A highly successful and novel model for treatment of chronic painful diabetic peripheral neuropathy.

Abstract:

OBJECTIVE:To investigate why, in spite of a vast variety of treatment agents, the alleviation of pain in patients with diabetic neuropathy is difficult. Previous studies have not used a treatment algorithm based on anatomic site and neuropathophysiological source of the neuropathic pain. RESEARCH DESIGN AND METHODS:A model that categorizes the types of pain into three groups (superficial, deep, and muscular) was applied in 75 diabetic patients with chronic (> 12 mo) painful distal symmetrical polyneuropathy in a controlled case series. Twenty-two patients were untreated and 53 patients were treated with imipramine +/- mexiletine for deep pain, capsaicin for superficial pain, and stretching exercises and metaxalone +/- piroxican for muscular pain. Each type of pain was scored separately on a scale of 0 (none) to 19 (worst), and the total of all three types was used as an index of overall pain. Ability to sleep through the night was scored by a scale of 1 (never) to 5 (always). RESULTS:No significant differences were observed in initial pain scores, sleep scores, demographics, biochemistries, or physical findings between the two groups. After 3 mo a significant improvement in scores was noted in the treated but not the untreated patients. In addition, a significant difference was found in the change of scores between the treated and untreated patients: total pain (-18 +/- 2 vs. 0 +/- 2), deep pain (-7 +/- 1 vs. 0 +/- 1), superficial pain (-5 +/- 1 vs. 0 +/- 1), muscular pain (-6 +/- 1 vs. 0 +/- 1), and sleep (1.2 +/- 0.2 vs. 0.2 +/- 0.2), all P < 0.0001. In treated patients 21% became pain-free (total pain < 2), 66% had improvement (decrease in total pain > 5, but not total elimination of painful symptoms), and 13% were considered treatment failures (a decrease in total pain of < or = 5). This compares with 0 (P < 0.02), 10 (P < 0.0001), and 90% (P < 0.0001), respectively, in the untreated patients. CONCLUSIONS:This study presents a new rationale and hypothesis for the successful treatment of chronic painful diabetic peripheral neuropathy. It uniquely bases the treatment algorithm on the types and sources of the pain.

journal_name

Diabetes Care

journal_title

Diabetes care

authors

Pfeifer MA,Ross DR,Schrage JP,Gelber DA,Schumer MP,Crain GM,Markwell SJ,Jung S

doi

10.2337/diacare.16.8.1103

subject

Has Abstract

pub_date

1993-08-01 00:00:00

pages

1103-15

issue

8

eissn

0149-5992

issn

1935-5548

journal_volume

16

pub_type

临床试验,杂志文章
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    abstract:OBJECTIVE:To evaluate the effect of a moderate dose of fish oil on glycemic control and in vivo insulin action in type 2 diabetic men with elevated plasma triacylglycerols and to determine the effect of the same treatment on gene expression of GLUT4, lipoprotein lipase (LPL), and hormone-sensitive lipase (HSL) in the a...

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    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.2337/diacare.21.5.717

    authors: Luo J,Rizkalla SW,Vidal H,Oppert JM,Colas C,Boussairi A,Guerre-Millo M,Chapuis AS,Chevalier A,Durand G,Slama G

    更新日期:1998-05-01 00:00:00

  • Processes and outcomes of care for diabetic acute myocardial infarction patients in Ontario: do physicians undertreat?

    abstract:OBJECTIVE:To compare the health service utilization and long-term outcomes of acute myocardial infarction (AMI) patients with and without diabetes in Ontario. RESEARCH DESIGN AND METHODS:We examined 25,697 patients from Ontario (6,052 and 19,645 patients with and without diabetes, respectively) who were hospitalized b...

    journal_title:Diabetes care

    pub_type: 杂志文章

    doi:10.2337/diacare.26.5.1427

    authors: Alter DA,Khaykin Y,Austin PC,Tu JV,Hux JE

    更新日期:2003-05-01 00:00:00

  • Acute effects of insulin in the control of VLDL production in humans. Implications for the insulin-resistant state.

    abstract::The role of hyperinsulinemia in the pathogenesis of triglyceride (TG) and VLDL over-production in insulin-resistant states remains controversial. While studies in humans and animals have generally suggested that chronic hyperinsulinemia facilitates VLDL production, particularly in the presence of an abundant supply of...

    journal_title:Diabetes care

    pub_type: 杂志文章,评审

    doi:10.2337/diacare.19.4.390

    authors: Lewis GF,Steiner G

    更新日期:1996-04-01 00:00:00

  • Diet-quality scores and the risk of type 2 diabetes in men.

