Diabetic Somatic Neuropathies

Boulton, Andrew J.M.; Malik, Rayaz A.; Arezzo, Joseph C.; Sosenko, Jay M.

doi:10.2337/diacare.27.6.1458

Cited by 780 publications

(666 citation statements)

References 291 publications

(230 reference statements)

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“…lower extremities are predominantly involved in diabetic neuropathy presumably because of a length-dependent degeneration of nerve fibers (25,26). If neuropathy is a factor, skeletal muscle function is more likely to be affected in the lower extremities than in the upper extremities.…”

Section: Statistical Analysesmentioning

confidence: 99%

Accelerated Loss of Skeletal Muscle Strength in Older Adults With Type 2 Diabetes

Park

Goodpaster²,

Strotmeyer³

et al. 2007

Diabetes Care

618

476

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OBJECTIVE -It has been shown that adults with either long-standing type 1 or type 2 diabetes had lower skeletal muscle strength than nondiabetic adults in cross-sectional studies. The aim of the study was to investigate longitudinal changes of muscle mass and strength in community-dwelling older adults with and without type 2 diabetes.RESEARCH DESIGN AND METHODS -We examined leg and arm muscle mass and strength at baseline and 3 years later in 1,840 older adults aged 70 -79 years in the Health, Aging, and Body Composition Study. Regional muscle mass was measured by dual energy X-ray absorptiometry, and muscle strength was measured using isokinetic and isometric dynamometers.RESULTS -Older adults with type 2 diabetes (n ϭ 305) showed greater declines in the leg muscle mass (Ϫ0.29 Ϯ 0.03 vs. Ϫ0.23 Ϯ 0.01 kg, P Ͻ 0.05) and strength (Ϫ16.5 Ϯ 1.2 vs. Ϫ12.4 Ϯ 0.5 Nm, P ϭ 0.001) compared with older adults without diabetes. Leg muscle quality, expressed as maximal strength per unit of muscle mass (Newton meters per kilogram), also declined more rapidly in older adults with diabetes (Ϫ1.6 Ϯ 0.2 vs. Ϫ1.2 Ϯ 0.1 Nm/kg, P Ͻ 0.05). Changes in arm muscle strength and quality were not different between those with and without diabetes. Rapid declines in leg muscle strength and quality were attenuated but remained significant after controlling for demographics, body composition, physical activity, combined chronic diseases, interleukin-6, and tumor necrosis factor-␣.CONCLUSIONS -In older adults, type 2 diabetes is associated with accelerated loss of leg muscle strength and quality. Diabetes Care 30

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Section: Statistical Analysesmentioning

confidence: 99%

Accelerated Loss of Skeletal Muscle Strength in Older Adults With Type 2 Diabetes

Park

Goodpaster²,

Strotmeyer³

et al. 2007

Diabetes Care

618

476

View full text Add to dashboard Cite

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“…Metabolic [3] and vascular [4][5][6][7] factors play an important role in its pathogenesis. Detailed neurophysiological studies in diabetic patients have shown that demyelination precedes axonal loss and that the latter may be responsible for the symptoms [8].…”

Section: Introductionmentioning

confidence: 99%

Sural nerve pathology in diabetic patients with minimal but progressive neuropathy

et al. 2005

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Aims/hypothesis: The early pathological features of human diabetic neuropathy are not clearly defined. Therefore we quantified nerve fibre and microvascular pathology in sural nerve biopsies from diabetic patients with minimal neuropathy. Methods: Twelve diabetic patients underwent detailed assessment of neuropathy and fascicular sural nerve biopsy at baseline, with repeat assessment of neuropathy 8.7±0.6 years later. Results: At baseline, neuropathic symptoms, neurological deficits, quantitative sensory testing, cardiac autonomic function and peripheral nerve electrophysiology showed minimal abnormality, which deteriorated at follow-up. Myelinated fibre density, fibre and axonal area, and g-ratio were normal but teased fibre studies showed paranodal abnormalities (p<0.001), segmental demyelination (p<0.01) and remyelination (p<0.01) without axonal degeneration. Unassociated Schwann cell profile density (p<0.04) and unmyelinated axon density (p<0.001) were increased and axon diameter was decreased (p<0.007). Endoneurial capillaries demonstrated basement membrane thickening (p<0.006), endothelial cell hyperplasia (p<0.004) and a reduction in luminal area (p<0.007). Conclusions/interpretation: The early pathological features of human diabetic neuropathy include an abnormality of the myelinated fibre Schwann cell and unmyelinated fibre degeneration with regeneration. These changes are accompanied by a significant endoneurial microangiopathy.

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“…Peripheral neuropathy affects the peripheral sensory nerves, and may include painful symptoms such as burning, deep aching, constricting and throbbing along with non-painful symptoms such as numbness, tingling, extreme sensitivity, or feelings of deadness within the lower limb [2,3]. The sensory loss associated with peripheral neuropathy increases the risk of foot ulceration and associated amputation [4].…”

Section: Introductionmentioning

confidence: 99%

Self-Reported Physical Activity Using the International Physical Activity Questionnaire (IPAQ) in Australian Adults with Type 2 Diabetes, with and Without Peripheral Neuropathy

Nolan

Raynor

Berry

et al. 2016

Canadian Journal of Diabetes

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ObjectiveThe aim of this study was to survey the level of self-reported physical activity in people with type 2 diabetes, with and without peripheral neuropathy. MethodsA sample of South Australian adults (n=481) aged 33-88 years with type 2 diabetes, including 55 people with peripheral neuropathy, completed the International Physical Activity Questionnaire (IPAQ). Levels of self-reported physical activity were compared between those with and without peripheral neuropathy. ResultsPeople with type 2 diabetes and peripheral neuropathy (Mdn =1433, IQR = 495-3390 MET.min/wk) were less physically active than those without peripheral neuropathy (Mdn =2106, IQR = 876-4380 MET.min/wk) (p = 0.04). A total of 49% of people with type 2 diabetes and peripheral neuropathy met physical activity recommendations of 150 minutes of at least moderate activity per week, compared to 57% of people with type 2 diabetes alone. ConclusionsThese findings demonstrate that people with type 2 diabetes and peripheral neuropathy reported being significantly less active than people with type 2 diabetes alone. People with type 2 diabetes and peripheral neuropathy need to be encouraged to perform higher levels of physical activity for biological, physical and psychological benefits. Further studies using objective measures of physical activity are required to support these results.

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Diabetic Somatic Neuropathies

Cited by 780 publications

References 291 publications

Accelerated Loss of Skeletal Muscle Strength in Older Adults With Type 2 Diabetes

Accelerated Loss of Skeletal Muscle Strength in Older Adults With Type 2 Diabetes

Sural nerve pathology in diabetic patients with minimal but progressive neuropathy

Self-Reported Physical Activity Using the International Physical Activity Questionnaire (IPAQ) in Australian Adults with Type 2 Diabetes, with and Without Peripheral Neuropathy

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