Assessment of pain and impact of care among patients with painful diabetic peripheral neuropathy

Schumacher, Christie; Glosner, Scott

doi:10.1331/japha.2014.13049

Cited by 12 publications

(9 citation statements)

References 17 publications

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“…Diabetic peripheral neuropathy (DPN) is one of the most frequent (approximately 50%) complications of type I and type II diabetes mellitus. Almost 10%–30% of diabetic patients develop neuropathic pain (DPNP), which shows abnormal pain sensations including hyperalgesia, allodynia, and hypoalgesia/hypoesthesia/numbness [ 6 , 7 , 8 , 9 , 10 ]. However, it remains elusive how the hypoalgesia is paradoxically accompanied with tonic and ongoing pain in diabetic patients.…”

Section: Introductionmentioning

confidence: 99%

Lysophosphatidic Acid Receptor 1- and 3-Mediated Hyperalgesia and Hypoalgesia in Diabetic Neuropathic Pain Models in Mice

Ueda

Neyama

Matsushita

2020

Cells

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Lysophosphatidic acid (LPA) signaling is known to play key roles in the initiation and maintenance of various chronic pain models. Here we examined whether LPA signaling is also involved in diabetes-induced abnormal pain behaviors. The high-fat diet (HFD) showing elevation of blood glucose levels and body weight caused thermal, mechanical hyperalgesia, hypersensitivity to 2000 or 250 Hz electrical-stimulation and hyposensitivity to 5 Hz stimulation to the paw in wild-type (WT) mice. These HFD-induced abnormal pain behaviors and body weight increase, but not elevated glucose levels were abolished in LPA1−/− and LPA3−/− mice. Repeated daily intrathecal (i.t.) treatments with LPA1/3 antagonist AM966 reversed these abnormal pain behaviors. Similar abnormal pain behaviors and their blockade by daily AM966 (i.t.) or twice daily Ki16425, another LPA1/3 antagonist was also observed in db/db mice which show high glucose levels and body weight. Furthermore, streptozotocin-induced similar abnormal pain behaviors, but not elevated glucose levels or body weight loss were abolished in LPA1−/− and LPA3−/− mice. These results suggest that LPA1 and LPA3 play key roles in the development of both type I and type II diabetic neuropathic pain.

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Section: Introductionmentioning

confidence: 99%

Lysophosphatidic Acid Receptor 1- and 3-Mediated Hyperalgesia and Hypoalgesia in Diabetic Neuropathic Pain Models in Mice

Ueda

Neyama

Matsushita

2020

Cells

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“…Diabetic peripheral neuropathy (DPN) is one of the most frequent late complications of diabetes, which severely limits the quality of life in patients. 1 Pain in the extremities and hypersensitivity to innocuous stimuli, such as tactile allodynia, are frequent in patients with DPN. About 30% of diabetic patients develop neuropathic pain.…”

Section: Introductionmentioning

confidence: 99%

Evoked hypoalgesia is accompanied by tonic pain and immune cell infiltration in the dorsal root ganglia at late stages of diabetic neuropathy in mice

et al. 2018

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Diabetic peripheral neuropathy is a major debilitating late complication of diabetes, which significantly reduces the quality of life in patients. Diabetic peripheral neuropathy is associated with a wide spectrum of sensory abnormalities, where in loss of sensation or hypoalgesia to applied external stimuli is paradoxically accompanied by debilitating tonic spontaneous pain. In numerous studies on animal models of diabetic peripheral neuropathy, behavioural measurements have been largely confined to analysis of evoked withdrawal to mechanical and thermal stimuli applied to dermatomes, whereas spontaneous, on-going pain has not been widely studied. In the Streptozotocin model of type 1 diabetes, we employed the Conditioned Place Preference test to assess tonic pain. Our results indicate that both phases, that is, early evoked hypersensitivity (i.e. 5–7 weeks post-Streptozotocin) as well as late stage hypoalgesia (i.e. 17–20 weeks post-Streptozotocin) are accompanied by significant tonic pain in mice with diabetic peripheral neuropathy. We also report on the temporal relation between on-going pain and neuropathological changes in the dorsal root ganglia of mice with diabetic peripheral neuropathy up to 6 months post-Streptozotocin. Neither early hypersensitivity nor late hypoalgesia were associated with markers of cellular stress in the dorsal root ganglia. Whereas significant neutrophil infiltration was observed in the dorsal root ganglia over both early and late stages post-Streptozotocin, T-cell infiltration in the dorsal root ganglia was prominent at late stages post-Streptozotocin. Thus, longitudinal analyses reveal that similar to patients with chronic diabetic peripheral neuropathy, mice show tonic pain despite sensory loss after several months in the Streptozotocin model, which is accompanied by neuroimmune interactions in the dorsal root ganglia.