    abstract:OBJECTIVE:To 1) compare associations of diet-quality scores, which were inversely associated with cardiovascular disease, with incident type 2 diabetes and 2) test for differences in absolute-risk reduction across various strata. RESEARCH DESIGN AND METHODS:Men from the Health Professionals Follow-Up Study, who were i...

    journal_title:Diabetes care

    pub_type: 杂志文章

    doi:10.2337/dc10-2352

    authors: de Koning L,Chiuve SE,Fung TT,Willett WC,Rimm EB,Hu FB

    更新日期:2011-05-01 00:00:00

  • Acute hypoglycemia impairs executive cognitive function in adults with and without type 1 diabetes.

    abstract:OBJECTIVE:Acute hypoglycemia impairs cognitive function in several domains. Executive cognitive function governs organization of thoughts, prioritization of tasks, and time management. This study examined the effect of acute hypoglycemia on executive function in adults with and without diabetes. RESEARCH DESIGN AND ME...

    journal_title:Diabetes care

    pub_type: 杂志文章

    doi:10.2337/dc13-0194

    authors: Graveling AJ,Deary IJ,Frier BM

    更新日期:2013-10-01 00:00:00

  • Central processing of gut pain in diabetic patients with gastrointestinal symptoms.

    abstract:OBJECTIVE:To evaluate the brain's responses to painful visceral and somatic stimuli in diabetic patients with gastrointestinal symptoms. RESEARCH DESIGN AND METHODS:The sensitivity to electrical esophageal and median nerve stimulations was assessed in 15 healthy volunteers and 14 type 1 diabetic patients with autonomi...

    journal_title:Diabetes care

    pub_type: 杂志文章

    doi:10.2337/dc09-0324

    authors: Frøkjaer JB,Søfteland E,Graversen C,Dimcevski G,Egsgaard LL,Arendt-Nielsen L,Drewes AM

    更新日期:2009-07-01 00:00:00

  • The community ecology of diabetes patient classification and practice characteristics.

    abstract::We examined the clinical and epidemiologic characteristics of diabetic subjects ascertained from five different sources (hospital, private practice, specialist practice, nursing home, and prevalence survey) in a medium-sized upstate New York community. Patients were categorized using the National Diabetes Data Group c...

    journal_title:Diabetes care

    pub_type: 杂志文章

    doi:10.2337/diacare.8.1.s87

    authors: Rothenberg RB,Olsen CL,Schnure JJ,Gerber TM,Cohen J,Curtis GB,Jesserer J,Roach J,Wirth C

    更新日期:1985-09-01 00:00:00

  • Natriuretic peptides, heart, and adipose tissue: new findings and future developments for diabetes research.

    abstract::Natriuretic peptides (NPs) play a key role in cardiovascular homeostasis, counteracting the deleterious effects of volume and pressure overload and activating antibrotic and antihypertrophic pathways in the heart. N-terminal B-type NP (NT-proBNP) also is a promising biomarker of global cardiovascular risk in the gener...

    journal_title:Diabetes care

    pub_type: 杂志文章,评审

    doi:10.2337/dc14-0669

    authors: Gruden G,Landi A,Bruno G

    更新日期:2014-11-01 00:00:00

  • Reimbursement issues in diabetes.

    abstract::Third-party reimbursement for outpatient education services and for new health care technologies in diabetes is an issue of concern to educators, administrators, and others in the diabetes health care system. Reimbursement for outpatient education has been obtained from 11 Blue Cross/Blue Shield plans in nine states, ...

    journal_title:Diabetes care

    pub_type: 杂志文章

    doi:10.2337/diacare.7.3.291

    authors: Sinnock P,Bauer DW

    更新日期:1984-05-01 00:00:00

  • Oxidative stress at onset and in early stages of type 1 diabetes in children and adolescents.

    abstract:OBJECTIVE:In diabetes, the persistence of hyperglycemia has been reported to cause increased production of oxygen free radicals through glucose autooxidation and nonenzymatic glycation. The aim of this study was to determine whether oxidative cellular damage occurs at the clinical onset of diabetes and in later stages ...

    journal_title:Diabetes care

    pub_type: 杂志文章

    doi:10.2337/diacare.21.10.1736

    authors: Domínguez C,Ruiz E,Gussinye M,Carrascosa A

    更新日期:1998-10-01 00:00:00

  • Accelerated insulin degradation: an alternate mechanism for insulin resistance.

    abstract::We have examined insulin and glucagon degrading activities of muscle and fat tissues in 11 subjects (4 lean controls, 3 insulin-resistant obese subjects, 2 non-insulin-dependent diabetic subjects, and 2 insulin-treated diabetic subjects) and correlated degrading activity with (1) basal insulin level and (2) state of i...

