Perspectives of glycemic variability in diabetic neuropathy: a comprehensive review

Abstract

Diabetic neuropathy is one of the most prevalent chronic complications of diabetes, and up to half of diabetic patients will develop diabetic neuropathy during their disease course. Notably, emerging evidence suggests that glycemic variability is associated with the pathogenesis of diabetic complications and has emerged as a possible independent risk factor for diabetic neuropathy. In this review, we describe the commonly used metrics for evaluating glycemic variability in clinical practice and summarize the role and related mechanisms of glycemic variability in diabetic neuropathy, including cardiovascular autonomic neuropathy, diabetic peripheral neuropathy and cognitive impairment. In addition, we also address the potential pharmacological and non-pharmacological treatment methods for diabetic neuropathy, aiming to provide ideas for the treatment of diabetic neuropathy.

The Effectiveness of Massage Therapy on Healing of Diabetic Neuropathy in Diabetes Mellitus Patients

“…There are many subgroups of neuropathies, but the most common form is symmetrical diabetic peripheral neuropathy (DPN), which mainly affects the lower extremities [8], [10], [11]. DM patients with DPN often complain of symptoms such as numbness, tingling, pain, weakness, and instability when walking [6], [8], [9], [10], [12]. Our study found that foot massage therapy is effective in the healing of DPN in DM patients.…”

“…DN is among the most common of all the longterm complications of DM with significant mortality and morbidity [8], [13], [5], [19], [20]. It is predicted that up to 50% of DM patients affect DN [6], [11], [21]. There are many subgroups of neuropathies, but the most common form is symmetrical diabetic peripheral neuropathy (DPN), which mainly affects the lower extremities [8], [10], [11].…”

“…The longer people have diabetes, the less controlled blood sugar, and the higher the risk of complications [1], [2], [4], [5]. Diabetic neuropathy (DN) is one of the most prevalent chronic complications of DM and is a serious complication of Type 1 and Type 2 DM [6], [7]. It is usually affecting both sides of the body.…”

“…It is usually affecting both sides of the body. The most common symptoms of DN include decreased sensation and numbness (loss of sense of touch), burning sensation in feet, prickling, or aching sensations [6], [7], [8].…”

“…The most common type of neuropathy has diabetes peripheral neuropathy (DPN) [9], [10], which mainly affects the lower extremities and is a major cause of morbidity because of its effects leading to the risk of ulcers, amputations, and subsequent disability [8], [11], [12], [13]. DN reduces the patient's quality of life and the quality of diabetes management itself and, as a result, worsens the prognosis of other diabetic complications [6], [10], [12]. Globally, it is estimated that in Type 2 DM patients, the prevalence of DPN ranges from 21.3 to 34.5%, and in Type 1 ranges from 7 to 34.2% [14].…”