Screening, diagnosis and management of diabetic sensorimotor polyneuropathy in clinical practice: International expert consensus recommendations

Ziegler, Dan; Tesfaye, Solomon; Spallone, Vincenza; Gurieva, Irina; Kaabi, Juma Al; Mankovsky, B. N.; Martinka, Emil; Radulian, Gabriela; Nguyen, Khue Thy; Stirban, Alin; Tankova, Tsvetalina; Várkonyi, Tamás; Freeman, Roy; Kempler, Péter; Boulton, Andrew J.M.

doi:10.1016/j.diabres.2021.109063

Cited by 92 publications

(147 citation statements)

References 164 publications

(194 reference statements)

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“…Previous studies link neuropathic pain with interference with daily activities [28,29]. Others relate neuropathic pain with a disability, quality of life and psychosocial impairment [30,31]. Other studies, however, have indicated that pain may be associated with poor quality of life [32] while others also have reported that symptoms of pain may be associated with reduced well-being or quality of life [33].…”

Section: Discussionmentioning

confidence: 99%

Analysis of Variance of Diabetic Neuropathic Pain Interference, Intensity and Hypertension Types in Ghana

Adzika

Appiah-Poku

Mensah

et al. 2022

Preprint

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Diabetic Neuropathic Pain (PDN) is the most prevalent chronic complication of diabetes and affects 30–90% of patients with adjuvant complications. Hypertension has been found to increase the risk of long-term vascular complications of Type 2 diabetes mellitus which includes peripheral sensory diabetic neuropathic pain. However, the relationship between Diabetic Neuropathic Pain Interference, Intensity and Hypertension types among Type 2 Diabetes has not been extensively investigated. This study investigates the relationship between hypertension PDN intensity interference and pain intensity. The research design was a cross-sectional descriptive design. A sample of 125 participants was systematically selected for the study A demographic questionnaire and the Brief Pain Inventory for Painful Diabetic Peripheral Neuropathy was used to collect the data. ANOVA was used to determine whether there is an association, between the hypertension types and PDN pain intensity and interference. The study concluded that there was no relationship between Hypertension types and PDN intensity and interference. The study further discovered that whether a patient had normal hypertension, pre-hypertension, stage 1 hypertension, or Stage 2 hypertension, they felt equal pain.

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Section: Discussionmentioning

confidence: 99%

Analysis of Variance of Diabetic Neuropathic Pain Interference, Intensity and Hypertension Types in Ghana

Adzika

Appiah-Poku

Mensah

et al. 2022

Preprint

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“…A second limitation is the clinical diagnosis of DSPN. Indeed, we did not use more sophisticated modalities, such as nerve conduction velocity, intraepidermal nerve fibre density via skin biopsy, or corneal confocal microscopy, which may enable earlier diagnosis of subclinical DSPN [ 1 , 2 , 29 ]. Moreover, subjects were included in a tertiary care centre, and so results may not be directly applicable to primary care and/or the general T2DM population.…”

Section: Discussionmentioning

confidence: 99%

“…Diabetic neuropathy remains a major chronic complication of diabetes mellitus [ 1 ]. It may, in turn, lead to further complications, notably diabetic foot, neuropathic pain, and autonomic failure [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

Skin Advanced Glycation End Products among Subjects with Type 2 Diabetes Mellitus with or without Distal Sensorimotor Polyneuropathy

Papachristou

Pafili

Trypsianis

et al. 2021

Journal of Diabetes Research

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Aim of the Study. To examine the correlation between skin AGEs and parameters of distal sensorimotor polyneuropathy (DSPN) in type 2 diabetes mellitus (T2DM). Materials and Methods. We included 132 subjects (88 men) with a mean age of 64.57 years and median T2DM duration of 14.5 years. Skin AGEs were measured with AGE reader mu connect (Diagnoptics) on the dominant arm. The device enables single and automated triplicate measurements: both of these were performed. DSPN was diagnosed through the neuropathy disability score (NDS). Small nerve fibre function was assessed by temperature and pinprick sensation on the foot. Bilateral measurement of the vibration perception threshold (VPT) on the hallux was carried out by using a neurothesiometer (Horwell Scientific Laboratory Supplies). Results. Single and triplicate AGE measurements were positively correlated with each other (Pearson’s correlation coefficient r = 0.991 , 95 % CI = 0.987 -0.994, p < 0.001 ). AGEs were higher among subjects with vs. those without DSPN ( p < 0.001 ). Furthermore, they were higher among subjects with reduced vs. normal temperature sensation ( p < 0.001 ), among subjects with reduced vs. normal pinprick sensation ( p = 0.002 ), among those with abnormal vs. normal monofilament examination ( p < 0.001 ), and among those with abnormal vs. normal VPT ( p < 0.001 ). AGEs were correlated with NDS, VPT, and monofilament score. Conclusions. In T2DM, skin AGEs are increased in the presence of DSPN. This holds true both for large and for small nerve function impairment. Moreover, AGEs are correlated with DSPN severity.

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“…Benfotiamin proved its beneficial effects in type 2 DM patients in regards to vascular function in terms of restoring reactive hyperaemia and laboratory parameters of endothelial function if given in advance of an AGE-rich meal [ 31 ]. In addition, Benfotiamin is a licensed drug and approved for the treatment of diabetic polyneuropathy (DPN) in several countries worldwide [ 32 ], and its use in symptomatic DPN is recommended [ 33 ]. Still, new substances are under clinical evaluation [ 34 ].…”

Section: Therapeutic Possibilitiesmentioning

confidence: 99%

Dicarbonyl Stress in Diabetic Vascular Disease

Stratmann

2022

IJMS

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Late vascular complications play a prominent role in the diabetes-induced increase in morbidity and mortality. Diabetes mellitus is recognised as a risk factor driving atherosclerosis and cardiovascular mortality; even after the normalisation of blood glucose concentration, the event risk is amplified—an effect called “glycolytic memory”. The hallmark of this glycolytic memory and diabetic pathology are advanced glycation end products (AGEs) and reactive glucose metabolites such as methylglyoxal (MGO), a highly reactive dicarbonyl compound derived mainly from glycolysis. MGO and AGEs have an impact on vascular and organ structure and function, contributing to organ damage. As MGO is not only associated with hyperglycaemia in diabetes but also with other risk factors for diabetic vascular complications such as obesity, dyslipidaemia and hypertension, MGO is identified as a major player in the development of vascular complications in diabetes both on micro- as well as macrovascular level. In diabetes mellitus, the detoxifying system for MGO, the glyoxalase system, is diminished, accounting for the increased MGO concentration and glycotoxic load. This overview will summarise current knowledge on the effect of MGO and AGEs on vascular function.

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Screening, diagnosis and management of diabetic sensorimotor polyneuropathy in clinical practice: International expert consensus recommendations

Cited by 92 publications

References 164 publications

Analysis of Variance of Diabetic Neuropathic Pain Interference, Intensity and Hypertension Types in Ghana

Analysis of Variance of Diabetic Neuropathic Pain Interference, Intensity and Hypertension Types in Ghana

Skin Advanced Glycation End Products among Subjects with Type 2 Diabetes Mellitus with or without Distal Sensorimotor Polyneuropathy

Dicarbonyl Stress in Diabetic Vascular Disease

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