Exercise increases cutaneous nerve density in diabetic patients without neuropathy

Singleton, J. Robinson; Marcus, Robin L.; Jackson, Justin E.; Lessard, Margaret; Graham, Timothy E.; Smith, A. Gordon

doi:10.1002/acn3.125

Cited by 101 publications

(109 citation statements)

References 19 publications

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“…In the Lifestyle Intervention for Pre-Diabetic Neuropathy study, there was up to 1.4 ± 2.3 fibers/mm (p < 0.004) improvement in IENFD after 1 year of treatment, indicating that [44]. This improvement has also been shown in patients with metabolic syndrome [45], confirming that IENFD is an useful marker with potential to detect SFN reversal.…”

Section: Methods For Assessment Of Small Fiber Neuropathysupporting

confidence: 52%

Distal Sensorimotor Neuropathy: Improvements in Diagnosis

2015

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■ AbstractNeurological complications of diabetes are common, affecting up to 50% of people with diabetes. In these patients, diabetic sensorimotor neuropathy (DSPN) is by far the most frequent complication. Detecting DSPN has traditionally been a clinical exercise that is based on signs and symptoms. However, the appearance of morphometric and neurophysiological techniques along with composite scoring systems and new screening tools has induced a paradigm change in the detection and stratification of DSPN and our understanding of its natural history and etiopathogenesis. These newer techniques have provided further evidence that changes in small nerve fiber structure and function precede large fiber changes in diabetes. Although useful, the challenge for the use of these new techniques will be their sensitivity and specificity when widely adopted and ultimately, their ability to demonstrate improvement when pathogenic mechanisms are corrected. Concurrently, we have also witnessed an emergence of simpler screening tools or methods that are mainly aimed at quicker detection of large fiber neuropathy in the outpatient setting. In this review, we have focused on techniques and tools that receive particular attention in the current literature, their use in research and potential use in the clinical environment.Keywords: diabetic neuropathy · small fiber neuropathy · axon reflex test · nerve conduction · nerve fiber density · laser Doppler imager flare · corneal confocal microscopy · electromyography · sudomotor function

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Section: Methods For Assessment Of Small Fiber Neuropathysupporting

confidence: 52%

Distal Sensorimotor Neuropathy: Improvements in Diagnosis

2015

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“…Recently, Singleton and colleagues considered the impact of an exercise intervention on epidermal innervation, which is significantly reduced in DPN [140]. 100 patients with diabetes, but without peripheral neuropathy, were allocated to either a lifestyle counseling group or a weekly exercise intervention group.…”

Section: Non-pharmacological Approachesmentioning

confidence: 99%

Treating Diabetic Neuropathy: Present Strategies and Emerging Solutions

Javed¹,

Alam²,

Malik³

2015

Rev Diabet Stud

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■ AbstractDiabetic peripheral neuropathies (DPN) are a heterogeneous group of disorders caused by neuronal dysfunction in patients with diabetes. They have differing clinical courses, distributions, fiber involvement (large or small), and pathophysiology. These complications are associated with increased morbidity, distress, and healthcare costs. Approximately 50% of patients with diabetes develop peripheral neuropathy, and the projected rise in the global burden of diabetes is spurring an increase in neuropathy. Distal symmetrical polyneuropathy (DSPN) with painful diabetic neuropathy, occurring in around 20% of diabetes patients, and diabetic autonomic neuropathy (DAN) are the most common manifestations of DPN. Optimal glucose control represents the only broadly accepted therapeutic option though evidence of its benefit in type 2 diabetes is unclear. A number of symptomatic treatments are recommended in clinical guidelines for the management of painful DPN, including antidepressants such as amitriptyline and duloxetine, the γ-aminobutyric acid analogues gabapentin and pregabalin, opioids, and topical agents such as capsaicin. However, monotherapy is frequently not effective in achieving complete resolution of pain in DPN. There is a growing need for head-to-head studies of different single-drug and combination pharmacotherapies. Due to the ubiquity of autonomic innervation in the body, DAN causes a plethora of symptoms and signs affecting cardiovascular, urogenital, gastrointestinal, pupillomotor, thermoregulatory, and sudomotor systems. The current treatment of DAN is largely symptomatic, and does not correct the underlying autonomic nerve deficit. A number of novel potential candidates, including erythropoietin analogues, angiotensin II receptor type 2 antagonists, and sodium channel blockers are currently being evaluated in phase II clinical trials.

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“…З точки зору доказової медицини, кращі моделі інтенсивної модифікації способу життя для хворих на цукровий діабет на сьогоднішній день представлені в дослідженнях Diabetes Prevention Program (DPP) [15], steno-2 study [14], italian supervised treadmill study [16] та university of utah type 2 diabetes study [17]. в останньому дослідженні навіть повідомлялося про регенерацію нервових волокон у пацієнтів із цукровим діабетом 2 типу, які брали участь в програмі фізичних вправ в порівнянні з втратою нервових волокон у тих пацієнтів, хто лише дотримувався стандартної медичної допомоги.…”

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“…в останньому дослідженні навіть повідомлялося про регенерацію нервових волокон у пацієнтів із цукровим діабетом 2 типу, які брали участь в програмі фізичних вправ в порівнянні з втратою нервових волокон у тих пацієнтів, хто лише дотримувався стандартної медичної допомоги. в цілому, підхід інтенсивної модифікації способу життя для хворих на цукровий діабет фокусується або тільки на фізичних вправах (аеробні вправі та/або тренування з обтяженнями) [16,17], або на комбінації дієти і фізичних вправ. варто також зауважити, що психотерапевтичні заходи також показані на всіх рівнях надання медичної допомоги, оскільки одне лише медикаментозне лікування не в змозі змінити стан хворого і тільки сприяє хронізації захворювання.…”

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Painful diabetic neuropathy and its treatment by pregabaline

Хаустова¹

2017

CE&ES

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Exercise increases cutaneous nerve density in diabetic patients without neuropathy

Cited by 101 publications

References 19 publications

Distal Sensorimotor Neuropathy: Improvements in Diagnosis

Distal Sensorimotor Neuropathy: Improvements in Diagnosis

Treating Diabetic Neuropathy: Present Strategies and Emerging Solutions

Painful diabetic neuropathy and its treatment by pregabaline

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