Prevalence of and Risk Factors for Diabetic Peripheral Neuropathy in Youth With Type 1 and Type 2 Diabetes: SEARCH for Diabetes in Youth Study.
Mamta Jaiswal,Jasmin Divers,Dana Dabelea,Scott Isom,Ronny A. Bell,Catherine L. Martin,David J. Pettitt,Sharon Saydah,Catherine Pihoker,Debra Standiford,Lawrence M. Dolan,Santica M. Marcovina,Barbara Linder,Angela D. Liese,Rodica Pop-Busui,Eva L. Feldman +15 more
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The high rates of DPN among youth with diabetes are a cause of concern and suggest a need for early screening and better risk factor management.Abstract:
OBJECTIVE We assessed the prevalence of and risk factors for diabetic peripheral neuropathy (DPN) in youth with type 1 diabetes (T1D) and type 2 diabetes (T2D) enrolled in the SEARCH for Diabetes in Youth (SEARCH) study. RESEARCH DESIGN AND METHODS The Michigan Neuropathy Screening Instrument (MNSI) was used to assess DPN in 1,734 youth with T1D (mean ± SD age 18 ± 4 years, T1D duration 7.2 ± 1.2 years, and HbA1c 9.1 ± 1.9%) and 258 youth with T2D (age 22 ± 3.5 years, T2D duration 7.9 ± 2 years, and HbA1c 9.4 ± 2.3%) who were enrolled in the SEARCH study and had ≥5 years of diabetes duration. DPN was defined as an MNSI exam score of >2. Glycemic control over time was estimated as area under the curve for HbA1c. RESULTS The prevalence of DPN was 7% in youth with T1D and 22% in youth with T2D. Risk factors for DPN in youth with T1D were older age, longer diabetes duration, smoking, increased diastolic blood pressure, obesity, increased LDL cholesterol and triglycerides, and lower HDL cholesterol (HDL-c). In youth with T2D, risk factors were older age, male sex, longer diabetes duration, smoking, and lower HDL-c. Glycemic control over time was worse among those with DPN compared with those without for youth with T1D (odds ratio 1.53 [95% CI 1.24; 1.88]) but not for youth with T2D (1.05 [0.7; 1.56]). CONCLUSIONS The high rates of DPN among youth with diabetes are a cause of concern and suggest a need for early screening and better risk factor management. Interventions in youth that address poor glycemic control and dyslipidemia may prevent or delay debilitating neuropathic complications.read more
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Diabetic Peripheral Neuropathy: Epidemiology, Diagnosis, and Pharmacotherapy.
Zohaib Iqbal,Shazli Azmi,Rahul Yadav,Maryam Ferdousi,Mohit Kumar,Daniel J. Cuthbertson,Jonathan Lim,Rayaz A. Malik,Uazman Alam,Uazman Alam +9 more
TL;DR: Clinical recognition of DPN is imperative for allowing timely symptom management to reduce the morbidity associated with this condition and consider potential new pharmacotherapies for painful DPN.
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Type 1 Diabetes in Children and Adolescents: A Position Statement by the American Diabetes Association
Jane L. Chiang,David M. Maahs,Katharine C. Garvey,Korey K. Hood,Lori M. Laffel,Stuart A. Weinzimer,Joseph I. Wolfsdorf,Desmond A. Schatz +7 more
TL;DR: This Position Statement provides recommendations for current standards of care for youth (children and adolescents) with type 1 diabetes and is not intended to be an exhaustive compendium on all aspects of care.
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Japanese Clinical Practice Guideline for Diabetes 2019
Eiichi Araki,Atsushi Goto,Tatsuya Kondo,Mitsuhiko Noda,Hiroshi Noto,Hideki Origasa,Haruhiko Osawa,Akihiko Taguchi,Yukio Tanizawa,Kazuyuki Tobe,Narihito Yoshioka +10 more
TL;DR: The current guideline represents the 6th edition of the “Japanese Clinical Practice Guideline for Diabetes” and it is hoped that the guideline will prove a helpful guide to evidence-based medicine (EBM) in clinical settings thereby.
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ISPAD Clinical Practice Consensus Guidelines 2018: Diabetes in adolescence
Fergus J. Cameron,Fergus J. Cameron,Katharine C. Garvey,Korey K. Hood,Carlo L. Acerini,Ethel Codner +5 more
TL;DR: Pre-conceptional counseling should begin early during puberty and mental health problems that may be associated with poor metabolic control should be treated early in girls, according to a report on diabetes-related technologies.
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Pathogenesis, diagnosis and clinical management of diabetic sensorimotor peripheral neuropathy
TL;DR: In this article, the authors discuss the latest advances in the mechanisms of diabetic sensorimotor peripheral neuropathy and painful DSPN, originating both from the periphery and the central nervous system, as well as the emerging diagnostics and treatments.
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TL;DR: In this article, the effects of intensive blood-glucose control with either sulphonylurea or insulin and conventional treatment on the risk of microvascular and macrovascular complications in patients with type 2 diabetes in a randomised controlled trial were compared.
Journal Article
Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). UK Prospective Diabetes Study (UKPDS) Group.
R C Turner,C Fox,Matthews,H McElroy,Carole A. Cull,Rury R. Holman,P. A. Neil,D R Hadden,D Wright,E Manley,Irene M Stratton,UK Prospective Diabetes,E M Kohner,Frighi,Michael Gnant +14 more
TL;DR: The effects of intensive blood-glucose control with either sulphonylurea or insulin and conventional treatment on the risk of microvascular and macrovascular complications in patients with type 2 diabetes in a randomised controlled trial were compared.
Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33)
TL;DR: The effects of intensive blood-glucose control with either sulphonylurea or insulin and conventional treatment on the risk of microvascular and macrovascular complications in patients with type 2 diabetes in a randomised controlled trial were compared.
Journal ArticleDOI
Effect of intensive diabetes treatment on the development and progression of long-term complications in adolescents with insulin-dependent diabetes mellitus: Diabetes Control and Complications Trial☆☆☆★★★
TL;DR: It is concluded that intensive therapy effectively delays the onset and slows the progression of diabetic retinopathy and nephropathy when initiated in adolescent subjects; the benefits outweigh the increased risk of hypoglycemia that accompanies such treatment.
Journal ArticleDOI
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.