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Update on the Management of Diabetic Neuropathy
IN BRIEF Distal symmetric polyneuropathy (DSPN) and diabetic autonomic neuropathies, particularly cardiovascular autonomic neuropathy (CAN), are prevalent diabetes complications with high morbidity, mortality, and amputation risks. The diagnosis of DSPN is principally a clinical one based on the pre...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
American Diabetes Association
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6092893/ https://www.ncbi.nlm.nih.gov/pubmed/30140138 http://dx.doi.org/10.2337/ds18-0036 |
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author | Ang, Lynn Cowdin, Nathan Mizokami-Stout, Kara Pop-Busui, Rodica |
author_facet | Ang, Lynn Cowdin, Nathan Mizokami-Stout, Kara Pop-Busui, Rodica |
author_sort | Ang, Lynn |
collection | PubMed |
description | IN BRIEF Distal symmetric polyneuropathy (DSPN) and diabetic autonomic neuropathies, particularly cardiovascular autonomic neuropathy (CAN), are prevalent diabetes complications with high morbidity, mortality, and amputation risks. The diagnosis of DSPN is principally a clinical one based on the presence of typical symptoms combined with symmetrical, distal-to-proximal stocking-glove sensory loss. CAN is an independent risk factor for cardiovascular mortality, arrhythmia, silent ischemia, major cardiovascular events, and myocardial dysfunction. Screening for CAN in high-risk patients is recommended. Symptoms of gastroparesis are nonspecific and do not correspond with its severity. Diagnosis of gastroparesis should exclude other factors well documented to affect gastric emptying such as hyperglycemia, hypoglycemia, and certain medications. There is a lack of treatment options targeting the neuropathic disease state. Managing neuropathic pain also remains a challenge. Given the high risk of addiction, abuse, psychosocial issues, and mortality, opioids are not recommended as first-, second-, or third-line agents for treating painful DSPN. |
format | Online Article Text |
id | pubmed-6092893 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | American Diabetes Association |
record_format | MEDLINE/PubMed |
spelling | pubmed-60928932019-08-01 Update on the Management of Diabetic Neuropathy Ang, Lynn Cowdin, Nathan Mizokami-Stout, Kara Pop-Busui, Rodica Diabetes Spectr From Research to Practice IN BRIEF Distal symmetric polyneuropathy (DSPN) and diabetic autonomic neuropathies, particularly cardiovascular autonomic neuropathy (CAN), are prevalent diabetes complications with high morbidity, mortality, and amputation risks. The diagnosis of DSPN is principally a clinical one based on the presence of typical symptoms combined with symmetrical, distal-to-proximal stocking-glove sensory loss. CAN is an independent risk factor for cardiovascular mortality, arrhythmia, silent ischemia, major cardiovascular events, and myocardial dysfunction. Screening for CAN in high-risk patients is recommended. Symptoms of gastroparesis are nonspecific and do not correspond with its severity. Diagnosis of gastroparesis should exclude other factors well documented to affect gastric emptying such as hyperglycemia, hypoglycemia, and certain medications. There is a lack of treatment options targeting the neuropathic disease state. Managing neuropathic pain also remains a challenge. Given the high risk of addiction, abuse, psychosocial issues, and mortality, opioids are not recommended as first-, second-, or third-line agents for treating painful DSPN. American Diabetes Association 2018-08 /pmc/articles/PMC6092893/ /pubmed/30140138 http://dx.doi.org/10.2337/ds18-0036 Text en © 2018 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. See http://creativecommons.org/licenses/by-nc-nd/3.0 for details. |
spellingShingle | From Research to Practice Ang, Lynn Cowdin, Nathan Mizokami-Stout, Kara Pop-Busui, Rodica Update on the Management of Diabetic Neuropathy |
title | Update on the Management of Diabetic Neuropathy |
title_full | Update on the Management of Diabetic Neuropathy |
title_fullStr | Update on the Management of Diabetic Neuropathy |
title_full_unstemmed | Update on the Management of Diabetic Neuropathy |
title_short | Update on the Management of Diabetic Neuropathy |
title_sort | update on the management of diabetic neuropathy |
topic | From Research to Practice |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6092893/ https://www.ncbi.nlm.nih.gov/pubmed/30140138 http://dx.doi.org/10.2337/ds18-0036 |
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