Novel and Emerging Electrophysiological Biomarkers of Diabetic Neuropathy and Painful Diabetic Neuropathy

Marshall, Anne; Alam, Uazman; Themistocleous, Andreas C.; Calcutt, Nigel A.; Marshall, Andrew

doi:10.1016/j.clinthera.2021.03.020

Cited by 27 publications

(32 citation statements)

References 143 publications

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“…As a result, the risk of foot trauma is significantly higher (26)(27)(28)(29). Foot injuries and ulcers are neglected by patients and doctors due to the lack of pain symptoms (30,31). Hence, foot injuries and ulcers often go undetected by doctors for weeks.…”

Section: Discussionmentioning

confidence: 99%

Nomogram Prediction for the Risk of Diabetic Foot in Patients With Type 2 Diabetes Mellitus

Wang

Xue

et al. 2022

Front. Endocrinol.

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AimsTo develop and validate a nomogram prediction model for the risk of diabetic foot in patients with type 2 diabetes mellitus (T2DM) and evaluate its clinical application value.MethodsWe retrospectively collected clinical data from 1,950 patients with T2DM from the Second Affiliated Hospital of Xi’an Jiaotong University between January 2012 and June 2021. The patients were divided into training cohort and validation cohort according to the random number table method at a ratio of 7:3. The independent risk factors for diabetic foot among patients with T2DM were identified by multivariate logistic regression analysis. Then, a nomogram prediction model was developed using the independent risk factors. The model performances were evaluated by the area under the receiver operating characteristic curve (AUC), calibration plot, Hosmer–Lemeshow test, and the decision curve analysis (DCA).ResultsMultivariate logistic regression analysis indicated that age, hemoglobin A1c (HbA1c), low-density lipoprotein (LDL), total cholesterol (TC), smoke, and drink were independent risk factors for diabetic foot among patients with T2DM (P < 0.05). The AUCs of training cohort and validation cohort were 0.806 (95% CI: 0.775∼0.837) and 0.857 (95% CI: 0.814∼0.899), respectively, suggesting good discrimination of the model. Calibration curves of training cohort and validation cohort showed a favorable consistency between the predicted probability and the actual probability. In addition, the P values of Hosmer–Lemeshow test for training cohort and validation cohort were 0.826 and 0.480, respectively, suggesting a high calibration of the model. When the threshold probability was set as 11.6% in the DCA curve, the clinical net benefits of training cohort and validation cohort were 58% and 65%, respectively, indicating good clinical usefulness of the model.ConclusionWe developed and validated a user-friendly nomogram prediction model for the risk of diabetic foot in patients with T2DM. Nomograms may help clinicians early screen and identify patients at high risk of diabetic foot.

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Section: Discussionmentioning

confidence: 99%

Nomogram Prediction for the Risk of Diabetic Foot in Patients With Type 2 Diabetes Mellitus

Wang

Xue

et al. 2022

Front. Endocrinol.

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“…Although the autonomic tests by monofilament examination and nerve conduction studies gives better diagnosis of diabetic neuropathy (76).However, prediction of diabetic neuropathy among type-1 and type-2 DM patients using clinical and behavioral characteristics of alone enabled to identify low and high risk diabetes mellitus patients. behavioral predictors that make it applicable in primary care settings.…”

Section: Discussionmentioning

confidence: 99%

“…Despite different strategies and initiatives implemented to reduce the Burdon of diabetic neuropathy, up to one third of patients with diabetes have neuropathic pain(23) which often leads to sleep disturbance, poor quality of life, depression, and unemployment. Both acute and chronic diabetic neuropathies had occur in DM patients (24) that results diabetic foot disease, including ulceration and non-traumatic amputations that might be due to lack of screening tool that can be used to identify diabetic patients who is at risk of diabetic neuropathy.…”

Section: Introductionmentioning

confidence: 99%

Prediction of the risk for diabetic neuropathy among diabetes mellitus patients at selected referral hospitals, in Amhara regional state Northwest Ethiopia, January, 2005- December 2021; Development and validation of risk prediction model

