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General Thermography
Published in James Stewart Campbell, M. Nathaniel Mead, Human Medical Thermography, 2023
James Stewart Campbell, M. Nathaniel Mead
Diabetes mellitus adversely affects the peripheral nerves of the body. As the nerves to the foot are the longest in the human body, they are most likely to display diabetic neuropathy. Symptoms of diabetic neuropathy are numbness and paresthesias, accompanied by autonomic dysfunction. Loss of sympathetic vasoconstrictive control leads to skin warmth over the affected areas even in a cooled individual.200 Because the neuropathic areas are numb, injuries such as blisters or small abrasions may go unnoticed. With repeated injury or infection, skin ulcers, sometimes deep enough to expose bone, may be seen thermographically.
Diabetic Neuropathy
Published in Jahangir Moini, Matthew Adams, Anthony LoGalbo, Complications of Diabetes Mellitus, 2022
Jahangir Moini, Matthew Adams, Anthony LoGalbo
Diabetic neuropathy is a disease process associated with diabetes. It affects sensory axons, autonomic axons, and later, to a less extent, motor axons. How diabetes affects neurons/axons remains debated. Progressive diabetic neuropathy involves retraction and dying back of terminal sensory axons in the periphery. Data suggest that dysfunction of key plasticity molecules promotes abnormal protein processing, oxidative damage, and mitochondrial dysfunction, leading to the loss of peripheral nerve function. Diabetes is associated with a wide range of neuropathies, including mononeuritis multiplex, compression and entrapment mononeuropathies, cranial neuropathies, and autonomic neuropathies. It can also cause amyotrophy and dysautonomia. When diabetic neuropathy is severe, it can lead to ulcerations, infections, and eventual amputations of the affected areas of the body. Differential diagnosis is difficult because not all sensorimotor neuropathies are caused by diabetes. The classifications of the various types of diabetic neuropathy are shown in Figure 4.1.
Diabetes
Published in Sally Robinson, Priorities for Health Promotion and Public Health, 2021
Diabetic neuropathy refers to the damage to nerves caused by raised blood glucose travelling through the small blood vessels that supply the nerves. The nerves do not receive the nutrients that they need and become damaged. Diabetes UK (2020c) describe the three types of nerves that are affected.
Mechanisms behind diffuse idiopathic peripheral neuropathy in humans – a systematic review
Published in Scandinavian Journal of Gastroenterology, 2023
Hanna Tufvesson, Viktor Hamrefors, Bodil Ohlsson
If we are familiar with mechanisms behind neuropathy, this complication may be prevented or postponed. Identification of etiology may be of importance to provide targeted treatments, instead of symptomatic treatments often given to reduce the symptoms [3,10]. The most important step to prevent diabetic neuropathy is to optimize the metabolic control [21]. Even though painful diabetic neuropathy originally stems from the peripheral nervous system, the changes of increased pain sensitivity become imprinted in the central nervous system [19]. It is believed that microglia, which are immune cells of the central nervous system, become activated due to a persistent noxious stimulus in the peripheral tissues. Moreover, hyperglycemia may have a direct effect on the microglia. The persistent activation of the microglia is creating a neuroinflammatory response that activates the sympathetic nervous system and hypothalamic-pituitary complex. This leads to an increased sensation to pain also in the central nervous system, a phenomenon known as central sensitization. In diabetic neuropathy, especially spinal microglia have been of particular interest [19].
Effect of folic acid supplementation on nerve conduction velocity in diabetic polyneuropathy patients
Published in Neurological Research, 2019
Tayebeh Mottaghi, Fariborz Khorvash, Mohammadreza Maracy, Nick Bellissimo, Gholamreza Askari
Diabetes Mellitus is a threat to human health and a contributor to morbidity [1] and mortality worldwide [2]. Diabetes also influences the human vascular system [3]. In 2017, 451 million people were diagnosed with diabetes, which is predicted to affect 693 million by the year 2045 [4]. Diabetic neuropathy is a common complication associated with poorly controlled diabetes mellitus [5]. Diabetic neuropathy includes a wide range of syndromes with different clinical symptoms and trajectories [6], affecting a significant proportion of diabetic patients [6]. Diabetic neuropathy ranges from 10% to 90% depending on the sample size, type of diabetes, and method of diagnosis [7]. Diabetic neuropathy usually progresses slowly [8], and although chronic hyperglycemia is the major determinant of diabetic peripheral neuropathy, other factors such as nutrition, lifestyle, genetics, metabolic factors, duration of diabetes, hypertension, age, smoking, alcohol consumption, hypoinsulinemia, hyperinsulinemia, lipid disorders, inflammation and neuropathic ischemia are involved in the etiology of diabetic neuropathy [9–11].
The time to develop treatments for diabetic neuropathy
Published in Expert Opinion on Investigational Drugs, 2021
2.1 CLINICAL MEASURES. Clinical research to develop pharmacologic agents to improve neuronal function in diabetic neuropathy has been unrewarding. Diabetic neuropathy is a clinical condition that is defined by a spectrum of symptoms and signs of nerve impairment. Design of a protocol to measure the various aspects of this complexity has proven a formidable challenge. Several scales have been developed to quantitate symptoms and loss of sensation [29–39] (Table 3). There is considerable variability in assessment of clinical signs and symptoms among investigators [40]. Despite attempts to standardize clinical techniques, that variability persists [41,42].