https://doi.org/10.30565/medalanya.788960

Cited By: 2

Abstract

Diyabetik nöropati (DN), diabetes mellitusun en yaygın komplikasyonudur. Mikro ve makrovasküler hasara neden olur ve çoğu hekim tanıyı kolaylıkla gözden kaçırabilir. Genel olarak; DN tanısı, spesifik olmayan bulgularla başladığı, yavaş ilerleme gösterdiği ve birçok hastalığa ait şikayetlerle karışabileceği için diyabet tedavisi ile uğraşan hekimler tarafından ihmal edilebilir. 2030 yılında dünyada 578 milyon kişinin DN tanısı alacağı tahmin edilmektedir. Kronik hiperglisemi, mikrovasküler yetmezlik, oksidatif ve nitrozatif stres, bozulmuş nörotropizm ve otoimmünite sinir harabiyetine neden olan faktörlerden bazılarıdır. Karıncalanma, yanma, elektrik çarpması benzeri hisler, uyuşma, zonklama, bası, deriye iğne batması gibi parestezik yakınmalar en sık görülen semptomlardır. Diyabetik nöropatide nöronal hasarı tamamen ortadan kaldıran patogenetik mekanizmaların tedavisi yoktur. Tedavinin amacı hastalığın ilerlemesini yavaşlatmak, ağrıyı kontrol altına almak, komplikasyonları önlemek, oluşan komplikasyonların hızlı ve yeterli tedavisi ve hastanın fonksiyonel kapasitesini korumaktır. Bu derlemede, diyabetik nöropati, tanı ve tedaviye genel yaklaşımı kapsamlı bir şekilde ele almayı amaçladık.

