Rare diabetic neuropathies: It is not only distal symmetrical polyneuropathy

Samakidou, Georgia; Eleftheriadou, Ioanna; Tentolouris, Anastasios; Παπάνας, Νικόλαος; Tentolouris, Nikolaοs

doi:10.1016/j.diabres.2021.108932

Cited by 18 publications

(22 citation statements)

References 53 publications

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“…The classification of diabetic neuropathy consists of distal symmetric polyneuropathy, autonomic neuropathy, mononeuropathies and radiculopathies. 32,37 Diabetic neuropathy increases morbidity and mortality and is a risk factor for the development of diabetic foot ulcers. 32 Neuropathy is also among the earliest diabetic complications since it may develop even in people with prediabetes.…”

Section: Neuropathymentioning

confidence: 99%

“…Diabetic neuropathy is the most prevalent (30%–50% of people with DM) but least recognized diabetic microvascular complication. The classification of diabetic neuropathy consists of distal symmetric polyneuropathy, autonomic neuropathy, mononeuropathies and radiculopathies 32,37 . Diabetic neuropathy increases morbidity and mortality and is a risk factor for the development of diabetic foot ulcers 32 .…”

Section: Diabetes and Myeloma Common Clinical Presentationsmentioning

confidence: 99%

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Diabetes mellitus and multiple myeloma; common features of two distinct entities

Tentolouris

Ntanasis‐Stathopoulos

Eleftheriadou

et al. 2022

Diabetes Metabolism Res

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Diabetes mellitus (DM) has attained the status of a global pandemic. Cardiovascular disease (CV) was the leading cause of morbidity in people with type 2 DM, however, a transition from CV to cancer as the leading contributor to DM related death has been observed lately. Multiple myeloma (MM) is the second most common haematological malignancy. Obesity is a common risk factor for both DM and MM. Although data are limited, studies have shown that DM might be associated with increased risk for the development of MM. The presence of DM might affect the course of patients with MM, since hyperglycemia may have an impact on both the efficacy and the adverse effects of antimyeloma therapy. In parallel, DM and MM share common clinical presentations, such as nephropathy, neuropathy, and CV. In terms of antidiabetic medications, metformin might present a synergistic effect with antimyeloma drugs and also prevent some of the adverse effects of these drugs; pioglitazone might have favourable effects when given as add on treatment in people with relapsed or refractory MM. No clinically important interactions have been observed between antidiabetic agents and the most commonly used antimyeloma drugs. Further data are needed to examine the effect of all classes of antidiabetic medication on MM and its complications. A baseline assessment of risk factors for glucose intolerance and close monitoring of glucose levels during therapy is strongly suggested for patients with MM.

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Section: Neuropathymentioning

confidence: 99%

Section: Diabetes and Myeloma Common Clinical Presentationsmentioning

confidence: 99%

Diabetes mellitus and multiple myeloma; common features of two distinct entities

Tentolouris

Ntanasis‐Stathopoulos

Eleftheriadou

et al. 2022

Diabetes Metabolism Res

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“…Peroneal nerve compression at the head of the fibula not only causes pain, paresthesias and numbness over the dorsum of the foot but can in advanced cases lead to unilateral foot drop, which in turn may cause tripping and falls that may be associated with life-threatening injuries [31]. On occasion the foot drop can be bilateral.…”

Section: Lower Limb Entrapment Neuropathiesmentioning

confidence: 99%

“…Even more rarely compression of the posterior tibia nerve in the tarsal tunnel leads to pain, parasthesias and numbness of the plantar surface of the foot (tarsal tunnel syndrome) [31].…”

Section: Lower Limb Entrapment Neuropathiesmentioning

confidence: 99%

Diabetic Mononeuropathies and Diabetic Amyotrophy

Bell

2022

Diabetes Ther

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This brief review describes the etiology, pathophysiology, clinical features, therapy and prognosis of the diabetic mononeuropathies and diabetic amyotrophy and neuropathic cachexia. Mononeuropathies include cranial neuropathies, of which the oculomotor nerve is most commonly affected, and are thought to be due to microvascular occlusion. Peripherally, entrapment neuropathies occur in both the upper and lower limbs and are due to compression of an already damaged nerve in anatomically restricted channels. Diabetic radiculopathies occur in the dermatones of the thorax and abdomen, mimicking intraabdominal or intrathoracic pathology. I also describe the features of the rare but very distinctive diabetic amyotrophy and neuropathic cachexia. Overall, the prognosis from these conditions is excellent with residual pain or muscle weakness being rare with the exception of diabetic amyotrophy where the prognosis is dependent upon cooperation with intensive rehabilitation. Therapies include ''watchful waiting,'' physical therapy and rarely surgical intervention, which may be urgently needed for nerve decompression and reversal of motor defects.

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“…It is the most prevalent and studied clinical presentation of diabetic neuropathy, accounting for 75% of all cases [ 4 ], with the strongest evidence for its pathogenesis, and is thus the focus of this review article. Other clinical presentations of diabetic neuropathy, such as autonomic neuropathies, acute painful-distal sensory polyneuropathies (hyperglycemia- or treatment-induced), focal or multifocal neuropathies, mononeuropathy, mononeuropathy multiplex, radiculoplexus neuropathy and entrapment neuropathies [ 5 ], are beyond the scope of this article; however, we refer the reader to relevant review articles [ 4 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 ]. Also, the pathogeneses of other linked diabetes-related complications, such as retinopathy, foot ulceration and Charcot neuropathic osteoarthropathy, are not discussed in this article.…”

Section: Introductionmentioning

confidence: 99%

Pathogenesis of Distal Symmetrical Polyneuropathy in Diabetes

Smith

Normahani

Lane

et al. 2022

Life

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Distal symmetrical polyneuropathy (DSPN) is a serious complication of diabetes associated with significant disability and mortality. Although more than 50% of people with diabetes develop DSPN, its pathogenesis is still relatively unknown. This lack of understanding has limited the development of novel disease-modifying therapies and left the reasons for failed therapies uncertain, which is critical given that current management strategies often fail to achieve long-term efficacy. In this article, the pathogenesis of DSPN is reviewed, covering pathogenic changes in the peripheral nervous system, microvasculature and central nervous system (CNS). Furthermore, the successes and limitations of current therapies are discussed, and potential therapeutic targets are proposed. Recent findings on its pathogenesis have called the definition of DSPN into question and transformed the disease model, paving the way for new research prospects.

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Rare diabetic neuropathies: It is not only distal symmetrical polyneuropathy

Cited by 18 publications

References 53 publications

Diabetes mellitus and multiple myeloma; common features of two distinct entities

Diabetes mellitus and multiple myeloma; common features of two distinct entities

Diabetic Mononeuropathies and Diabetic Amyotrophy

Pathogenesis of Distal Symmetrical Polyneuropathy in Diabetes

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