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.

Awareness of neuropathy as a chronic complication of diabetes is constantly increasing. Diabetes centers adopt methods to diagnose neuropathy without neurological training. This trend calls for instructions on how to use and interpret diagnostic methods. This book includes recent research and covers clinical, technical, and public health aspects of neuropathy, bringing together the top experts in the field.

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 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.

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.

In this updated edition, leading medical specialists critically review for the general practitioner the latest techniques for the clinical management of diabetic neuropathy. The 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 pathogenesis of diabetic neuropathy.

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.

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.

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.

Peripheral nerve analysis is a challenging task for pathologists, given the advent of new diagnoses and techniques of analysis and the impact of molecular genetics. This book presents a simple, logical method for constructing a differential diagnosis based on pathology and clinical presentation. It also provides advice on the selection of ancillary molecular, immunohistochemical and genetic techniques to establish a definitive diagnosis. Clear, authoritative guidance is offered on diagnosis of the full range of neuropathies with the aid of a wealth of high-quality color photomicrographs and electron micrographs. The pathologist will benefit greatly from the identification of a variety of artifacts and normal structures occasionally encountered in nerve biopsies that need to be distinguished from specific pathologic alterations. This user-friendly, practical text will be an invaluable aid in achieving the most specific diagnosis possible.

Understanding the rapid changes in the evaluation and management of peripheral neuropathies, as well as the complexity of their mechanism, is a mandatory requirement for the practitioner to optimize patient's care. The objective of this book is to update health care professionals on recent advances in the pathogenesis, diagnosis and treatment of peripheral neuropathy. This work was written by a group of clinicians and scientists with large expertise in the field.

The MediFocus Guidebook on Peripheral Neuropathy is the most comprehensive, up-to-date source of information available. You will get answers to your questions, including risk factors of Peripheral Neuropathy, standard and alternative treatment options, leading doctors, hospitals and medical centers that specialize in Peripheral Neuropathy, results of the latest clinical trials, support groups and additional resources, and promising new treatments on the horizon. This one of a kind Guidebook offers answers to your critical health questions including the latest treatments, clinical trials, and expert research; high quality, professional level information you can trust and understand culled from the latest peer-reviewed journals; and a unique resource to find leading experts, institutions, and support organizations including contact information and hyperlinks. This Guidebook was updated on August 24, 2010.

Painful diabetic polyneuropathy is the most common and disturbing of painful conditions experienced by people with diabetes. As the diabetes rate continues to grow, the number of people suffering from painful diabetic polyneuropathy will as well – increasing both patient suffering and demands on healthcare resources. Painful Diabetic Polyneuropathy covers all aspects of these painful disorders from pathophysiology and diagnosis, treatment and prevention, future approaches and the nursing perspective, to billing issues and the patient’s experience. Written by experts in their fields, each chapter presents the full perspective of these painful disorders with an emphasis on evidence-based scientific information. Painful Diabetic Polyneuropathy is a comprehensive resource for general and family medicine practitioners, neurologists and pain medicine specialists. It will also serve as a resource for patients for education, support, and treatment sites.

Written by one of the world's leading experts — Professor Gérard Said MD FRCP, Dpt de Neurologie, Hôpital de la Salpêtrière, Paris, France Peripheral neuropathy is a common medical condition, the diagnosis of which is often protracted or delayed. It is not always easy to relate a neuropathy to a specific cause. Many people do not receive a full diagnosis, their neuropathy often being described as 'idiopathic' or 'cryptogenic'. It is said that in Europe, one of the most common causes is diabetes mellitus but there are also many other known potential causes. The difficulty of diagnosis, the limited number of treatment options, a perceived lack of knowledge of the subject —except in specialised clinics, the number of which are limited — all add to the difficulties which many neuropathy patients have to face. Another additional problem for many patients is that once having received a full, or even a partial diagnosis, they are then often discharged back to their primary healthcare team who, in many instances, know little about this condition and how it may impact upon their patients' lives. In order to help bridge this gap in medical knowledge and to give healthcare providers a better understanding of this often distressing condition, The Neuropathy Trust has commissioned a new book on this complex topic. Written by one of the world's leading experts on neuropathy, Professor Gérard Said, it is a 'must read' and also a handy reference book for doctors, nurses, physiotherapists, chiropodists/podiatrists and other health professionals.As well as covering the anatomy of the nervous system and the basic pathological processes that may affect the peripheral nerves, the book covers a whole range of neuropathic conditions. These include, for example, Guillain-Barré syndrome, chronic inflammatory demyelinating polyneuropathy, vasculitic neuropathies, infectious neuropathies, diabetic and other metabolic neuropathies, hereditary neuropathies and neuropathies in patients with cancer. Given the almost explosive increase in diabetes predicted over the coming years and the high incidence of HIV infections alone, not to mention all the other possible causes of peripheral neuropathy, no self-respecting medical unit should be without a copy of this new book on their shelves. The author, Professor Gérard Said, is based in the Department of Neurology at the prestigious Hôpital de la Salpêtrière in Paris. He has devoted a lifetime to the study of peripheral neuropathy and — alongside other great neurological names — added much to the world's ever-growing store of knowledge on this complex but fascinating condition which affects so many individuals.

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.

Nearly one in fifteen people—that's 20 million people in the United States—suffers from peripheral neuropathy, or nerve damage. Caused by such conditions as diabetes, cancer, vitamin deficiencies, and kidney disease as well as certain drugs and toxins, neuropathy brings numbness, tingling, and burning in the feet, legs, and fingertips. Neuropathy can be more than uncomfortable—it can be disabling: people whose fingertips are numb may find it hard to button clothing and complete other everyday tasks. Neuropathy is often dangerous, as well: people who cannot feel their feet are more likely to stumble and fall, and they may not notice injuries that need medical attention. Dr. Janice F. Wiesman, a neurologist with twenty years of experience helping people who have neuropathy find relief, shares her special insights into this painful and debilitating condition. With exceptional clarity, Dr. Wiesman begins by outlining the basics of nerve anatomy and function. She explains how peripheral neuropathy is diagnosed and treated, describes neuropathy’s disparate causes, and offers readers lifestyle changes that can help keep nerves healthy. A useful glossary defines terms, patient stories offer real-world experiences, and illustrations provide a visual key to the condition. A detailed resources section points the reader to reliable web sites and organizations that offer more help. Concentrating on the most common types of neuropathy, Dr. Wiesman provides hope, help, and comfort to patients, families, and caregivers.

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.