Diabetic Neuropathy

Diabetic neuropathy is very common, affecting up to 50 % of all diabetic patients. It can result in disabling neuropathic pain, lower extremity amputations and troublesome autonomic neuropathies. With the rising incidence of diabetes the prevalence of neuropathy is also likely to increase. This pocketbook discusses the condition in depth.

Painful Diabetic Neuropathy in Clinical Practice provides a concise, didactic and essential resource for clinicians in the management of neuropathic pain in diabetic patients. This volume opens with overviews of epidemiology, classification and clinical features, including a discussion of the negative effect of painful neuropathic symptoms on quality of life. These are followed by a chapter on diagnosis and staging, which includes approaches to history taking, clinical examination, pain assessment scales, testing and staging. The book concludes with a chapter on the various approaches in the management of neuropathic pain, including the most up-to-date guidelines on the pharmacological treatment of this condition. This concise handbook is an invaluable reference for primary care practitioners and diabetologists who wish to keep up to date with the diagnosis and management of neuropathic pain.

The diagnosis of diabetic neuropathy is based on the diagnosis of diabetes, typical symptoms and clinical findings, as well as exclusion of other causes leading to neuropathy. Neuropathy that affects the large fibres can be verified objectively by ENMG and small fibre neuropathy is revealed by quantitative sensory threshold testing. The loss of small nerve fibres may also be demonstrated by skin biopsy. Neuropathy may be the first sign of type 2 diabetes.The loss of protective sensation as a consequence of peripheral neuropathy is the most important risk factor of diabetic foot ulcer. Small fibre neuropathy may already emerge during the phase of impaired glucose tolerance. 11–25% of the patients may have peripheral neuropathy in the pre-diabetic phase already.

Leading medical specialists critically review for the general practitioner the latest techniques for the clinical management of diabetic neuropathy. These authoritative contributors focus on the practical aspects of diabetic neuropathy and describe in detail the treatments that are currently available or expected to become available in the near future. They also include concise discussions of the causes of diabetic neuropathy and highlight the relatively unknown features of neuropathy that can significantly impact a patient's life. Comprehensive, up-to-date bibliographies at the end of each chapter provide an opportunity for the interested physician to gain a more detailed picture of a particular topic. This book offers family physicians, internists, endocrinologists, podiatrists, cardiologists, neurologists, and gastroenterologists an authoritative practical guide and a vital day-to-day reference source for the management of their neuropathic diabetic patients.

Presenting the 2nd Edition of this well-regarded, definitive reference to the pathophysiology, differential diagnosis, and treatment of the various types of neuropathies in diabetic patients. Revised and expanded, this edition covers diabetes mellitus, neuropathic assessment, peripheral polyneuropathy, hypoglycemic polyneuropathy, cranial neuropathies, truncal neuropathies, autonomic neuropathies and much more through the contributions of experts in the field! High-quality illustrations enhance the text.

A number of hypotheses concerned with aetiology have been proposed by researchers. Yet despite progress in these aspects, which have aided therapeutic developments in diabetic neuropathy, the precise mechanisms remain one of the most important unsolved problems. This work discusses those problems.

A review of the clinical problems of diabetic neuropathy and the use of a new agent, gamma-linolenic acid, in its treatment. Dealing with one of the latest advances in the field, this book should be of interest to specialists in diabetics and neurology.

Comprised of contributions from a wealth of experts worldwide, this volume summarizes the latest research findings and new developments in diagnosis and treatment of diabetic neuropathy. While the actual cause of diabetic neuropathy, a common complication of diabetes mellitus, is not known, it is likely that no single mechanism predominates--rather that various mechanisms interact and culminate in the expression of neuropathy. The progressive nature of diabetic neuropathy and the high morbidity associated with it emphasize the need for early identification of patients at risk, particularly since the disease, if diagnosed early, can be corrected or controlled by intensified insulin treatment and strict metabolic control.

Textbook of Peripheral Neuropathy is a practical but authoritative reference for clinicians in anymedical specialty who are evaluating and treating patients with signs and symptoms of a peripheralneuropathy. Reviewing the full spectrum of clinically significant neuropathies, the book contains chapterson common and rare forms including mononeuropathy in the upper and lower extremities, mononeuritismultiplex, diffuse and symmetric polyneuropathies, brachial and lumbrosacral plexopathies, and spinalroot disordersódisorders that can mimic diffuse and/or focal neuropathies, complicating diagnosis andevaluation. Coverage encompasses both inherited and acquired diseases, including neuropathies arisingfrom physical injury, diabetes, alcoholism, toxins, autoimmune responses, nutritional deficiencies, vascularand metabolic disorders, medication-induced neuropathies, and idiopathic conditions. The textbookprovides an evidence-based approach to testing, differential diagnosis, and treatment, and should serveas a trusted resource for healthcare professionals confronting the many manifestations of peripheralneuropathy in clinical practice. The chapters are written by internationally renowned expert contributors with deep clinical experienceand contain numerous tables, figures, and algorithms providing clear diagnostic and managementguidelines. Boxed Clinical Pearls and Key Points allow for quick access to pertinent information, making evaluation and review easy and rewarding. Features of Textbook of Peripheral Neuropathy Include: ̈ Practical yet comprehensiveóan accessible ìgo-toî reference for clinicians ̈ Covers all clinically relevant peripheral neuropathies ̈ Clinical Pearls and Key Points are set off from the text for quick reference ̈ Contains clear diagnostic and management guidelines from expert contributors ̈ Structured chapters make it easy to find essential point-of-careinformation

