Recent Topics on Various Clinical Problems Related with Diabetic Neuropathy

Diabetes has been a crucial disease worldwide, and authors have continued diabetic practice and research. Recent topics on neuropathy are described. For diabetic patients, common symptoms of dysesthesia and loss of protective sensation (LOPS) should be checked annually. Diabetic peripheral neuropathy (DPN) has been treated by pregabalin, duloxetine, gabapentin and tapentadol. Autonomic Neuropathy (AN) includes Orthostatic Hypotension (OH), Cardiac Autonomic Neuropathy (CAN), gastroparesis and genitourinary disturbances. Diabetic foot may be related with Peripheral Arterial Disease (PAD), Diabetic Foot Infection (DFI), diabetic foot osteomyelitis (DFO) and amputation. For those, Hyperbaric Oxygen Therapy (HBOT) may be effective with continuing discussion

Current topics of possible pharmacotherapy for chronic kidney disease (CKD) and diabetes

The authors and colleagues have been involved in Non-Communicable Diseases (NCDs), especially including diabetes, chronic kidney disease (CKD) and hemodialysis. Some topics are described as possible therapy for CKD. (i) Metformin has inhibitory effect on cardiovascular events, and has an evidence for safe administration in mild to moderate renal impairment. (ii) Canagliflozin reduced moderately cardiovascular and renal outcomes across the primary and secondary prevention groups, from mega studies of CANVAS and CREDENCE. (iii) erythropoiesis stimulating agent (ESA) has been effective for improving anemia in HD for years. Some hypoxia-inducible factor (HIF) seems to be applied for clinical practice soon