Cycle Training improves vascular function and neuropathic symptoms in patients with type 2 diabetes and peripheral neuropathy: A randomized controlled trial

Gholami, Farhad; Nazari, Hamieh; Alimi, Milad

doi:10.1016/j.exger.2019.110799

Cited by 21 publications

(27 citation statements)

References 24 publications

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“…However, 10 g of nylon yarn, a 128 Hz tuning fork, the Leeds Assessment of Neuropathic Symptoms and Signs, the Toronto Clinical Scoring System, and other tools have been widely used in the diagnosis of DPN [ 5 – 8 ]. Currently, the Michigan Diabetic Neuropathy Score (MDNS) is also a commonly used tool for diagnosing DPN [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

Clinical Features and Rules of Chinese Herbal Medicine in Diabetic Peripheral Neuropathy Patients

Zhao

Xin

et al. 2020

Evidence-Based Complementary and Alternative Medicine

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Objective. To analyse the clinical features of diabetic peripheral neuropathy (DPN) and employ data mining technology to explore the rules of Chinese herbal medicine (CHM) therapy. Methods. The clinical data of 216 patients with DPN and qi-yin deficiency syndrome were obtained, and the clinical features of the patients were assessed by cluster analysis. Relevant information was entered into the clinical diagnosis and treatment collection system, and data mining techniques were used to analyse the drug frequency, core CHM, CHM pair, and so on. Results. In this study, glycated haemoglobin (HbA1c) and homocysteine (HCY) were closely related to the pathogenesis of DPN. Overall, 162 patients had typical DPN syndrome characteristics, and we analysed 216 prescriptions, including 182 CHM. The frequencies of prescription of Astragalus membranaceus, Ligusticum wallichii, Poria cocos, and Radix Rehmanniae were greater than 45%. A Bayesian network analysis diagram showed that the 9 most common core CHM included Astragalus membranaceus, Ligusticum wallichii, Poria cocos, atractylodes rhizome, and Salvia miltiorrhiza Bge. According to the association rules of CHM, Radix Ophiopogon is used for Codonopsis pilosula; Astragalus membranaceus and atractylodes rhizome for Rehmannia are also frequently used. Astragalus membranaceus and Cinnamomi Ramulus or Ligusticum wallichii and Moutan bark were highly related to a decreased Michigan Diabetic Neuropathy Score. Conclusion. HbA1c and HCY are related risk factors for DPN. Numbness is a typical syndrome characteristic. Astragalus membranaceus is a monarch CHM and is used most frequently.

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Section: Introductionmentioning

confidence: 99%

Clinical Features and Rules of Chinese Herbal Medicine in Diabetic Peripheral Neuropathy Patients

Zhao

Xin

et al. 2020

Evidence-Based Complementary and Alternative Medicine

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“…44 Others have shown promising improvements in pain interference, vascular health, and neuropathic symptoms in individuals with DPN following 16-week 20 45 and 12-week exercise interventions. 46 While there is no consensus on an optimal exercise regimen, 47 our study suggests that adipose infiltration and muscle composition improve within 10 weeks. We acknowledge that the small sample size is a limitation and point out that multiple comparison corrections were not performed, which increase the possibility of false correlations between changes in MRI and clinical measurements (table 3).…”

Section: Lists Pairs Of Mri Measurements and Diabetic Markers Whose Values Changed Between Preinterventionmentioning

confidence: 72%

Lower extremity MRI following 10-week supervised exercise intervention in patients with diabetic peripheral neuropathy

