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diabetics neuropathic

Nancy Cardinez, Leif E Lovblom, Johnny-Wei Bai, Evan Lewis, Alon Abraham, Daniel Scarr, Julie A Lovshin, Yuliya Lytvyn, Genevieve Boulet, Mohammed A Farooqi, Andrej Orszag, Alanna Weisman, Hillary A Keenan, Michael H Brent, Narinder Paul, Vera Bril, David Z Cherney, Bruce A Perkins
AIM: Neuropathy and neuropathic pain are common complications of type 1 diabetes (T1D). We aimed to determine if sex-specific differences in neuropathic pain are present in adults with longstanding T1D. METHODS: Canadians with ≥50 years of T1D (n = 361) completed health history questionnaires that included assessment of neuropathy (defined by Michigan Neuropathy Screening Instrument questionnaire components ≥3; NEUROPATHYMNSI-Q ) and neuropathic pain. Multivariable logistic regression was used to determine sex-differences in neuropathic pain controlling for neuropathy...
May 5, 2018: Journal of Diabetes and its Complications
Ashwinikumar Patil, Datta More, Anant Patil, Kishor A Jadhav, Myriam E Vijil Mejia, Suresh S Patil
OBJECTIVE: To examine the clinical pattern of foot-related complications in type 2 diabetes patients. MATERIAL AND METHODS: A cross-sectional study was conducted among indoor, adult type 2 diabetes patients with risk factors for diabetic foot complications. The diabetic neuropathy symptom score (DNSS), Doppler scanning, ankle brachial pressure index (ABPI) assessment, neuropathy assessment, neuropathic disability score (NDS), biothesiometry evaluation, and bacteriological examination was performed...
April 18, 2018: Curēus
Christine B Sieberg, Caitlin Taras, Aya Gomaa, Chelsea Nickerson, Cindy Wong, Catherine Ward, Georgios Baskozos, David L H Bennett, Juan D Ramirez, Andreas C Themistocleous, Andrew S C Rice, Pallai R Shillo, Solomon Tesfaye, Robert R Edwards, Nick A Andrews, Charles Berde, Michael Costigan
Background: Epidemiological studies in patients with neuropathic pain demonstrate a strong association with psychiatric conditions such as anxiety; however, the precipitating pathology between these symptoms remains unclear. To investigate this, we studied the effects of lifelong stress on levels of neuropathic pain-like behavior and conversely, the effects of chronic neuropathic injury on anxiety-like status in male and female mice. In addition, we assayed this link in painful and painless diabetic peripheral neuropathy patients...
May 2018: Pain Reports (Baltimore, Md.)
Shayuan Li, Chunli Sun, Peijing Rong, Xu Zhai, Jinling Zhang, Max Baker, Shuxing Wang
Painful neuropathy is a frequent comorbidity in diabetes. Zucker diabetic fatty (ZDF, fa/fa) rats develop type 2 diabetes spontaneously with ageing and show nociceptive hypersensitivity by age of 13wk. In preclinical and clinical studies, the treatment of diabetic neuropathy is challenging but complementary medicine like transcutaneous auricular vagus nerve stimulation (taVNS) appears beneficial to the relief of neuropathic pain. However, the mechanism behind the effectiveness of taVNS remains unclear. In this study we show that daily 30min taVNS (2/15Hz, 2mA) for consecutive 27 days effectively inhibited the development of nociceptive hypersensitivity in ZDF rats as detected by thermal hyperalgesia and mechanical allodynia in hindpaw...
January 1, 2018: Molecular Pain
Jarkko Kalliomäki, Bror Jonzon, Karin Huizar, Michael O'Malley, Anita Andersson, David M Simpson
Background and aims Preclinical data suggest that the chemokine receptor 2 (CCR2) is involved in the pathophysiology of neuropathic pain through modulation of neuronal excitability, synaptic transmission and activation of spinal cord microglia. CCR2-antagonists have shown to be effective in preclinical models of neuropathic pain. The aim of this study was to evaluate the analgesic efficacy, safety and tolerability of a novel CCR2-antagonist, AZD2423, in patients with painful diabetic neuropathy (PDN). Methods This was a double-blind, randomized, parallel-group, multi-center study in patients with symmetric distal sensory polyneuropathy due to type 1 or 2 diabetes and duration of neuropathic pain between 3 months and 5 years...
