Painful and non‐painful diabetic polyneuropathy: Clinical characteristics and diagnostic issues

Gylfadottir, Sandra Sif; Weeracharoenkul, Danita; Andersen, Signe; Niruthisard, Supranee; Suwanwalaikorn, Sompongse; Jensen, Troels Staehelin

doi:10.1111/jdi.13105

Cited by 68 publications

(63 citation statements)

References 63 publications

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“…DPN causes many debilitating symptoms, such as paresthesia, dysesthesia, decreased sensation, motor weakness, and neuropathic pain, particularly in the upper and lower extremities (Ang, Cowdin, Mizokami‐Stout, & Pop‐Busui, 2018). Diabetic peripheral neuropathic pain (DPNP) is probably the most debilitating symptom of DPN and is generally described by patients as burning, electric shocks, shooting pain, or uncomfortable tingling and numbness (Gylfadottir et al, 2019). In addition, DPNP results in various physical challenges, including enhanced risk for falling, loss of balance when standing or walking, susceptibility to injuries due to loss in sensation, sleep disturbances, and fatigue (Brod, Pohlman, Blum, Ramasamy, & Carson, 2015).…”

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confidence: 99%

Progressive Muscle Relaxation and Mindfulness Meditation on Neuropathic Pain, Fatigue, and Quality of Life in Patients With Type 2 Diabetes: A Randomized Clinical Trial

İzgü

Metin

Karadas

et al. 2020

J of Nursing Scholarship

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Purpose To examine the effects of progressive muscle relaxation and mindfulness meditation on the severity of diabetic peripheral neuropathic pain (DPNP), fatigue, and quality of life in patients with type 2 diabetes. Design An assessor‐blinded prospective randomized controlled trial. Methods Participants were randomly assigned to the relaxation group (RG; n = 28), meditation group (MG; n = 25), or control group (CG; n = 24). The mean age of participants was 64.2 ± 8.1 years in the RG, 61.6 ± 8.0 years in the MG, and 64.1± 6.6 years in the CG. Patients in the intervention groups performed progressive muscle relaxation or mindfulness meditation at their home for 12 weeks, 20 min daily. The CG received only an attention‐matched controlled education on pancreas anatomy and diabetes. Data collection was performed at baseline and at weeks 12 and 14 using the VAS, FACIT Fatigue Scale (FACIT‐F), and Neuropathic Pain Impact on Quality of Life Questionnaire (NePIQoL). Findings VAS scores were significantly lower in the RG and MG at week 12 (p < .05) and were statistically significant in the RG at week 14. Additionally, fatigue severity decreased significantly in the RG at weeks 12 and 14, compared to that in the CG (p < .05). While no significant difference was found in the quality of life scores between the study groups at weeks 12 and 14 (p > .05), a significant improvement in quality of life scores in the RG were provided at week 12 compared to those at baseline and week 14 (p < .05). Conclusions Both progressive muscle relaxation and mindfulness meditation had a positive impact on providing pain relief in patients with DPNP. Moreover, progressive muscle relaxation also appeared to have a beneficial effect on fatigue. Clinical Relevance Based on the results, progressive muscle relaxation and mindfulness meditation can be recommended as supportive therapies for the management of DPNP.

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confidence: 99%

Progressive Muscle Relaxation and Mindfulness Meditation on Neuropathic Pain, Fatigue, and Quality of Life in Patients With Type 2 Diabetes: A Randomized Clinical Trial

İzgü

Metin

Karadas

et al. 2020

J of Nursing Scholarship

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“…In practice, the physical and mental components of the quality of life are significantly altered in patients with DPN. In the literature, anxiety, depression, and sleep disorders have been noted in approximately 43% of patients with DPN [ 19 ]. This situation warrants implementation of strategies even in the absence of pain [ 19 ].…”

Section: Discussionmentioning

confidence: 99%

“…It is noteworthy that, compared to the other complications of diabetes, DPN is more often associated with depression and anxiety disorders. It, therefore, requires early and effective treatment [ 19 ]. In practice, it is essential to develop effective intervention strategies to limit the physical and psychological impacts of DPN on patients [ 20 , 21 ].…”

Section: Introductionmentioning

confidence: 99%

Diabetic polyneuropathy with/out neuropathic pain in Mali: A cross-sectional study in two reference diabetes treatment centers in Bamako (Mali), Western Africa