Brown

Sharafi

Slade

et al. 2021

BMJ Open Diab Res Care

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IntroductionThe purpose of this study was to characterize using MRI the effects of a 10-week supervised exercise program on lower extremity skeletal muscle composition, nerve microarchitecture, and metabolic function in individuals with diabetic peripheral neuropathy (DPN).Research design and methodsTwenty participants with DPN completed a longitudinal trial consisting of a 30-day control period, during which subjects made no change to their lifestyle, followed by a 10-week intervention program that included three supervised aerobic and resistance exercise sessions per week targeting the upper and lower extremities. The participants’ midcalves were scanned with multinuclear MRI two times prior to intervention (baseline1 and baseline2) and once following intervention to measure relaxation times (T1, T1ρ, and T2), phosphocreatine recovery, fat fraction, and diffusion parameters.ResultsThere were no changes between baseline1 and baseline2 MRI metrics (p>0.2). Significant changes (p<0.05) between baseline2 and postintervention MRI metrics were: gastrocnemius medialis (GM) T1 –2.3%±3.0% and soleus T2 –3.2%±3.1%. Trends toward significant changes (0.05<p<0.1) between baseline2 and postintervention MRI metrics were: calf adipose infiltration –2.6%±6.4%, GM T1ρ –4.1%±7.7%, GM T2 –3.5%±6.4%, and gastrocnemius lateral T2 −4.6±7.4%. Insignificant changes were observed in gastrocnemius phosphocreatine recovery rate constant (p>0.3) and tibial nerve fractional anisotropy (p>0.6) and apparent diffusion coefficient (p>0.4).ConclusionsThe 10-week supervised exercise intervention program successfully reduced adiposity and altered resting tissue properties in the lower leg in DPN. Gastrocnemius mitochondrial oxidative capacity and tibial nerve microarchitecture changes were not observed, either due to lack of response to therapy or to lack of measurement sensitivity.

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“…The levels of evidence evaluated according to the quality of the selected articles received a score of 1++ in 9.2% ( n = 1) [ 53 ] qualifying it as high quality, 27.3% of the studies received a score of 1+ or medium quality ( n = 3) [ 54 , 55 , 56 ], and the rest of the articles were scored as low quality, 1−, representing 63.5% ( n = 7) [ 15 , 57 , 58 , 59 , 60 , 61 , 62 ].…”

Section: Resultsmentioning

confidence: 99%

“…Of the 11 included studies, seven were parallel-group RCTs [ 59 , 61 ], of which one was placebo-controlled [ 53 ]. The remaining four studies were cohort studies from RCTs, [ 58 , 60 ], of which one was placebo-controlled.…”

Section: Resultsmentioning

confidence: 99%

“…The total number of participants in all studies was 23,595, with ages ranging from 33.6 ± 7 to 66.7 ± 9.2 years, including 1834 patients with TIDM and 21,761 patients with TIIDM [ 54 , 55 , 56 , 57 , 58 , 59 , 61 , 62 ]. All studies divided participants into two groups, except the 2015 Diabetes Prevention Program Research Group et al [ 57 ] study, which randomized participants into two intervention groups and one control group.…”

Section: Resultsmentioning

confidence: 99%

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Prevention of Peripheral Distal Polyneuropathy in Patients with Diabetes: A Systematic Review

Carvajal-Moreno

Coheña‐Jiménez

García-Ventura

et al. 2022

JCM

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Background: Diabetic peripheral neuropathy (DPN) is the most frequent chronic complication and is that which generates the highest disability and mortality in diabetes mellitus (DM). As it is currently the only microvascular complication of DM without a specific treatment, prevention is essential. The aim of this study was to determine the most effective preventive strategy to avoid or delay the appearance and/or development of DPN in patients with DM. Methods: A systematic search was carried out in the main health science databases (PubMed, Scopus, CINAHL, PEDro and The Cochrane Library) from 1 January 2010 to 31 August 2020. The study selection was conducted by two independent reviewers and data extraction was performed by the author. The eligibility criteria included randomized clinical trials (RCTs) and cohort studies from RCTs. Results: Eleven studies were selected that included 23,595 participants with DM. The interventions evaluated were intensive or standard glycemic control, the use of drugs to achieve glycemic control, and the promotion of a healthy lifestyle and exercise. Intensive glucose control achieved a significant reduction in the development of DPN in TIDM patients, and lifestyle modifications and exercise achieved it moderately in TIIDM patients. Conclusions: The main preventive strategy for DPN is intensive glycemic control with a target HbA1c < 6% in patients with TIDM and standard control of 7.0–7.9 in patients with TIIDM, incorporating lifestyle modifications.

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Cycle Training improves vascular function and neuropathic symptoms in patients with type 2 diabetes and peripheral neuropathy: A randomized controlled trial

Cited by 21 publications

References 24 publications

Clinical Features and Rules of Chinese Herbal Medicine in Diabetic Peripheral Neuropathy Patients

Clinical Features and Rules of Chinese Herbal Medicine in Diabetic Peripheral Neuropathy Patients

Lower extremity MRI following 10-week supervised exercise intervention in patients with diabetic peripheral neuropathy

Prevention of Peripheral Distal Polyneuropathy in Patients with Diabetes: A Systematic Review

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