December 29, 2017: Scandinavian Journal of Pain
Marianne Rørbæk, Lise Ventzel, Hanne Gottrup
Background Neuropathic pain is usually treated with antidepressants and anticonvulsant. The use of systemic treatment is, however, limited due to poor tolerability and low efficacy. Qutenza, a topical capsaicin patch (8%), is a relatively new treatment for patients with peripheral neuropathic pain (PNP) conditions. The indication for using topical capsaicin treatment is peripheral neuropathic pain in patients without diabetes. Aim To describe the use of topical capsaicin treatment in a pain clinic in patients with PNP...
December 29, 2017: Scandinavian Journal of Pain
Christina Brock, Carina Graversen, Jens B Frøkjær, Eirik Søfteland, Massimiliano Valeriani, Asbjørn M Drewes
Background/aims Abnormal visceral sensory function in diabetes mellitus (DM) leads to neuronal changes in the enteric, peripheral and/or central nervous system (CNS). To explore the role of diabetic autonomic neuropathy (DAN) in patients with long-standing DM, we investigated psychophysical responses and neuronal activity recorded as evoked brain potentials (EPs) and dipolar source modelling. Methods Fifteen healthy volunteers and 14 type-1 DM patients with DAN were assessed with a symptom score index characterizing upper GI abnormalities...
December 29, 2017: Scandinavian Journal of Pain
Kaare Meier
Background Spinal cord stimulation (SCS) is a surgical treatment for chronic neuropathic pain refractory to conventional treatment. SCS treatment consists of one or more leads implanted in the epidural space of the spinal canal, connected to an implantable pulse generator (IPG). Each lead carries a number of contacts capable of delivering a weak electrical current to the spinal cord, evoking a feeling of peripheral paresthesia. With correct indication and if implanted by an experienced implanter, success rates generally are in the range of about 50-75%...
December 29, 2017: Scandinavian Journal of Pain
L Ferhatovic, A Jelicic, M Boric, A Banozic, D Sapunar, L Puljak
Aim The aim of this study was to compare expression of total calcium/calmodulin-dependent protein kinase II (tCaMKII) and its α, β, γ and δ isoforms in dorsal root ganglion (DRG) in rat models of diabetes mellitus type I (DM1), 6 months and 1 year after diabetes induction. Methods A total of 45 male Sprague-Dawley rats weighing 160-200 g were assigned into four experimental groups: 6-months DM1 and its control group, 1-year and its control group. For the induction of DM1, after overnight fasting animals were injected intraperitonealy with 55 mg/kg of the streptozotocine (STZ)...
December 29, 2017: Scandinavian Journal of Pain
Clifford J Bailey, Caroline Day
Introduction or background: Type 2 diabetes, which accounts for ~90% of all diabetes, is a heterogeneous and progressive disease with a variety of causative and potentiating factors. The hyperglycaemia of type 2 diabetes is often inadequately controlled, hence the need for a wider selection of glucose-lowering treatments. Sources of data: Medline, PubMed, Web of Science and Google Scholar. Areas of agreement: Early, effective and sustained control of blood glucose defers the onset and reduces the severity of microvascular and neuropathic complications of type 2 diabetes and helps to reduce the risk of cardiovascular (CV) complications...
June 1, 2018: British Medical Bulletin
Cağdaş Erdoğan, Nedim Ongun, Selim Tümkaya, Hakan Alkan, Neşe Öztürk
Background and purpose: Depression and anxiety are frequent in patients with chronic diseases such as diabetic neuropathic pain. The pain seems to be more severe in patients in whom depressive findings accompanied pain symptoms. Pregabalin was reported to have positive effects on anxiety and depression. This brings out the question, whether the pain relief effect of pregabalin is due to its analgesic effect or to its effects on mood? The aim of this study is to find out whether the positive effect of pregabalin in patients with diabetic neuropathic pain is limited to its effect on pain...