Maiga

Diallo²,

Konipo

et al. 2020

PLoS ONE

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Introduction Diabetic polyneuropathy (DPN) with or without neuropathic pain is a frequent complication of diabetes. This work aimed to determine the prevalence of diabetic polyneuropathy, to describe its epidemiological aspects, and to analyze the therapeutic itinerary of patients with DPN. Methods This was a cross-sectional, descriptive study performed synchronously over six months at two major follow-up sites for patients with diabetes in Mali. DPN was diagnosed based on the Michigan Neuropathy Screening Instrument (MNSI). The neuropathic nature of the pain and the quality of life of patients were evaluated by the DN4 and the ED-5D scale, respectively. We used three (3) different questionnaires to collect data from patients (one at inclusion and another during the follow-up consultation) and from the caregivers of patients with DPN. Results We included 252 patients with diabetes, and DPN was found to have a healthcare facility-based prevalence of 69.8% (176/252). The sex ratio was approximately three females for every male patient. The patients were mostly 31 to 60 years of age, 83% had type 2 diabetes, and 86.9% had neuropathic pain Approximately half of the patients (48.3%) had autonomic neuropathy and they reported moderate to intense pain, which was mainly described as a burning sensation. The patients exhibited impaired exteroceptive and proprioceptive sensations in 51.7% of cases. The patients smoked tobacco in 3.4% of cases, while 36.6% of the patients were obese and had dyslipidemia. The caregivers clearly indicated that appropriate medications were not readily accessible or available for their patients with DPN. Conclusion The healthcare facility-based prevalence of DPN with or without neuropathic pain was high in our cohort. These inexpensive and easy-to-use tools (MNSI, DN4) can be used to adequately diagnose DPN in the African context. In Mali, screening and early treatment of patients at risk of DPN should allow for a reduction of the burden of the disease, while caregivers need to be adequately trained to manage DPN.

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“…Diabetic neuropathy (DN) is a common complication of diabetes, where the patients’ pain threshold can be increased or decreased. Non-painful DN represents a clinical and diagnostic challenge, often going unnoticed until irreversible nerve damage has occurred (Gylfadottir et al, 2019). Over time, at least 50% of patients with diabetes develop DN.…”

Section: Discussionmentioning

confidence: 99%

Modulation of Glycine Receptor-Mediated Pain Signaling in vitro and in vivo by Glucose

Hussein

Ahmed

Breitinger

2019

Front. Mol. Neurosci.

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The inhibitory glycine receptor (GlyR) plays an important role in rapid synaptic inhibition in mammalian spinal cord, brainstem, higher brain centers, and is involved in transmission of nociceptive signals. Glucose and related mono- and disaccharides potentiate currents mediated by recombinant α1, α1-β, and α3 GlyRs. Here, we confirmed the specific potentiation of α3 GlyR signaling by glucose through: (i) patch-clamp electrophysiology on recombinant receptors; and (ii) by verifying in vitro data in a mouse model in vivo. Mice were intraperitoneally (IP) injected with glucose (2 g/kg) or vehicle, and then challenged with sublethal doses of strychnine (0.2 mg/kg and 0.5 mg/kg). Pain-related behavior was assessed using two established models: (i) touch sensitivity tests using von Frey filaments; and (ii) hotplate assay. We observed a reduction of pain sensitivity in glucose-treated mice relative to vehicle-treated control mice. Injection of strychnine resulted in an increased sensitivity to tactile and heat stimuli, which was reversed in the presence of glucose. Analgesic effects of glucose were more pronounced in von Frey experiments, consistent with the established use of this model for neuropathic pain. Overall, glucose showed mild analgesic effects and was able to compensate for strychnine-induced allodynia in mice. Since the action of strychnine is specific for GlyR, these experiments show for the first time an in vivo potentiation of GlyR activity by glucose and suggest a molecular mechanism for glucose-mediated analgesia.

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Painful and non‐painful diabetic polyneuropathy: Clinical characteristics and diagnostic issues

Cited by 68 publications

References 63 publications

Progressive Muscle Relaxation and Mindfulness Meditation on Neuropathic Pain, Fatigue, and Quality of Life in Patients With Type 2 Diabetes: A Randomized Clinical Trial

Progressive Muscle Relaxation and Mindfulness Meditation on Neuropathic Pain, Fatigue, and Quality of Life in Patients With Type 2 Diabetes: A Randomized Clinical Trial

Diabetic polyneuropathy with/out neuropathic pain in Mali: A cross-sectional study in two reference diabetes treatment centers in Bamako (Mali), Western Africa

Modulation of Glycine Receptor-Mediated Pain Signaling in vitro and in vivo by Glucose

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