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Diabetic Neuropathy
1st Edition - February 16, 2022
Editor: Mitra Tavakoli
Paperback ISBN:9780128206690
9 7 8 - 0 - 1 2 - 8 2 0 6 6 9 - 0
eBook ISBN:9780128206706
9 7 8 - 0 - 1 2 - 8 2 0 6 7 0 - 6
Diabetic Neuropathy identifies the most accurate early biomarkers of nerve damage to better understand pathophysiology and diagnose diabetic neuropathy in the clinical care of… Read more
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Diabetic Neuropathy identifies the most accurate early biomarkers of nerve damage to better understand pathophysiology and diagnose diabetic neuropathy in the clinical care of patients, and in particular, permit an accurate evaluation of future therapies in clinical trials. This succinct reference focuses on the current data and research on diabetic neuropathy and is essential reading for researchers in endocrinology, neurology and pharmacology, along with clinicians that need to better understand the novel pathogenetic pathways leading to diabetic neuropathy and the treatments.
Serves as a starting point for researchers and medical professionals on risk factors, prevention and newly discovered mechanisms involved in the pathogenesis and eventually treatments of diabetic neuropathy
Discusses a broad range of issues relating to diabetic neuropathy, from epidemiology, to pathophysiology, genetics, advances in diagnostic techniques, and the latest clinical trials and clinical management
Endocrinologists, diabetologists, neurologists, general practitioners, physician assistants
Cover image
Title page
Table of Contents
Copyright
Dedication
List of contributors
About the editor
Foreword
Preface
Acknowledgments
Chapter 1. Classification, risk factors, and clinical presentation diabetic neuropathy
Abstract
Introduction
Classification
Conclusion
References
Chapter 2. Pathologic basis for diabetic neuropathy in humans
Abstract
Introduction
Classification of diabetic neuropathy
Basic pathologic changes in several types of neuropathy
Sensory nerve pathology
Motor nerve pathology
Autonomic nerve pathology
Implication of microangiopathy in diabetic polyneuropathy
Pathology of nerve microenvironment
Skin biopsy
Conclusion
Declaration of competing interests
References
Chapter 3. Electrodiagnostic evaluation in diabetic neuropathy
Abstract
Introduction
Pathophysiology of diabetic sensorimotor polyneuropathy
Nerve conduction parameters and correlation with pathology
Physiological changes in nerve function in diabetic sensorimotor polyneuropathy and correlation with nerve conduction studies
Which nerves to choose and what parameters to test
How to diagnose diabetic sensorimotor polyneuropathy with nerve conduction studies
Evolution from subclinical to clinical diabetic sensorimotor polyneuropathy
Nerve conduction studies features in diabetic sensorimotor polyneuropathy: type 1 versus type 2 diabetes mellitus
Impact of treatment in nerve conduction studies
Atypical features in nerve conduction studies—demyelinating features in diabetic sensorimotor polyneuropathy and when to suspect chronic inflammatory demyelinating polyradiculoneuropathy
Nerve conduction studies in predicting prognosis
Vibration perception thresholds in diabetic neuropathy
Electromyography in diabetic sensorimotor polyneuropathy
Limitations of nerve conduction studies
Conclusion
References
Chapter 4. Advances in screening, early diagnosis, and accurate staging of diabetic neuropathy
Abstract
Introduction
Diagnostic tests for diabetic peripheral neuropathy
Conclusions
References
Chapter 5. Skin biopsy analysis in diabetic neuropathy
Abstract
Introduction
Advantages and disadvantages of skin biopsies
IENFD quantification in nondiabetic etiologies
How and where to take a skin punch biopsy following EFNS/PNS guidelines
Freezing the biopsy
Staining protocol for IENFD analysis
IENFD quantification
Diagnostic accuracy of IENFD analysis in DN
Relationship between skin biopsy outcomes and symptoms or signs of DN
Other morphological changes
Alternative markers used on skin biopsies
Biomarkers of pain pathophysiology
Autonomic structures
Conclusion
References
Chapter 6. Central nervous system involvement in diabetic peripheral neuropathy
Abstract
Painful diabetic neuropathy
Central nervous system changes in response to peripheral nerve injury and how these changes result in chronic pain in diabetes
Clinical implications
Future direction
Conclusions
References
Chapter 7. Spinal cord involvement in diabetic neuropathy and neuropathic pain
Abstract
Introduction
Glucotoxicity in the spinal cord
Spinal cord pathology associated with diabetes and neuropathy
Studies in animal models of diabetes
Clinical studies of spinally mediated pain in diabetes
Conclusion
Acknowledgments
References
Chapter 8. The conundrum and enigma of painful and painless neuropathy
Abstract
Introduction
Clinical presentations and highly variable patterns of neuropathy
Risk factors for developing diabetic peripheral and neuropathic pain
Huge unmet clinical needs and treatment challenges
Current status for detecting painful and painless neuropathy
Early detection and prevention
Similarities in treatment of painful and painless neuropathy
Deep sensory profiling and mechanism-based treatment in painful and painless neuropathy
Novel clinical endpoints and research methodologies
Perspectives
References
Chapter 9. Motor dysfunction in diabetes
Abstract
Introduction
