Diabetic peripheral neuropathy: Person-centered care.

ABSTRACT: Patients with diabetes mellitus may experience painful and nonpainful diabetic peripheral neuropathy (DPN). This article offers an overview of DPN and the clinical assessment and management of patients with DPN, as well as the nurse's role in supporting these patients.

A Nurse's Guide to the Prevention of Neuropathic Ulcers in Patients with Diabetes.

Neuropathic ulcers present a significant issue for patients with diabetes. Neuropathic ulcers reduce mobility and increase the risk for infection and other complications. Prevention of ulceration is a primary nursing goal in the care of patients with diabetes.

Diabetes-associated cardiac autonomic neuropathy.

Cardiac autonomic neuropathy (CAN) is an underdiagnosed cardiovascular complication associated with diabetes. NPs are in a pivotal position to screen patients for CAN. As the incidence of diabetes increases in an aging population, NPs can help prevent complications associated with diabetes and CAN.

Diabetic autonomic neuropathy resulting in sexual dysfunction.

Although diabetic autonomic neuropathy (DAN), a complication associated with diabetes, is increasing in prevalence, it is often overlooked. Knowledge regarding the development and progression of this complication is limited. NPs are in a key position to prevent complications of DAN, including sexual dysfunction, in this vulnerable population.

Diagnosis and Treatment of Common Pain Syndromes and Disorders.

Management of chronic pain has become a significant challenge for primary care providers, and the population of patients with chronic pain is expected to increase. Common syndromes seen in the primary care setting include myofascial pain syndrome, fibromyalgia, chronic postsurgical pain, complex regional pain syndrome, and painful diabetic neuropathy. This article describes these syndromes and presents current treatment options.

Isolated use of vibration perception thresholds and semmes-weinstein monofilament in diagnosing diabetic polyneuropathy: "the North Catalonia diabetes study".

Several systems are used for the diagnosis of diabeticpolyneuropathy (DPN). We analyzed the isolated use of vibration perception thresholds (VPTs) or monofilament (MF) for the diagnosis of DPN. A group of 400 patients who had type 2 diabetes was selected from the North Catalonia Study Group. A clinical neurologic evaluation was performed based on three categories of the San Antonio Consensus. Neurothesiometer and quantitative tuning fork explored VPT, and MF was assessed by Olmos and Michigan Diabetic Neuropathy Score (MDNS) criteria. The use of VPT and MF showed a high specificity and low sensitivity. MF, by MDNS criteria, was more sensitive and specific, and showed more accurate positive and negative predictive values. The predicted probability of DPN diagnosis was higher with a tuning fork evaluation.

Identifying early signs of peripheral neuropathy among patients with diabetes mellitus.

This article aims to help nurse practitioners develop a best practice algorithm to identify the early signs of peripheral neuropathy (PNP) among individuals living with diabetes mellitus. This literature review also seeks to determine if there are better clinical testing methods than the Semmes-Weinstein monofilament examination to detect diabetes-related PNP.

Diabetes and peripheral neuropathy: keeping people on their own two feet.

Peripheral neuropathy is one of the most common forms of diabetes-related neuropathy, and most commonly affects the feet. Loss of sensation leaves the feet at risk of damage--from environmental hazards, incorrectly fitting footwear or un-felt pressure damage--which can lead to the need for amputations. This article discusses how to reduce the risk of peripheral neuropathy through glycaemic control, and the steps that need to be taken to reduce the risk of injury on the neuropathic foot.

[Guided clinical practice guidelines: how to blunt the weapon of evidence]. / Linee Guida guidate. (Come spuntare le armi dell'evidenza).

The public should trust practice guidelines only if the recommendations accurately reflect the underlying evidence about benefits and harms to individual patients. However, the process of development of clinical practice guidelines is fraught with problem, conflicts and controversies. A few examples, starting from the guidelines on osteoporosis are presented and commented on.

Peripheral diabetic neuropathy or restless legs syndrome in persons with type 2 diabetes mellitus: Differentiating diagnosis in practice.

PURPOSE: Restless legs syndrome (RLS) affects 8% of the population and is identified in 21% of individuals with type 2 diabetes (T2DM). Symptoms of RLS manifest as discomfort in the legs (e.g., numbness, tingling, electrical stimulations), usually occurring at night or at rest (sitting or lying), resulting in the need to move the legs. Peripheral diabetic neuropathy (PDN), which has symptoms similar to RLS, is a common consequence of T2DM. The purpose of this article is to provide nurse practitioners (NPs) with (a) an overview of RLS, (b) the association of RLS with T2DM, (c) the defining characteristics that differentiate PDN from RLS, and (d) implications to improve health outcomes of persons with T2DM. DATA SOURCES: The literature was reviewed for the most current data on RLS and the defining characteristics of PDN. CONCLUSIONS: PDN is a common consequence of T2DM and is described as numbness, tingling, or discomfort in the lower extremities, symptoms that are similar to RLS. Differentiating the symptoms of PDN and RLS may be confusing and result in misdiagnoses, lack of treatment, and poor outcomes. IMPLICATIONS FOR PRACTICE: It is essential that NPs are knowledgeable about the diagnostic and defining features of RLS as well as the characteristics of other conditions, specifically PDN, which mimics RLS.

Nursing management of diabetic peripheral neuropathies.

This article provides a brief description of each of the diabetic peripheral neuropathies. Each distinct peripheral neuropathy is discussed in terms of its incidence, symptomatology, physical signs, medical management, and prognosis. Then Leavell and Clark's Levels of Prevention is used as a framework for nursing intervention for the patient with diabetic peripheral neuropathies. Nursing intervention includes health promotion and specific protection, early diagnosis and prompt treatment, and rehabilitation.

Chronic complications of diabetes mellitus.

This article addresses the long-term or chronic complications of diabetes mellitus, including macroangiopathy, microangiopathy, and neuropathy, with a special emphasis on the insensate foot frequently seen in patients with diabetes. This article presents nursing strategies for assessment and suggestions for effective nursing interventions related to these complications. It also identifies some strategies for preventing further complications.

Neurologic complications in diabetes mellitus.

This article has discussed diabetic neuropathies and current knowledge about these somewhat baffling disorders. As research continues, new therapies for diabetic neuropathies will be found. Meanwhile, the nurse should remember that encouraging tight blood glucose control may be the best preventive therapy we have currently.

Diabetic peripheral neuropathies.

Diabetic peripheral neuropathy is not just a pain in the leg, a symptom of one of many diabetic peripheral neuropathies. Rather, diabetic peripheral neuropathy causes many symptoms, and requires individualized medical and nursing management based on the type of neuropathy.