Keywords

diabetes mellitus, tanı, tedavi, nöropati, nöropatik ağrı

References

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2. Harding JL, Pavkov ME, Gregg EW. et al., Trends of Nontraumatic Lower-Extremity Amputation in End-Stage Renal Disease and Diabetes: United States, 2000-2015, Diabetes Care 2019;42(8):1430-1435. https://doi.org/10.2337/dc19-0296
3. Perez C, Latymer M, Almas M. et al., Does Duration of Neuropathic Pain Impact the Effectiveness of Pregabalin?, Pain Pract 2017;17(4):470-479. https://doi.org/10.1111/papr.12469
4. Vinik AI, Nevoret ML, Casellini C. et al., Diabetic neuropathy, Endocrinol Metab Clin North Am 2013;42(4):747-87. https://doi.org/10.1016/j.ecl.2013.06.001
5. Hasan R, Firwana B, Elraiyah T, et al., A systematic review and meta-analysis of glycemic control for the prevention of diabetic foot syndrome, J Vasc Surg 2016;63(2):22S-28S e1-2. https://doi.org/10.1016/j.jvs.2015.10.005
6. Barrett EJ, Liu Z, Khamaisi M., et al., Diabetic Microvascular Disease: An Endocrine Society Scientific Statement, J Clin Endocrinol Metab 2017;102(12):4343-4410. https://doi.org/10.1210/jc.2017-01922
7. Fisher VL, Tahrani AA. Cardiac autonomic neuropathy in patients with diabetes mellitus: current perspectives, Diabetes Metab Syndr Obes 2017;10:419-434. https://doi.org/10.2147/DMSO.S129797
8. Saeedi P, Petersohn I, Salpea P. et al., Global and regional diabetes prevalence estimates for 2019 and projections for 2030 and 2045: Results from the International Diabetes Federation Diabetes Atlas, 9(th) edition, Diabetes Res Clin Pract 2019;157:107843. https://doi.org/10.1016/j.diabres.2019.107843
9. Satman I, Yilmaz T, Sengul A. et al., Population-based study of diabetes and risk characteristics in Turkey: results of the turkish diabetes epidemiology study (TURDEP), Diabetes Care 2002;25(9):1551-6. https://doi.org/10.2337/diacare.25.9.1551
10. Erbas T, Ertas M, Yucel A. et al., Prevalence of peripheral neuropathy and painful peripheral neuropathy in Turkish diabetic patients, J Clin Neurophysiol 2011;28(1):51-5. https://doi.org/10.1097/WNP.0b013e3182051334
11. Thomas PK. Classification, differential diagnosis, and staging of diabetic peripheral neuropathy, Diabetes 1997;46(2): S54-7. https://doi.org/10.2337/diab.46.2.s54
12. Kazamel M, Dyck PJ. Sensory manifestations of diabetic neuropathies: anatomical and clinical correlations, Prosthet Orthot Int 2015;39(1):7-16. https://doi.org/10.1177/0309364614536764
13. Bodman MA, Varacallo M. Peripheral Diabetic Neuropathy, StatPearls, Treasure Island (FL), 2020. Internet Address: https://www.ncbi.nlm.nih.gov/pubmed/28723038
14. Vinik A, Casellini C, Nevoret ML. Diabetic Neuropathies. [Updated 2018 Feb 5]. In: Feingold KR, Anawalt B, Boyce A, et al., editors. Endotext [Internet]. South Dartmouth (MA): MDText.com, Inc.; 2000-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK279175/
15. Tesfaye S, Boulton AJ, Dyck PJ, et al., Diabetic neuropathies: update on definitions, diagnostic criteria, estimation of severity, and treatments, Diabetes Care 2010;33(10):2285-93. https://doi.org/10.2337/dc10-1303
16. Barsegian A, Lee J, Salifu MO, et al., Corneal Neuropathy: An Underrated Manifestation of Diabetes Mellitus, J Clin Endocrinol Diabetes 2018;2(1):JCED-111 https://doi.org/10.29011/JCED-111/100011
17. Erol K, Uğurlu H. Tip 2 Diyabetes Mellitus Tanılı Hastalarda El Komplikasyonları ve Klinik Verilerle İlişkisi, Ege Tıp Bilimleri Dergisi 2020;3(2):67-73. https://doi.org/10.33713/egetbd.769896
18. Bril V, Blanchette CM, Noone JM. et al., The dilemma of diabetes in chronic inflammatory demyelinating polyneuropathy, J Diabetes Complications 2016;30(7):1401-7. https://doi.org/10.1016/j.jdiacomp.2016.05.007
19. Fatehi F, Nafissi S, Basiri K., et al., Chronic inflammatory demyelinating polyneuropathy associated with diabetes mellitus, J Res Med Sci 2013;18(5):438-41. https://www.ncbi.nlm.nih.gov/pubmed/24174953
20. Nukada H. Ischemia and diabetic neuropathy, Handb Clin Neurol 2014;126:469-87. https://doi.org/10.1016/B978-0-444-53480-4.00023-0