    journal_title:Diabetes care

    pub_type: 杂志文章

    doi:10.2337/diacare.2.5.414

    authors: Kitabchi AE,Stentz FB,Cole C,Duckworth WC

    更新日期:1979-09-01 00:00:00

  • Development of stable film test for rapid estimation of blood or plasma 3-hydroxybutyrate.

    abstract::A film test for the rapid detection of plasma/serum 3-hydroxybutyrate (3-OHB) has been developed. The film contains NAD, nitro blue tetrazolium, 3-OHB dehydrogenase, and diaphorase, and the surface is coated with modified biomembrane and can detect 50-1500 microM 3-OHB within 2-3 min. One drop or 50 microliters of pla...

    journal_title:Diabetes care

    pub_type: 杂志文章

    doi:10.2337/diacare.13.5.522

    authors: Harano Y,Aoki T,Nakajima Y,Kojima H,Kosugi K,Harano A,Hidaka H,Yamada S,Uno S,Shigeta Y

    更新日期:1990-05-01 00:00:00

  • The effect of ruboxistaurin on nephropathy in type 2 diabetes.

    abstract:OBJECTIVE:Ruboxistaurin selectively inhibits protein kinase C-beta and ameliorates kidney disease in animal models of diabetes. The purpose of this study was to evaluate the effects of ruboxistaurin on diabetic nephropathy in humans. RESEARCH DESIGN AND METHODS:A randomized, double-blind, placebo-controlled, multicent...

    journal_title:Diabetes care

    pub_type: 临床试验,杂志文章,多中心研究,随机对照试验

    doi:10.2337/diacare.28.11.2686

    authors: Tuttle KR,Bakris GL,Toto RD,McGill JB,Hu K,Anderson PW

    更新日期:2005-11-01 00:00:00

  • Twenty-Year Progression Rate to Clinical Onset According to Autoantibody Profile, Age, and HLA-DQ Genotype in a Registry-Based Group of Children and Adults With a First-Degree Relative With Type 1 Diabetes.

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    journal_title:Diabetes care

    pub_type: 杂志文章

    doi:10.2337/dc16-2228

    authors: Gorus FK,Balti EV,Messaaoui A,Demeester S,Van Dalem A,Costa O,Dorchy H,Mathieu C,Van Gaal L,Keymeulen B,Pipeleers DG,Weets I,Belgian Diabetes Registry.

    更新日期:2017-08-01 00:00:00

  • Effect of temperament on metabolic control in children with diabetes mellitus.

    abstract::Fifty-one children with insulin-dependent diabetes mellitus (IDDM) and 24 healthy sibling controls were compared on one of two temperament questionnaires completed by parents. Children with IDDM did not provide a characteristic temperament profile or show any problem areas. A regression analysis to predict diabetic co...

    journal_title:Diabetes care

    pub_type: 杂志文章

    doi:10.2337/diacare.11.1.77

    authors: Rovet JF,Ehrlich RM

    更新日期:1988-01-01 00:00:00

  • Altered postprandial insulin requirement in IDDM patients with gastroparesis.

    abstract:OBJECTIVE:To evaluate the effect of gastric emptying on postprandial insulin requirement in insulin-dependent diabetes mellitus (IDDM) patients with and without gastroparesis. RESEARCH DESIGN AND METHODS:Postprandial insulin requirement and gastric emptying were simultaneously evaluated in five IDDM patients with gast...

    journal_title:Diabetes care

    pub_type: 临床试验,杂志文章

    doi:10.2337/diacare.17.8.901

    authors: Ishii M,Nakamura T,Kasai F,Onuma T,Baba T,Takebe K

    更新日期:1994-08-01 00:00:00

  • The association between cardiovascular autonomic neuropathy and mortality in individuals with diabetes: a meta-analysis.

    abstract:OBJECTIVE:To examine by meta-analysis the relationship between cardiovascular autonomic neuropathy (CAN) and risk of mortality in individuals with diabetes. RESEARCH DESIGN AND METHODS:We searched Medline for English-language articles published from 1966 to 2001. Fifteen studies having a baseline assessment of cardiov...

    journal_title:Diabetes care

    pub_type: 杂志文章,meta分析

    doi:10.2337/diacare.26.6.1895

    authors: Maser RE,Mitchell BD,Vinik AI,Freeman R

    更新日期:2003-06-01 00:00:00

  • Dose-response effect of pioglitazone on insulin sensitivity and insulin secretion in type 2 diabetes.

    abstract:OBJECTIVE:To investigate the dose-response effects of pioglitazone on glycemic control, insulin sensitivity, and insulin secretion in patients with type 2 diabetes. RESEARCH DESIGN AND METHODS:A total of 58 diet-treated patients with type 2 diabetes (aged 54 +/- 1 years; 34 men and 24 women; BMI 31.5 +/- 0.6 kg/m(2)) ...