May 30, 2018: Ideggyógyászati Szemle
Rajsavi S Anand, Paul Stey, Sukrit Jain, Dustin R Biron, Harikrishna Bhatt, Kristina Monteiro, Edward Feller, Megan L Ranney, Indra Neil Sarkar, Elizabeth S Chen
Diabetes constitutes a significant health problem that leads to many long term health issues including renal, cardiovascular, and neuropathic complications. Many of these problems can result in increased health care costs, as well risk of ICU stay and mortality. To date, no published study has used predictive modeling to examine the relative influence of diabetes, diabetic health maintenance, and comorbidities on outcomes in ICU patients. Using the MIMIC-III database, machine learning and binomial logistic regression modeling were applied to predict risk of mortality...
2018: AMIA Summits on Translational Science Proceedings
E Galosi, S La Cesa, G Di Stefano, P Karlsson, A Fasolino, C Leone, A Biasiotta, G Cruccu, A Truini
BACKGROUNDS: Patients with diabetic polyneuropathy commonly suffer from ongoing burning pain and dynamic mechanical allodynia. In this clinical and skin biopsy study, we aimed at assessing how intraepidermal regenerating nerve sprouts are associated with these two types of pain. METHODS: We consecutively enrolled 85 patients with diabetic polyneuropathy. All patients underwent skin biopsy at the distal leg. Intraepidermal nerve fibres were immunostained with the anti-protein gene product 9...
June 8, 2018: European Journal of Pain: EJP
Raj Shilpa, T P Sreekrishnan, K P Gireesh Kumar, C M Neethu
This is a case report on a 77-year-old diabetic patient with peripheral neuropathy and paresthesias in his feet, for which he was treated with pregabalin. During the therapy, his eosinophil level was high (60.3%). Pregabalin was stopped, and after one month his differential eosinophil had dropped dramatically, to 7.3%. Based on the Naranjo Adverse Drug Reaction scale, it is probable that the eosinophilia was induced by pregabalin, as the Naranjo probability score was calculated to be 8. BACKGROUND: Pregabalin, a structural derivative of the inhibitory neurotransmitter gamma amino butyric acid, has antiepileptic, analgesic, and anxiolytic properties; therefore, it is used for painful diabetic neuropathy, postherpetic neuralgia, fibromyalgia, and neuropathic pain associated with spinal-cord injury and as adjunctive therapy in refractory partial seizures...
June 1, 2018: Consultant Pharmacist: the Journal of the American Society of Consultant Pharmacists
Ting-Ting Zhang, Rui Xue, Shi-Yong Fan, Qiong-Yin Fan, Lei An, Juan Li, Lei Zhu, Yu-Hua Ran, Li-Ming Zhang, Bo-Hua Zhong, Yun-Feng Li, Cai-Ying Ye, You-Zhi Zhang
BACKGROUND: Diabetic neuropathic pain (DNP) is a common and distressing complication in patients with diabetes, and the underlying mechanism remains unclear. Tricyclic antidepressants (TCAs) and serotonin and norepinephrine reuptake inhibitors (SNRIs) are recommended as first-line drugs for DNP. Ammoxetine is a novel and potent SNRI that exhibited a strong analgesic effect on models of neuropathic pain, fibromyalgia-related pain, and inflammatory pain in our primary study. The present study was undertaken to investigate the chronic treatment properties of ammoxetine on DNP and the underlying mechanisms for its effects...
June 7, 2018: Journal of Neuroinflammation
Grace Messenger, Richard Masoetsa, Imtiaz Hussain, Sriraman Devarajan, Mohamed Jahromi
Objective : This single-centred study aims to evaluate the incidence, risk factors and treatment outcomes of a podiatry led, evidence-based diabetic foot ulcer (DFU) clinic. Research design and methods : Data from the DFU database and patient electronic health records were retrospectively collected from patients with new DFUs who were referred for treatment to the Department of Podiatry, Dasman Diabetes Institute, Kuwait, from 1 October 2014, to 31 December 2016. Patients were followed-up until healing occurred or until 6 months after the study end date, whichever came first...
