Current Pharmacological Treatment of Painful Diabetic Neuropathy: A Narrative Review

Ardeleanu, Valeriu; Toma, Adrian Ioan; Pafili, Kalliopi; Παπάνας, Νικόλαος; Motofei, Ion G.; Diaconu, Camelia Cristina; Rizzo, Manfredi; Stoian, Anca Pantea

doi:10.3390/medicina56010025

Cited by 42 publications

(31 citation statements)

References 76 publications

(130 reference statements)

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“…The contribution of obesity to the risk of DFU is questionable. There are studies revealing that it is associated with DFUs, while other studies show that BMI has no significant correlation [ 18 , 19 , 20 , 21 ]. The analysis revealed that patients with DFU had higher BMIs range (from 25 to 46 kg/m 2 ), and the DFU prevalence was higher in type 2 diabetes mellitus than in type 1 diabetes mellitus patients, which was consistent with the results of previous studies, but the mechanisms explaining it were not completely elucidated [ 20 , 22 , 23 , 24 ].…”

Section: Discussionmentioning

confidence: 99%

Clinical, Pathological and Microbiological Evaluation of Diabetic Foot Syndrome

et al. 2020

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Background and objectives: Diabetic foot ulcer (DFU) is one of the serious complications of diabetes, being related to frequent and long-term hospitalisation, reduced quality of life of the patient, amputations, a high rate of morbidity and mortality. The bacterial aetiology is complex, sometimes involving more than one pathogen, playing a major role in the infection prognosis and development of microbial resistance. This study evaluated the current state of the aetiology, clinical and pathological characteristics of DFU in a single diabetes centre in order to provide some specific measures to prevent it. Materials and Methods: This retrospective study was conducted on patients with diabetes mellitus (252 individuals diagnosed with DFU) between January 2018–December 2019. All participants were assessed based on their clinical characteristics, including complications of diabetes and pathological and microbiological evaluations. Results: The present research revealed that diabetic foot ulcer prevalence was higher in males than in females and higher in type 2 diabetic patients than in type 1 diabetic patients. The patients with diabetic foot ulcer were older, had a higher body mass index (BMI), longer diabetic duration and had more diabetic complications, such as retinopathy, diabetic polyneuropathy and diabetic kidney disease, than patients without diabetic foot ulceration. Conclusions: Taking into account all factors involved, including the aetiology and the antibiotic susceptibility pattern of these isolates, planning the suitable treatment options of patients is possible.

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Section: Discussionmentioning

confidence: 99%

Clinical, Pathological and Microbiological Evaluation of Diabetic Foot Syndrome

et al. 2020

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“…This figure is also extended to those professional figures who by definition acquire skills during the university training courses (Langher et al, 2014(Langher et al, , 2018Donsì, 2018, Settineri et al, 2018;Parola and Donsì, 2019;Merlo et al, 2020b;Parola and Felaco, 2020). The success or failure of therapies and treatments often depends on the skills of health professionals, and this suggests that they cannot be overlooked, with particular reference to adult and adolescent medical conditions (Mullen, 1997;Brown, 1999;Lingiardi et al, 2010;Shrivastava et al, 2013;Sugiharto et al, 2017;Di Giuseppe et al, 2019a;Martino et al, 2019a;Rosa et al, 2019Ardeleanu et al, 2020;Martino et al, 2020;Moroianu et al, 2020;Muzi, 2020;Nedelcu et al, 2020).…”

