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Pathogenesis, diagnosis and clinical management of diabetic sensorimotor peripheral neuropathy.
Sloan, Gordon; Selvarajah, Dinesh; Tesfaye, Solomon.
Afiliação
  • Sloan G; Diabetes Research Unit, Royal Hallamshire Hospital, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK.
  • Selvarajah D; Diabetes Research Unit, Royal Hallamshire Hospital, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK.
  • Tesfaye S; Department of Oncology and Human Metabolism, University of Sheffield, Sheffield, UK.
Nat Rev Endocrinol ; 17(7): 400-420, 2021 07.
Article em En | MEDLINE | ID: mdl-34050323
Diabetic sensorimotor peripheral neuropathy (DSPN) is a serious complication of diabetes mellitus and is associated with increased mortality, lower-limb amputations and distressing painful neuropathic symptoms (painful DSPN). Our understanding of the pathophysiology of the disease has largely been derived from animal models, which have identified key potential mechanisms. However, effective therapies in preclinical models have not translated into clinical trials and we have no universally accepted disease-modifying treatments. Moreover, the condition is generally diagnosed late when irreversible nerve damage has already taken place. Innovative point-of-care devices have great potential to enable the early diagnosis of DSPN when the condition might be more amenable to treatment. The management of painful DSPN remains less than optimal; however, studies suggest that a mechanism-based approach might offer an enhanced benefit in certain pain phenotypes. The management of patients with DSPN involves the control of individualized cardiometabolic targets, a multidisciplinary approach aimed at the prevention and management of foot complications, and the timely diagnosis and management of neuropathic pain. Here, we discuss the latest advances in the mechanisms of DSPN and painful DSPN, originating both from the periphery and the central nervous system, as well as the emerging diagnostics and treatments.
Assuntos

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Neuropatias Diabéticas Tipo de estudo: Diagnostic_studies / Etiology_studies / Prognostic_studies / Screening_studies Limite: Animals / Humans Idioma: En Revista: Nat Rev Endocrinol Assunto da revista: ENDOCRINOLOGIA Ano de publicação: 2021 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Neuropatias Diabéticas Tipo de estudo: Diagnostic_studies / Etiology_studies / Prognostic_studies / Screening_studies Limite: Animals / Humans Idioma: En Revista: Nat Rev Endocrinol Assunto da revista: ENDOCRINOLOGIA Ano de publicação: 2021 Tipo de documento: Article