2018: Diabetic Foot & Ankle
Gianluca Castelnuovo, Emanuele Maria Giusti, Gian Mauro Manzoni, Donatella Saviola, Samantha Gabrielli, Marco Lacerenza, Giada Pietrabissa, Roberto Cattivelli, Chiara Anna Maria Spatola, Alessandro Rossi, Giorgia Varallo, Margherita Novelli, Valentina Villa, Francesca Luzzati, Andrea Cottini, Carlo Lai, Eleonora Volpato, Cesare Cavalera, Francesco Pagnini, Valentina Tesio, Lorys Castelli, Mario Tavola, Riccardo Torta, Marco Arreghini, Loredana Zanini, Amelia Brunani, Ionathan Seitanidis, Giuseppe Ventura, Paolo Capodaglio, Guido Edoardo D'Aniello, Federica Scarpina, Andrea Brioschi, Matteo Bigoni, Lorenzo Priano, Alessandro Mauro, Giuseppe Riva, Daniele Di Lernia, Claudia Repetto, Camillo Regalia, Enrico Molinari, Paolo Notaro, Stefano Paolucci, Giorgio Sandrini, Susan Simpson, Brenda Kay Wiederhold, Santino Gaudio, Jeffrey B Jackson, Stefano Tamburin, Fabrizio Benedetti
Background: It is increasingly acknowledged that the outcomes of medical treatments are influenced by the context of the clinical encounter through the mechanisms of the placebo effect. The phenomenon of placebo analgesia might be exploited to maximize the efficacy of neurorehabilitation treatments. Since its intensity varies across neurological disorders, the Italian Consensus Conference on Pain in Neurorehabilitation (ICCP) summarized the studies on this field to provide guidance on its use...
2018: Frontiers in Neurology
Takahiro Akamine, Naoki Kusunose, Naoya Matsunaga, Satoru Koyanagi, Shigehiro Ohdo
The intensity of pain in diabetic neuropathy varies in a circadian time-dependent manner. It is well known that diabetes has two distinct types, which are differentiated based on the cause of the disease. Previous studies have yet to compare the circadian properties of the pain intensity of diabetic neuropathy between type I and type II diabetes. In this study, we demonstrated that the pain intensity of diabetic peripheral neuropathy in a db/db mouse model of type II diabetes showed a significant diurnal oscillation, but such time-dependent oscillation was not detected in a streptozotocin (STZ)-induced type I diabetic mouse model...
June 1, 2018: Biochemical and Biophysical Research Communications
Li-Huai Qin, Zhi-Long Wang, Xin Xie, Ya-Qiu Long
The chemokine CC receptor subtype 2 (CCR2) has attracted intensive interest for drug development in diverse therapeutic areas, including chronic inflammatory diseases, diabetes, neuropathic pain, atherogenesis and cancer. By employing a cut-and-sew scaffold hopping strategy, we identified an active scaffold of 3,4-dihydro-2,6-naphthyridin-1(2H)-one as the central pharmacophore to derive novel CCR2 antagonists. Systematic structure-activity relationship study with respect to the ring size and the substitution on the naphthyridinone ring gave birth to 1-arylamino-6-alkylheterocycle-6,7,8,9-tetrahydro-5H-pyrido[4,3-c]azepin-5-ones as a brand new chemotype of CCR2 antagonists with nanomolar inhibitory activity...
May 19, 2018: Bioorganic & Medicinal Chemistry
Martin Grohmann, Stefan Benedikt, Anna Vasilyeva, Heinz Bürger, Abigail Forbes, Michael Valentin Schintler
Despite various therapy options, the prophylactic and symptomatic treatment of recurrent ulcerations in the diabetic foot are still challenging. We report the application of a free vascularized medial femoral condyle flap to prevent the recurrence of pressure ulcer in a patient with diabetic foot syndrome. Our patient had type 2 diabetes and presented with pressure ulcers and osteomyelitis of metatarsal heads 2 and 3 after a great toe amputation. We chose to use a medial femoral condyle flap as a damper in the area of the metatarsal heads because of the relatively young age and good vascularity of our patient...
May 24, 2018: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
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