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“…(1) Complications of diabetes include cardiovascular disease, nephropathy and retinopathy, but the most commonly encountered complication is diabetic peripheral neuropathy (DPN), (2) and it is estimated that approximately 30% of diabetic patients have painful diabetic peripheral neuropathy (pDPN). (2)(3)(4)(5)(6) Clinically, DPN is a diagnosis of exclusion, defined as "the presence of symptoms and/or signs of peripheral nerve dysfunction in people with diabetes after the exclusion of other causes". (7) pDPN has a significant negative impact on quality of life by reducing patients' mobility and ability to perform everyday tasks, increasing the risk of foot ulcers and amputation, disturbing sleep and causing psychological distress.…”

Section: Introductionmentioning

confidence: 99%

“…(5) Other studies have also shown that patients who do receive treatment are often dissatisfied with the outcomes. (6,9) The few studies of pDPN that have been conducted in Middle Eastern and North African countries suggest prevalence ranges from 22-65%, reflecting different populations and methods of diagnosing this condition, but may also indicate true differences from the expected prevalence of approximately 30%. (1,(10)(11)(12) The present review and clinical guidelines aim to increase awareness of pDPN among physicians in the Middle East and North Africa as well as to provide practical consensus recommendations to facilitate the diagnosis and management of pDPN in the region.…”

Section: Introductionmentioning

confidence: 99%

The Dos and Don'ts of Painful Diabetic Peripheral Neuropathy : Primary Care Guidelines for the Middle East and North Africa

Aizarani¹,

Amir²,

Benchouk³

2017

ME-JFM

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Background: Diabetes mellitus (DM) is becoming increasingly common in developing countries and is of major concern in the Middle East and North Africa (MENA). Since at least 30% of diabetic patients may develop painful diabetic peripheral neuropathy (pDPN) within their lifetime, there is an urgent need to increase awareness of the condition among physicians in the region.Objectives: To increase awareness of physicians in the Middle East and North Africa of the increasing prevalence of DM and pDPN and to provide practical consensus recommendations to facilitate the diagnosis and management of pDPN.Methods: A panel of family medicine physicians was convened in Dubai to discuss current awareness of pDPN in the region and to develop consensus statements based on a review of meta-analyses, systematic reviews, and evidence-based guidelines on the screening, diagnosis and management of pDPN.Recommendations: The panel recommends that all patients with diabetes be screened at least annually for symptoms of neuropathic pain using screening tools such as the Doleur Neuropathique en 4 Questions (DN4) as well as thorough examination of the patient's feet. Treatment should aim to achieve a clinically meaningful reduction in pain using first-line agents including pregabalin, duloxetine or tricyclic antidepressants.Conclusion: pDPN is common but under-diagnosed and inadequately treated in the Middle East and North Africa. Physicians in the region are encouraged to implement screening for pDPN and manage patients according to published guidelines.

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Assessment of pain and impact of care among patients with painful diabetic peripheral neuropathy

Cited by 12 publications

References 17 publications

Lysophosphatidic Acid Receptor 1- and 3-Mediated Hyperalgesia and Hypoalgesia in Diabetic Neuropathic Pain Models in Mice

Lysophosphatidic Acid Receptor 1- and 3-Mediated Hyperalgesia and Hypoalgesia in Diabetic Neuropathic Pain Models in Mice

Evoked hypoalgesia is accompanied by tonic pain and immune cell infiltration in the dorsal root ganglia at late stages of diabetic neuropathy in mice

The Dos and Don'ts of Painful Diabetic Peripheral Neuropathy : Primary Care Guidelines for the Middle East and North Africa

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