Gelaw¹,

Muche

Alem

et al. 2022

Preprint

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Background:-Diabetic neuropathy is the most common complication in both Type-1 and Type-2 DM patients with more than one half of all patients developing nerve dysfunction in their lifetime. Although, risk prediction model was developed for diabetic neuropathy in developed countries, It is not applicable in clinical practice, due to poor data, methodological problems, inappropriately analyzed and reported. To date, no risk prediction model developed for diabetic neuropathy among DM in Ethiopia, Therefore, this study aimed prediction the risk of diabetic neuropathy among DM patients, used for guiding in clinical decision making for clinicians Objective:- Prediction of the risk for diabetic neuropathy among diabetes mellitus patients, in selected referral hospitals, Amhara regional state, northwest Ethiopia,2022 Methods:- A retrospective follow up study was conducted with a total of 808 DM patients were enrolled from January 1,2005 to December 30,2021 at two selected referral hospitals in Amhara regional state. Multi-stage sampling techniques were used and the data was collected by checklist from medical records by Kobo collect and exported to STATA version-17 for analysis. Lasso method were used to select predictors and entered to multivariable logistic regression with P-value<0.05 was used for nomogram development. Model performance was assessed by AUC and calibration plot. Internal validation was done through bootstrapping method and decision curve analysis was performed to evaluate net benefit of model Results:-The incidence proportion of diabetic neuropathy among DM patients was 21.29 %( 95% CI; 18.59, 24.25).In multivariable logistic regression glycemic control, other comorbidities, physical activity, hypertension, alcohol drinking, type of treatment , white blood cells and red blood cells count were statistically significant. Nomogram was developed, has discriminating power AUC; 73.2 %( 95% CI; 69.0%, 77.3%) and calibration test (P-value = 0.45). It was internally validated by bootstrapping method with discrimination performance 71.7(95% CI; 67.2 %, 75.9%).It had less optimism coefficient (0.015).To make nomogram accessible, mobile based tool were developed. In machine learning, classification and regression tree has discriminating performance of 70.2 %( 95 % CI; 65.8%, 74.6%).The model had high net benefit at different threshold probabilities in both nomogram and classification and regression tree. Conclusion:- The developed nomogram and decision tree, has good level of accuracy and well calibration, easily individualized prediction of diabetic neuropathy. Both models had added net benefit in clinical practice and to be clinically applicable mobile based tool were developed.

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“…Furthermore, these patients display a loss of sensitivity (i.e. diabetic peripheral neuropathy) in the affected foot due to damage caused to short and long fibers (A-beta and A-delta) secondary to hyperglycemia [66,67]. Chronic hyperglycemia, a hallmark of diabetes mellitus, provides a suitable medium for bacterial growth, mainly aerobic Gram-positive cocci (e.g.…”

Section: Infectionmentioning

confidence: 99%

Association between Diabetic Kidney Disease and Diabetic Foot Ulceration

Dugbartey¹,

Alornyo²

2023

Diabetic Foot - Recent Advances

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Diabetic kidney disease (DKD) is a common global health challenge characterized by a decline in renal function among the diabetic population, which progresses to end-stage renal disease (ESRD). Evidence in the literature suggests a strong association between DKD and the development of diabetic foot ulceration (DFU). DFU is a serious health issue that complicates both type 1 and type 2 diabetes mellitus, and negatively impacts the quality of life of diabetic patients. Patients with advanced DKD or ESRD have a five-fold increased risk of developing DFU, with 6.5–10 times higher rate of amputation than their non-nephropathic counterparts. Multiple and inter-related pathways of DFU in DKD have been identified in which ischemia, neuropathy and infection are major contributing pathologies. However, extensive research to comprehensively assess the progression of DFU in DKD is lacking. In this chapter, we discuss the causal pathways in DFU development and progression, the relationship between DKD and DFU as well as treatment options and measures to achieve both primary and secondary prevention.

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Novel and Emerging Electrophysiological Biomarkers of Diabetic Neuropathy and Painful Diabetic Neuropathy

Cited by 27 publications

References 143 publications

Nomogram Prediction for the Risk of Diabetic Foot in Patients With Type 2 Diabetes Mellitus

Nomogram Prediction for the Risk of Diabetic Foot in Patients With Type 2 Diabetes Mellitus

Prediction of the risk for diabetic neuropathy among diabetes mellitus patients at selected referral hospitals, in Amhara regional state Northwest Ethiopia, January, 2005- December 2021; Development and validation of risk prediction model

Association between Diabetic Kidney Disease and Diabetic Foot Ulceration

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