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Towards prevention of diabetic peripheral neuropathy: clinical presentation, pathogenesis, and new treatments

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Title: Towards prevention of diabetic peripheral neuropathy: clinical presentation, pathogenesis, and new treatments
Authors: Melissa A Elafros, Henning Andersen, David L Bennett, Masha G Savelieff, Vijay Viswanathan, Brian C Callaghan, Eva L Feldman
Source: Elafros, M A, Andersen, H, Bennett, D L, Savelieff, M G, Viswanathan, V, Callaghan, B C & Feldman, E L 2022, 'Towards prevention of diabetic peripheral neuropathy : clinical presentation, pathogenesis, and new treatments', The Lancet Neurology, vol. 21, no. 10, pp. 922-936. https://doi.org/10.1016/S1474-4422(22)00188-0
Publisher Information: Elsevier BV, 2022.
Publication Year: 2022
Subject Terms: Metabolic Syndrome, 03 medical and health sciences, 0302 clinical medicine, Diabetes Mellitus, Type 2, Diabetic Neuropathies, Diabetic Neuropathies/diagnosis, Diabetes Mellitus, Type 2/complications, Quality of Life, Humans, Pain, Pain/etiology, Metabolic Syndrome/complications, 3. Good health
Description: Diabetic peripheral neuropathy (DPN) occurs in up to half of individuals with type 1 or type 2 diabetes. DPN results from the distal-to-proximal loss of peripheral nerve function, leading to physical disability and sometimes pain, with the consequent lowering of quality of life. Early diagnosis improves clinical outcomes, but many patients still develop neuropathy. Hyperglycaemia is a risk factor and glycaemic control prevents DPN development in type 1 diabetes. However, glycaemic control has modest or no benefit in individuals with type 2 diabetes, probably because they usually have comorbidities. Among them, the metabolic syndrome is a major risk factor for DPN. The pathophysiology of DPN is complex, but mechanisms converge on a unifying theme of bioenergetic failure in the peripheral nerves due to their unique anatomy. Current clinical management focuses on controlling diabetes, the metabolic syndrome, and pain, but remains suboptimal for most patients. Thus, research is ongoing to improve early diagnosis and prognosis, to identify molecular mechanisms that could lead to therapeutic targets, and to investigate lifestyle interventions to improve clinical outcomes.
Document Type: Article
Language: English
ISSN: 1474-4422
DOI: 10.1016/s1474-4422(22)00188-0
Access URL: https://pubmed.ncbi.nlm.nih.gov/36115364
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10112836/pdf/nihms-1884395.pdf
http://www.scopus.com/inward/record.url?scp=85138043741&partnerID=8YFLogxK
https://doi.org/10.1016/S1474-4422(22)00188-0
https://pure.au.dk/portal/en/publications/0002fac9-88ff-4965-96fd-621459688a18
Rights: Elsevier TDM
Accession Number: edsair.doi.dedup.....d40bd5d9dbcaf2d71435827d17c60fb9
Database: OpenAIRE
Description
Abstract:Diabetic peripheral neuropathy (DPN) occurs in up to half of individuals with type 1 or type 2 diabetes. DPN results from the distal-to-proximal loss of peripheral nerve function, leading to physical disability and sometimes pain, with the consequent lowering of quality of life. Early diagnosis improves clinical outcomes, but many patients still develop neuropathy. Hyperglycaemia is a risk factor and glycaemic control prevents DPN development in type 1 diabetes. However, glycaemic control has modest or no benefit in individuals with type 2 diabetes, probably because they usually have comorbidities. Among them, the metabolic syndrome is a major risk factor for DPN. The pathophysiology of DPN is complex, but mechanisms converge on a unifying theme of bioenergetic failure in the peripheral nerves due to their unique anatomy. Current clinical management focuses on controlling diabetes, the metabolic syndrome, and pain, but remains suboptimal for most patients. Thus, research is ongoing to improve early diagnosis and prognosis, to identify molecular mechanisms that could lead to therapeutic targets, and to investigate lifestyle interventions to improve clinical outcomes.
ISSN:14744422
DOI:10.1016/s1474-4422(22)00188-0