The majority of diabetics develop neuropathy, which can be debilitating, but the underlying pathophysiological mechanisms are poorly understood. Diabetic neuropathy progresses in a distal to proximal manner. Previous studies have shown that glutamate, the most common excitatory neurotransmitter, plays a role in the pathogenesis of neuropathy. The reason why the role of glutamate in nociception becomes a problem in diabetes and the mechanisms that are involved are unknown. Based on the preliminary data, the hypothesis was that glutamate pathways are likely to be involved in diabetic neuropathy particularly neuropathic pain. Pathways were investigated to look for changes that might reflect neuropathic pain and fit with previously established pharmacological evidence. The aim of this project was to identify changes in expression of genes and their protein products that are involved in glutamate signalling in diabetes. This will help to further the understanding of the mechanisms of diabetic neuropathy. In diabetic rats, there were consistent changes in expression, particularly in the lumbar and sacral dorsal root ganglia of the spinal cord and in the sympathetic ganglia. The changes were consistent between the different groups of animals as well as between adjacent groups of ganglia. The most prominent changes in both the GK groups included marked upregulation of Gria4 (ionotropic AMPA receptor), downregulation of Grik3 and Grik4 (both ionotropic, kainite receptors) and Grin1 and Grin2A (both ionotropic, NMDA receptors), activation of all of which has been shown to induce hyperalgesia; downregulation of Slc1a6 (excitatory amino acid transporter 4) and upregulation of Slc1a1 (excitatory amino acid transporter 3), both of which mediate neural reuptake of glutamate from the synaptic cleft; and upregulation of Gclc (glutathione synthase), which reflects a response to protect against oxidative damage. Despite many theories existing about the pathogenesis of diabetic neuropathy, there is no unifying hypothesis. It is possible that changes in glutamate signalling can contribute to these other mechanisms and possibly unify these different theories. A better understanding of the role that glutamate plays in development of diabetic neuropathy may pave the way for future therapeutic intervention.

This seminal work brings together, for the first time, information on international trends and data for diabetes mellitus. Diabetes is on the increase throughout both the developed and developing world. Currently there are approximately 150 million people with diabetes worldwide, mainly Type 2 diabetes, and it is possible that as many as half of the cases have not been diagnosed. These numbers are likely to increase over the next 25 years. This text takes an international look at the epidemiology of diabetes, focusing primarily on geographical aspects of the disease. Topics covered include: Etiological factors and time trends Definitions and evidence for prevention Caucasian populations Non-Caucasian populations Associated risk factors and complications Implications The Epidemiology of Diabetes Mellitus: An International Perspective is essential reading for every diabetologist, clinical endocrinologist, epidemiologist and all the members of the diabetes specialist team.

The Treatment of Diabetes Mellitus with Chinese Medicine is a textbook and a clinical manual on the Chinese medical treatment of diabetes mellitus (DM) and its many complications. Each facet of this complex condition is discussed in terms of its Western medical definition, epidemiology, etiology, pathophysiology, diagnosis, current standards of care, complications, and treatment plans. This text outlines goals of therapeutic care, general considerations, diet & exercise, patient education, blood glucose monitoring and much more. This text discusses: * Gestational Diabetes * Diabetic Ketoacidosis * Diabetic Hypertension * Diabetic Hyperlipoproteinemia * Diabetic Retinopathy * Diabetic Neuropathy * Common opportunistic infections in patients with diabetes * Patient adherence and practitioner monitoring * Appendix of Chinese medicinals, and Western pharmaceuticals.

Diabetes is a huge and growing healthcare worry, especially in Western countries. The treatment of both types – 1 and 2 – of this disease has changed radically over the past few years. This work provides an overview of all the changes that will come to be implemented in clinical practice. Summarizing all aspects of treatment, this book delineates the large amount of research work that has been completed over the last few years into the relief of complications in diabetes and vascular medicine in general.

Neuropathy: New Insights for the Healthcare Professional: 2013 Edition is a ScholarlyEditions™ book that delivers timely, authoritative, and comprehensive information about Diagnosis and Screening. The editors have built Neuropathy: New Insights for the Healthcare Professional: 2013 Edition on the vast information databases of ScholarlyNews.™ You can expect the information about Diagnosis and Screening in this book to be deeper than what you can access anywhere else, as well as consistently reliable, authoritative, informed, and relevant. The content of Neuropathy: New Insights for the Healthcare Professional: 2013 Edition has been produced by the world’s leading scientists, engineers, analysts, research institutions, and companies. All of the content is from peer-reviewed sources, and all of it is written, assembled, and edited by the editors at ScholarlyEditions™ and available exclusively from us. You now have a source you can cite with authority, confidence, and credibility. More information is available at http://www.ScholarlyEditions.com/.

Prevention and Treatment of Diabetic Late Complications.