Motor nerve dysfunction
Muscle strength and functional impairments
Muscular composition and structure
References
Chapter 10. Diabetic autonomic neuropathy, measurement and management; part 1: measurement
Abstract
Autonomic neuropathy
A history of assumption and approximation quantified
Diabetes: also considered a model of the effect of chronic disease on P&S activity over time
Earlier detection and earlier intervention
Diagnosis of autonomic dysfunction
Acknowledgments
References
Chapter 11. Diabetic neuropathy in children and youth
Abstract
Background
Definitions and classifications
Epidemiology
Clinical presentations
Risk factors
Screening and diagnosis
Diabetic neuropathy, quality of life, and mortality
Management of symptoms associated with treatment-induced neuropathy of diabetes
Outcomes of treatment-induced neuropathy of diabetes and association with other microvascular complications
Discussion
Declaration of competing interests
Acknowledgments
References
Chapter 13. Health economics of diabetic foot disease: costs of diabetic neuropathy and diabetic foot
Abstract
Background
Cost-of-illness studies on diabetic foot disease
Cost-effectiveness and cost-utility of diabetic foot disease-related interventions
Conclusion
References
Chapter 14. Diabetic foot
Abstract
Introduction
Epidemiology of diabetic foot problems
Risk assessment
Diabetic peripheral neuropathy
Peripheral neuropathy and autoimmune disease
Charcot neuroarthropathy
Management of diabetic foot ulceration
Antibiotic-resistant organisms
Treatment of infection in diabetic foot disease
References
Chapter 15. Management of diabetic foot disease
Abstract
Introduction
Management of diabetic foot ulceration
Charcot neuroarthropathy “Charcot foot”
Surgical management of the diabetic foot
Future outlook
Conclusion
References
Chapter 16. Strategies for the prevention or reversal of neuropathy
Abstract
Introduction
Improved glycemic control
Lifestyle interventions
Bariatric surgery
Dietary interventions
Multifactorial treatment
Treatment based on pathogenic concepts
Conclusion
Acknowledgments
References
Chapter 17. Treatment of diabetic peripheral neuropathy: technologies, exercise, and alternative treatments
Abstract
Introduction
Technologies
Exercise
Alternative treatments
Discussion
Conclusion
References
Chapter 18. Treatment of diabetic polyneuropathy
Abstract
Epidemiology and historical trials in diabetic polyneuropathy
Glucose control and diabetic polyneuropathy
Treatment of pain in diabetic polyneuropathy
Serotonin norepinephrine reuptake inhibitors
Tricyclic antidepressants
Antiepileptic drugs
Opioids
Supplements and alternative treatments for painful diabetic polyneuropathy
Cannabidiol and cannabis-derived treatments
Exercise and nonpharmacologic treatments
Emerging treatments and recent trials
Conclusion
References
Chapter 19. Diabetic autonomic neuropathy, measurement and management; part II: management
Abstract
Autonomic neuropathy
Earlier detection and earlier intervention
Disease initiation and progression of neuropathy
Treating diabetic autonomic dysfunction and neuropathy
Acknowledgements and disclaimers
References
Chapter 20. Translating a treatment for diabetic peripheral neuropathy from rodents to humans: can a case be made for fish oil and salsalate?
Abstract
Diabetic peripheral neuropathy
Omega-3 polyunsaturated fatty acid; eicosapentaenoic acid and docosahexaenoic acid
Omega-3 polyunsaturated fatty acid and cardiovascular health
Omega-3 polyunsaturated fatty acid and vascular dysfunction
Omega-3 polyunsaturated fatty acid and peripheral neuropathy related to obesity and insulin resistance
Omega-3 polyunsaturated fatty acids and diabetic peripheral neuropathy
References
Chapter 21. Bedside clinical features and translational snapshots of diabetic polyneuropathy
Abstract
Introduction
Symptoms
Examination
Complications
Neuropathy scales
Clinical trials in DPN, a recent snapshot
Translational opportunities
Conclusions
References
Index
No. of pages: 398
Language: English
Published: February 16, 2022
Imprint: Elsevier
Paperback ISBN: 9780128206690
eBook ISBN: 9780128206706
MT
Mitra Tavakoli
Professor Mitra Tavakoli is Associate Professor of Medicine at the University of Exeter and is distinguished for her significant contribution to our understanding of the small fibre neuropathy at diabetes and establishing the technique of “Corneal Confocal Microscopy”. She is an internationally recognised researcher in diabetes care, with a significant focus on innovation and bringing new ideas to the field.
Her recent work elucidated the role of intervention for the regeneration of nerves at type 1 and type 2 diabetes. Her ongoing research into understanding the role of novel intervention at rare models of neuropathies, which initiated a new direction of research.
Dr Tavakoli has been the lead investigator in several national and international multisite clinical trials and a Chief Investigator in major clinical trials. Her research is funded mainly by Industry, National Institute of Health Research (NIHR), National Institute of Health (NIH). She has published over 75 peer-reviewed scientific papers and textbook chapters and in excess of 100 abstracts. She regularly speaks at international and national conferences and meetings. In addition, she is widely respected for training scientists across the world. She spearheads new technologies and contributes to the major UK and international collaborations.