The Short-term Prognosis in Diabetic Neuropathy

Mayne, N

doi:10.2337/diab.17.5.270

Cited by 25 publications

(16 citation statements)

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“…28 The natural history of symptomatic diabetic neuropathy is controversial. Whereas Mayne 29 suggested that painful symptoms tend to resolve over a few years, in our experience 30 and according to Fry et al, 5 painful symptoms remained unchanged over a similar period of time. It is therefore unlikely that the symptomatic improvement seen within a few weeks in this study is a reflection of the natural history of the condition.…”

Section: Discussionsupporting

confidence: 47%

Continuous Subcutaneous Insulin Infusion in the Management of Painful Diabetic Neuropathy

et al. 1982

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Nine patients with diabetic neuropathy were treated as outpatients with continuous subcutaneous insulin infusion (CSII). Painful symptoms were scored on a 10-cm horizontal graphic rating scale; motor conduction velocity (MCV) was measured in the median and peroneal nerves; and vibration perception threshold (VPT) was recorded in the great toes. All investigations were repeated after 6 wk and at the completion of 4 mo of CSII. Improved diabetic control was confirmed by significantly lower mean blood glucose levels, M-values, and glycosylated hemoglobin. Symptomatic relief was noted by all patients and was accompanied by a significant improvement in pain scores. There was also significant improvement in VPT and MCV after 6 wk of CSII, which was maintained throughout the 4-mo period. However, sensory studies in the median nerve showed no significant changes during the study. It is concluded that strict glucoregulation is indicated in all cases of symptomatic diabetic neuropathy. It remains to be seen whether strict diabetic control from diagnosis will lead to a reduction in the incidence of this complication.

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Section: Discussionsupporting

confidence: 47%

Continuous Subcutaneous Insulin Infusion in the Management of Painful Diabetic Neuropathy

et al. 1982

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“…In the past, with regard to neuropathy, there have been far too many clinical reports in which the diagnosis is based on trivial symptomatology or physical signs or even on nerve conduction velocity measurements alone, a view supported by recent reports [46,47]. The presence of ankle jerks, with or without patchy sensory loss, has been shown to be identical in a group of elderly diabetic patients diagnosed as having neuropathy when compared with a matched group in which no such diagnosis had been made [48]. Even the presence of significant sounding symptoms may, on occasions, be misleading.…”

Section: Assessment Of Diabetic Leg Painmentioning

confidence: 84%

The diabetic leg

Ward

1982

Diabetologia

100

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Summary. Many clinical problems arise as a result of tissue pathology in the diabetic leg. Neuropathic or vascular ischaemic syndromes are readily identified but on occasions differentiation of the two may be difficult. This survey reviews the aetiological background of neuropathy and ischaemia, examines the relationship of physiological blood flow abnormalities to both areas and comments on management of the clinical states encountered, including the common problem of the ulcerated diabetic foot.

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“…Painful diabetic neuropathy tends to improve within 1-2 years (71)(72)(73), especially if the onset was associated with a recent metabolic disturbance (72); however, the longer the pain has been present, the more likely it is to persist (73)(74)(75). Signs of large fiber neuropathy (vibration, ankle jerks, pain sensation) tend to remain stable or worsen over time (71,74).…”

Section: Peripheral Neuropathymentioning

confidence: 97%