Section: Discussionmentioning

confidence: 99%

Clinical Psychological Figures in Healthcare Professionals: Resilience and Maladjustment as the “Cost of Care”

et al. 2020

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Background: The health professionals are involved in the paths of care for patients with different medical conditions. Their life is frequently characterized by psychopathological outcomes so that it is possible to identify consistent burdens. Besides the possibility to develop pathological outcomes, some protective factors such as resilience play a fundamental role in facilitating the adaptation process and the management of maladaptive patterns. Personal characteristics and specific indexes such as burdens and resilience are essential variables useful to study in-depth ongoing conditions and possible interventions. The study was aimed at highlighting the presence and the relations among factors as personal variables, burdens, and resilience, to understand health professionals' specific structure and functions.Methods: The observation group was composed of 210 participants, 55 males (26.2%), and 155 females (73.8%), aged from 18 to 30 years old with a mean age of 25.92 years old (SD = 3.33). The study considered personal characteristics of the subjects, such as age, gender, years of study, days of work per week, hours of work per week, and years of work. Our study had been conducted with the use of measures related to burdens (Caregivers Burden Inventory) and resilience (Resilience Scale for Adults).Results: The performed analyses consisted of descriptive statistics, correlations, and regressions among the considered variables. Several significant correlations emerged among personal characteristics, CBI, and RSA variables. Specifically, age and work commitment indexes appeared to be significantly related to the development of burdens, differently from the years of study. Significant correlations emerged among personal and RSA variables, indicating precise directions for both domains. Age and gender were identified as predictors to perform multivariate regression analyses concerning CBI factors. Significant dependence relations emerged with reference to all CBI variables.Conclusion: Pathological outcomes and resilience factors represent two sides of the health professionals' experiences, also known as “invisible patients.” Greater knowledge about present conditions and future possibilities is a well-known need in literature so that the current analyses considered fundamental factors. In line with state of the art, future studies are needed in order to deepen elusive phenomena underlying maladjustment.

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“…The therapeutic principles of DN may be summarised as follows: optimisation of glycaemic control, treatment of other vascular risk factors (dyslipidaemia, hypertension, smoking), pathogenesis-oriented treatment, analgesia as required and avoidance of complications (such as foot ulceration) [1,4,19]. There has been considerable progress in pain relief [1,4,19]. Conversely, pathogenesis-oriented treatment is still suboptimal and only alpha-lipoic acid has shown efficacy [4,19].…”

Section: Dnmentioning

confidence: 99%

“…There has been considerable progress in pain relief [1,4,19]. Conversely, pathogenesis-oriented treatment is still suboptimal and only alpha-lipoic acid has shown efficacy [4,19].…”

Section: Dnmentioning

confidence: 99%

Skin AGEs and diabetic neuropathy

2021

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Advanced glycation end-products (AGEs) are heterogeneous molecules produced by the non-enzymatic glycation of proteins, lipids, or nucleic acids during hyperglycaemia. Accumulation of AGEs in the peripheral nerves has recently been proposed as an additional risk factor for the development of diabetic neuropathy (DN). The gold standard for measurement of tissue-bound AGEs is tissue biopsy. However, their assessment with the newer, fast and simple method of skin autofluorescence (sAF) has recently gained special interest by virtue of its non-invasive, highly reproducible nature and its acceptable correlation with the reference method of skin biopsy. Accumulation of tissue AGEs evaluated by sAF has been shown to independently correlate with DN. Importantly, increasing evidence underscores their potential value as early biomarkers of the latter. Further important associations include diabetic nephropathy, diabetic retinopathy and cardiovascular autonomic neuropathy. However, the value of the implementation of screening with skin AGEs for DN remains unclear. The aim of the present review is to critically summarise current evidence on the association between skin AGEs and diabetic microvascular complications, with a particular emphasis on diabetic neuropathy, and to note the most important limitations of existing knowledge. Longer follow-up studies are also highly anticipated to clarify its role and provide data on patient selection and cost-effectiveness.

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Current Pharmacological Treatment of Painful Diabetic Neuropathy: A Narrative Review

Cited by 42 publications

References 76 publications

Clinical, Pathological and Microbiological Evaluation of Diabetic Foot Syndrome

Clinical, Pathological and Microbiological Evaluation of Diabetic Foot Syndrome

Clinical Psychological Figures in Healthcare Professionals: Resilience and Maladjustment as the “Cost of Care”

Skin AGEs and diabetic neuropathy

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