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Diabetic sensorimotor polyneuropathy (DSPN) is encountered in approximately one-third of people with diabetes. This, in turn, might markedly impoverish their quality of life, mainly owing to neuropathic pain and foot ulcerations. Painful DSPN might be as frequent as 25% in diabetes patients. Symptoms as a result of DSPN typically comprise pain, paresthesia and numbness in the distal lower limbs. Asymptomatic DSPN might reach 50% among patients with this condition. Unfortunately, DSPN is still not adequately diagnosed and treated. Its management has three priorities: (i) lifestyle improvement, near-normoglycemia and multifactorial cardiovascular risk intervention; (ii) pathogenesis-oriented pharmacotherapy; and (iii) symptomatic alleviation of pain. Intensive diabetes therapy showed evidence for favorable effects on the incidence and deterioration of DSPN in type 1 diabetes, but not type 2 diabetes. Among pathogenesis-oriented treatments, alipoic acid, actovegin, benfotiamine and epalrestat are currently authorized to treat DSPN in several countries. Symptomatic therapy uses analgesics, notably antidepressants, opioids and anticonvulsants, reducing pain by ≥50% in approximately 50% of individuals, but might be limited, particularly by central nervous system-related adverse events. Local treatment with the capsaicin 8% patch might offer an alternative. In addition to pain relief, therapy should improve sleep, mobility and quality of life. In conclusion, multimodal treatment of DSPN should consider the individual risk profile, pathogenetic treatment and pain management using pharmacotherapy (combinations, if required), as well as non-pharmacological options.

Overall, the literature supports beneficial pleotropic effects of statin use in contrast-induced nephropathy, head injury, Alzheimer's and Parkinson's disease, nuclear cataract, prostate cancer, infection management, and spinal cord injury. Further investigation is warranted, and randomized clinical trials are needed to confirm the clinical utility suggested by the reported studies included in this meta-analysis.

Aims/hypothesis We estimated the current prevalence of type 2 diabetes in the Vietnamese population and developed simple diagnostic models for identifying individuals at high risk of undiagnosed type 2 diabetes. Methods The study was designed as a cross-sectional investigation with 721 men and 1,421 women, who were aged between 30 and 72 years and were randomly sampled from Ho Chi Minh City (formerly Saigon) in Vietnam. A 75 g oral glucose tolerance test to assess fasting and 2 h plasma glucose concentrations were determined for each individual. The ADA diagnostic criteria were used to determine the prevalence of type 2 diabetes. WHR and blood pressure were also measured in all individuals.Results The prevalence of type 2 diabetes was 10.8% in men and 11.7% in women. Higher WHR and blood pressure were independently associated with a greater risk of type 2 diabetes. Compared with participants without central obesity and hypertension, the odds of diabetes was increased by 6.4-fold (95% CI 3.2-13.0) in men and 4.1-fold (2.2-7.6) in women with central obesity and hypertension. Two nomograms were developed that help identify men and women at high risk of type 2 diabetes. Conclusions/interpretation The current prevalence of type 2 diabetes in the Vietnamese population is high. Simple field measurements such as waist-to-hip ratio and systolic blood pressure can identify individuals at high risk of undiagnosed type 2 diabetes.

Aims To assess diabetes care delivery and prevention of short-and long-term diabetes-related complications in patients with type 2 diabetes mellitus (T2DM) in Vietnam. Methods DiabCare Asia is an observational, non-interventional, cross-sectional study of hospital-based outpatient care for patients diagnosed with T2DM. Results A total of 1631 patients (mean age 62.7 years; 58.9% female) participated in the study. The percentage of patients with HbA1c < 7.0% (< 53 mmol/mol) was 36.1% and mean (standard deviation) HbA1c was 7.9 ± 1.8% (63 ± 19 mmol/mol). The proportion of patients using insulin was 40%, at a mean total daily dose of 35.4 U. Apart from dyslipidemia (81.2%) and hypertension (78.4%), the most common diabetes-related complications were peripheral neuropathy (37.9%) and eye complications (39.5%). Current insulin therapy was associated with peripheral vascular disease (odds ratio [OR] = 2.28 [95% confidence interval (CI) 1.68; 3.09]) and eye complications (OR = 1.70 [95% CI 1.37; 2.11]). Conclusion In this sample of patients with T2DM in Vietnam, the majority had poor glycemic and metabolic control. Concerted efforts are needed to optimize control and prevent complications in these patients. Trial registration: NCT02066766