21. Tan CY, Arumugam T, Razali SNO, et al., Nerve ultrasound can distinguish chronic inflammatory demyelinating polyneuropathy from demyelinating diabetic sensorimotor polyneuropathy, J Clin Neurosci 2018;57:198-201. https://doi.org/10.1016/j.jocn.2018.08.031
22. J.W. Albers, W.H. Herman, R. Pop-Busui, et al., Effect of prior intensive insulin treatment during the Diabetes Control and Complications Trial (DCCT) on peripheral neuropathy in type 1 diabetes during the Epidemiology of Diabetes Interventions and Complications (EDIC) Study, Diabetes Care 2010;33(5):1090-6. https://doi.org/10.2337/dc09-1941
23. Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). UK Prospective Diabetes Study (UKPDS) Group, Lancet 1998;352(9131):837-53. https://www.ncbi.nlm.nih.gov/pubmed/9742976
24. Group AC, Patel A, MacMahon S., et al., Intensive blood glucose control and vascular outcomes in patients with type 2 diabetes, N Engl J Med 2008;358(24):2560-72. https://doi.org/10.1056/NEJMoa0802987
25. Rodriguez-Gutierrez R, Gonzalez-Gonzalez JG, Zuniga-Hernandez JA, et al., Benefits and harms of intensive glycemic control in patients with type 2 diabetes, BMJ 2019;367: l5887. https://doi.org/10.1136/bmj.l5887
A. American Diabetes, 2. Classification and Diagnosis of Diabetes: Standards of Medical Care in Diabetes-2019, Diabetes Care 2019;42(Suppl 1):S13-S28. https://doi.org/10.2337/dc19-S002
26. Agathos E, Tentolouris A, Eleftheriadou I, et al., Effect of alpha-lipoic acid on symptoms and quality of life in patients with painful diabetic neuropathy, J Int Med Res 2018; 46(5): 1779-1790. https://doi.org/10.1177/0300060518756540
27. Roman-Pintos LM, Villegas-Rivera G, Rodriguez-Carrizalez AD, et al., Diabetic Polyneuropathy in Type 2 Diabetes Mellitus: Inflammation, Oxidative Stress, and Mitochondrial Function, J Diabetes Res 2016:3425617. https://doi.org/10.1155/2016/3425617
28. Oyenihi AB, Ayeleso AO, Mukwevho E, et al., Antioxidant strategies in the management of diabetic neuropathy, Biomed Res Int 2015;515042. https://doi.org/10.1155/2015/515042
29. Ruessmann HJ, A.N.D. German Society of out patient diabetes centres, Switching from pathogenetic treatment with alpha-lipoic acid to gabapentin and other analgesics in painful diabetic neuropathy: a real-world study in outpatients, J Diabetes Complications 2009;23(3): 174-7. https://doi.org/10.1016/j.jdiacomp.2008.02.002
30. Decroli E, Manaf A, Syahbuddin S, et al., The Correlation between Malondialdehyde and Nerve Growth Factor Serum Level with Diabetic Peripheral Neuropathy Score, Open Access Maced J Med Sci 2019;7(1): 103-106. https://doi.org/10.3889/oamjms.2019.029
31. Saboory E, Gholizadeh-Ghaleh Aziz S, Samadi M, et al., Exercise and insulin-like growth factor 1 supplementation improve angiogenesis and angiogenic cytokines in a rat model of diabetes- induced neuropathy, Exp Physiol 2020;105(5):783-792. https://doi.org/10.1113/EP088069
32. Rivard A, Silver M, Chen D, et al., Rescue of diabetes-related impairment of angiogenesis by intramuscular gene therapy with adeno-VEGF, Am J Pathol 1999;154(2):355-63. https://doi.org/10.1016/S0002-9440(10)65282-0
33. Vinik AI, Anandacoomaraswamy D, Ullal J, Antibodies to neuronal structures: innocent bystanders or neurotoxins?, Diabetes Care 2005;28(8):2067-72. https://doi.org/10.2337/diacare.28.8.2067
34. Moore RA, Derry S, Aldington D, et al., Amitriptyline for neuropathic pain in adults, Cochrane Database Syst Rev 2015;7:CD008242. https://doi.org/10.1002/14651858.CD008242.pub3
35. Gao Y, Ning G, Jia WP, et al., Duloxetine versus placebo in the treatment of patients with diabetic neuropathic pain in China, Chin Med J (Engl) 2010;123(22):3184-92. https://www.ncbi.nlm.nih.gov/pubmed/21163113
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Details

Primary Language	English
Subjects	Internal Diseases
Journal Section	Review
Authors	Bora Uzuner 0000-0001-9498-0289 Sertaç Ketenci 0000-0002-2950-8778 Ender Salbaş 0000-0001-9498-0289
Publication Date	October 29, 2020
Submission Date	September 1, 2020
Acceptance Date	September 7, 2020
Published in Issue	Year 2020 Volume: 4 Issue: 3

Cite

Vancouver	Uzuner B, Ketenci S, Salbaş E. General Approach to Diabetic Neuropathy. Acta Med. Alanya. 2020;4(3):296-308.

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