Diabetic polyneuropathies: update on research definition, diagnostic criteria and estimation of severity
Peter J. Dyck,James W. Albers,Henning Andersen,Joseph C. Arezzo,Geert Jan Biessels,Vera Bril,Eva L. Feldman,William J. Litchy,Peter C. O'Brien,James W. Russell +9 more
TLDR
The performance characteristics of several criteria for the diagnosis of sensorimotor polyneuropathy in healthy subject‐ and diabetic subject cohorts are provided and staged and continuous approaches to estimate severity of DSPN are outlined.Abstract:
Prior to a joint meeting of the Neurodiab Association and International Symposium on Diabetic Neuropathy held in Toronto, Ontario, Canada, 13-18 October 2009, Solomon Tesfaye, Sheffield, UK, convened a panel of neuromuscular experts to provide an update on polyneuropathies associated with diabetes (Toronto Consensus Panels on DPNs, 2009). Herein, we provide definitions of typical and atypical diabetic polyneuropathies (DPNs), diagnostic criteria, and approaches to diagnose sensorimotor polyneuropathy as well as to estimate severity. Diabetic sensorimotor polyneuropathy (DSPN), or typical DPN, usually develops on long-standing hyperglycaemia, consequent metabolic derangements and microvessel alterations. It is frequently associated with microvessel retinal and kidney disease-but other causes must be excluded. By contrast, atypical DPNs are intercurrent painful and autonomic small-fibre polyneuropathies. Recognizing that there is a need to detect and estimate severity of DSPN validly and reproducibly, we define subclinical DSPN using nerve conduction criteria and define possible, probable, and confirmed clinical levels of DSPN. For conduct of epidemiologic surveys and randomized controlled trials, it is necessary to pre-specify which attributes of nerve conduction are to be used, the criterion for diagnosis, reference values, correction for applicable variables, and the specific criterion for DSPN. Herein, we provide the performance characteristics of several criteria for the diagnosis of sensorimotor polyneuropathy in healthy subject- and diabetic subject cohorts. Also outlined here are staged and continuous approaches to estimate severity of DSPN.read more
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Diabetic Neuropathy: A Position Statement by the American Diabetes Association
Rodica Pop-Busui,Andrew J.M. Boulton,Eva L. Feldman,Vera Bril,Roy Freeman,Rayaz A. Malik,Jay M. Sosenko,Dan Ziegler +7 more
TL;DR: Although screening for rarer atypical forms of diabetic neuropathy may be warranted, DSPN and autonomic neuropathy are the most common forms encountered in practice and the strongest available evidence regarding treatment pertains to these forms.
Journal ArticleDOI
Risk of diabetes-associated diseases in subgroups of patients with recent-onset diabetes: a 5-year follow-up study.
Oana P. Zaharia,Klaus Strassburger,Alexander Strom,Gidon J. Bönhof,Yanislava Karusheva,Sofia Antoniou,Kálmán Bódis,D Markgraf,Volker Burkart,Karsten Müssig,Jong-Hee Hwang,Olof Asplund,Leif Groop,Emma Ahlqvist,Jochen Seissler,Peter P. Nawroth,Stefan Kopf,Sebastian M. Schmid,Michael Stumvoll,Andreas Pfeiffer,Stefan Kabisch,Sergey Tselmin,Hans U. Häring,Dan Ziegler,Oliver Kuss,Julia Szendroedi,Michael Roden,Bengt-Frederik Belgardt,Anette E. Buyken,Jürgen Eckel,Gerd Geerling,Hadi Al-Hasani,Christian Herder,Andrea Icks,Jorg Kotzka,Eckart Lammert,Daniel F. Markgraf,Wolfgang Rathmann +37 more
TL;DR: In patients with newly diagnosed type 1 or type 2 diabetes, hepatocellular lipid content was highest at baseline in patients assigned to the SIRD cluster and insulin resistance index at baseline was highest in patients with SIRD and MOD.
Journal ArticleDOI
The Effect of Exercise on Neuropathic Symptoms, Nerve Function, and Cutaneous Innervation in People with Diabetic Peripheral Neuropathy
Patricia M. Kluding,Mamatha Pasnoor,Rupali Singh,Stephen Jernigan,Kevin L. Farmer,Jason Rucker,Neena K. Sharma,Douglas E. Wright +7 more
TL;DR: Improvements in neuropathic and cutaneous nerve fiber branching following supervised exercise in people with diabetic peripheral neuropathy are described, particularly promising given the short duration of the intervention.
Journal ArticleDOI
Early Detection of Nerve Fiber Loss by Corneal Confocal Microscopy and Skin Biopsy in Recently Diagnosed Type 2 Diabetes
Dan Ziegler,Nikolaos Papanas,Andrey Zhivov,Stephan Allgeier,Karsten Winter,Iris Ziegler,Jutta Brüggemann,Alexander Strom,Sabine Peschel,Bernd Köhler,Oliver Stachs,Rudolf F. Guthoff,Michael Roden +12 more
TL;DR: CCM and skin biopsy both detect nerve fiber loss in recently diagnosed type 2 diabetes, but largely in different patients, suggesting a patchy manifestation pattern of small fiber neuropathy.
Journal ArticleDOI
Epidemiology of Peripheral Neuropathy and Lower Extremity Disease in Diabetes.
TL;DR: Given that approximately 50% of adults with diabetes will be affected by peripheral neuropathy in their lifetime, more diligent screening and management are important to reduce the complications and health care burden associated with the disease.
References
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Diabetic Neuropathies: Update on Definitions, Diagnostic Criteria, Estimation of Severity, and Treatments
Solomon Tesfaye,Andrew J.M. Boulton,Peter J. Dyck,Roy Freeman,Michael Horowitz,Péter Kempler,Giuseppe Lauria,Rayaz A. Malik,Vincenza Spallone,Aaron I. Vinik,Luciano Bernardi,Paul Valensi +11 more
TL;DR: A joint meeting of the 19th annual Diabetic Neuropathy Study Group of the European Association for the Study of Diabetes (NEURODIAB) and the 8th International Symposium on Diabetes in Toronto, Canada, 13-18 October 2009, expert panels were convened to provide updates on classification, definitions, diagnostic criteria, and treatments of diabetic peripheral neuropathies as mentioned in this paper.
Journal ArticleDOI
Diabetic neuropathies: a statement by the American Diabetes Association.
Andrew J.M. Boulton,Andrew J.M. Boulton,Arthur I. Vinik,Joseph C. Arezzo,Vera Bril,Eva L. Feldman,Roy Freeman,Rayaz A. Malik,Raelene E. Maser,Jay M. Sosenko,Dan Ziegler +10 more
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Journal Article
The prevalence by staged severity of various types of diabetic neuropathy, retinopathy, and nephropathy in a population-based cohort
Peter J. Dyck,K. M. Kratz,Jeannine L. Karnes,William J. Litchy,Ronald Klein,John M. Pach,David M. Wilson,P. C. O'Brien,L. Joseph Melton +8 more
TL;DR: Two thirds of diabetic patients have objective evidence for some variety of neuropathy, but only about 20% have symptoms, and only 6% of IDDM and only 1% of NIDDM patients have sufficiently severe polyneuropathy to be graded stage 2b, and none were graded stage 3.