Распространенность и факторы риска развития диабетической полиневропатии у стационарных больных сахарным диабетом 1-го типа

The NISLL scale and 7 electrophysiological tests were used to diagnose distal symmetric sensorimotor polyneuropathy in 120 inpatients with type 1 diabetes mellitus. The high rate (68.3%) of symptomatic or subclinical polyneuropathy was found. The duration of metabolic disturbances rather than short-term fluctuations in glycemia in terms of HbA1c levels was shown to mainly affect the degree of polyneuropathy in the patients of this group. The additional risk factors of polyneuropathy were retinopathy, smoking or hyperlipidemia.У лечившихся в стационаре больных сахарным диабетом 1-го типа (n = 120) проведена диагностика дистальной симметричной сенсорно-моторной полиневропатии с использованием шкалы NISLL и 7 электрофизиологических тестов. Выявлена высокая частота симптомной или субклинической полиневропатии (68,3 %). Показано, что основное влияние на выраженность полиневропатии у больных данной группы оказывает длительность нарушений метаболизма, но не кратковременные колебания гликемии по показателю HbA1c. Дополнительными факторами риска развития полиневропатии являлись наличие ретинопатии, курениеи гиперлипидемия

Combination therapy of back pain with B vitamins and non-steroidal anti-inflammatory drugs

The article highlights the approaches to the treatment of back pain. There is evidence-based data on the efficiency of non-steroidal anti-inflammatory medicines and B vitamins in nociceptive and neuropathic pain

Cardiac diabetic autonomic neuropathy

The prevalence of diabetes mellitus (DM) is steadily increasing and represents a significant public health problem. At the same time, the incidence of neurological complications of diabetes mellitus, especially diabetic polyneuropathy, is increasing. Cardiac autonomic neuropathy, a form of diabetic polyneuropathy, is the most serious complication of diabetes mellitus, as it is an independent risk factor for cardiovascular complications in patients with diabetes mellitus and is associated with increased mortality. Due to prolonged asymptomatic flow, cardiac autonomic neuropathy is often diagnosed at a late stage when treatment is not very effective. A targeted search for clinical symptoms of the disease and especially the conduct of cardiovascular tests, which make it possible to diagnose the pathology at an early stage, is essential. Clinical manifestations of cardiac autonomic neuropathy, methods of clinical and instrumental diagnostics, treatment of the disease are considered in detail in the article. The clinical case of a patient with type 2 diabetes mellitus and cardiac autonomic neuropathy, represented by orthostatic hypotension, which is the most disabling symptom, is considered. On the example of a clinical case the medicamentous and non-medicamentous approaches to treatment are discussed, as well as the role of antioxidant therapy, in particular, the preparation of alpha-lipoic acid («Berlithion») in the treatment of cardiac autonomic neuropathy

Proximal diabetic neuropathy (medical case)

A medical case of a rare form of damage to the peripheral nervous system in diabetes, proximal diabetic amyotrophy (PDA), is described. PDA is characterized by asymmetric proximal lesions in the leg combined with neuropathic pain, muscle weakness and atrophy, mild sensation disorders, increased protein in the cerebrospinal fluid and severe disability. The etiopathogenesis is determined by immune-mediated lesions of vessels, nerves and nerve roots, peri-and microvasculitis, ischemia of the peripheral nervous system structures. Combination treatment with glucocorticoid medications, thioctic acid drugs (Berlithion®) normalization of glycemic profile and symptomatic treatment of neuropathic pain, resulted in a marked positive effect - decreased motor defects and pain, and significant regression of sensory disorders

Diabetic cervicobrachial radiculoplexopathy

Peripheral nervous system (PNS) damage is one of the most common complications of diabetes mellitus. There may be different PNS damage types that differ in clinical symptoms and pathogenesis. A clinical case of diabetic cervicobrachial radiculoplexopathy is presented for the first time in Russia. The paper discusses the clinical features of this type versus diabetic lumbosacral radiculoplexopathy, instrumental diagnosis of diabetic radiculoplexopathies, pathogenetic mechanisms of the disease, and treatment approaches. It shows the efficacy of alpha-lipoic acid supplementation in a patient with diabetic radiculoplexopathy

Diabetic polyneuropathy: a current algorithm for patient management

Diabetic polyneuropathy (DPN) is the most common chronic complication of diabetes mellitus and can develop just at the prediabetes stage. As DPN progresses and, in the absence of its adequate treatment, leads to worse quality of life and its shorter expectancy in patients. The paper discusses current clinical guidelines for the examination and management of patients with DPN, diagnostic methods, and pathogenetic treatment of this disease