    journal_title:Diabetes care

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.2337/diacare.25.3.517

    authors: Miyazaki Y,Matsuda M,DeFronzo RA

    更新日期:2002-03-01 00:00:00

  • Gestational diabetes, pregnancy hypertension, and late vascular disease.

    abstract::The complexity of the several pathogenic pathways that cause hypertension and vascular disease and the prolonged interval that appears to predate clinical morbidity have hindered inquiry into the association between GDM and vascular disorders. As a forme fruste of later type 2 diabetes, GDM-affected gravidas are ident...

    journal_title:Diabetes care

    pub_type: 杂志文章,评审

    doi:10.2337/dc07-s224

    authors: Carpenter MW

    更新日期:2007-07-01 00:00:00

  • Circulating levels of adipocyte and epidermal fatty acid-binding proteins in relation to nephropathy staging and macrovascular complications in type 2 diabetic patients.

    abstract:OBJECTIVE:To investigate the relationships of serum adipocyte fatty acid-binding protein (A-FABP) and epidermal fatty acid-binding protein (E-FABP) with renal dysfunction and macrovascular complications in type 2 diabetic patients. RESEARCH DESIGN AND METHODS:The associations of serum A-FABP and E-FABP with markers of...

    journal_title:Diabetes care

    pub_type: 杂志文章

    doi:10.2337/dc08-1333

    authors: Yeung DC,Xu A,Tso AW,Chow WS,Wat NM,Fong CH,Tam S,Sham PC,Lam KS

    更新日期:2009-01-01 00:00:00

  • Effect of High-Deductible Insurance on High-Acuity Outcomes in Diabetes: A Natural Experiment for Translation in Diabetes (NEXT-D) Study.

    abstract:OBJECTIVE:High-deductible health plans (HDHPs) are now the predominant commercial health insurance benefit in the U.S. We sought to determine the effects of HDHPs on emergency department and hospital care, adverse outcomes, and total health care expenditures among patients with diabetes. RESEARCH DESIGN AND METHODS:We...

    journal_title:Diabetes care

    pub_type: 杂志文章

    doi:10.2337/dc17-1183

    authors: Wharam JF,Zhang F,Eggleston EM,Lu CY,Soumerai SB,Ross-Degnan D

    更新日期:2018-05-01 00:00:00

  • The incidence of insulin-dependent diabetes mellitus in Israeli children and adolescents 0-20 years of age: a retrospective study, 1975-1980.

    abstract::A survey of the entire population of Israel revealed 392 newly diagnosed type I diabetic children and adolescents aged 0-20 for the period of 1975-80. The mean annual age specific incidence of type I (insulin-dependent) diabetes mellitus was 3.8/10(5) for the age group 0-14 yr and 4.2/10(5) for the age group 0-20 yr. ...

    journal_title:Diabetes care

    pub_type: 杂志文章

    doi:10.2337/diacare.8.1.s24

    authors: Laron ZV,Karp M,Modan M

    更新日期:1985-09-01 00:00:00

  • Mechanisms of Sodium-Glucose Cotransporter 2 Inhibition: Insights From Large-Scale Proteomics.

    abstract:OBJECTIVE:To assess the effects of empagliflozin, a selective sodium-glucose cotransporter 2 (SGLT2) inhibitor, on broad biological systems through proteomics. RESEARCH DESIGN AND METHODS:Aptamer-based proteomics was used to quantify 3,713 proteins in 144 paired plasma samples obtained from 72 participants across the ...

    journal_title:Diabetes care

    pub_type: 杂志文章

    doi:10.2337/dc20-0456

    authors: Ferrannini E,Murthy AC,Lee YH,Muscelli E,Weiss S,Ostroff RM,Sattar N,Williams SA,Ganz P

    更新日期:2020-09-01 00:00:00

  • Glycated hemoglobin and risk of hypertension in the atherosclerosis risk in communities study.

    abstract:OBJECTIVE:Diabetes and hypertension often co-occur and share risk factors. Hypertension is known to predict diabetes. However, hyperglycemia also may be independently associated with future development of hypertension. We investigated glycated hemoglobin (HbA(1c)) as a predictor of incident hypertension. RESEARCH DESI...

    journal_title:Diabetes care

    pub_type: 杂志文章

    doi:10.2337/dc11-2248

    authors: Bower JK,Appel LJ,Matsushita K,Young JH,Alonso A,Brancati FL,Selvin E

    更新日期:2012-05-01 00:00:00

  • Amputation prevention initiative in South India: positive impact of foot care education.

    abstract:OBJECTIVE:To determine whether intensive treatment and education strategies for type 2 diabetic patients with high-risk diabetic foot disease helps in preventing foot amputations. RESEARCH DESIGN AND METHODS:Participants included 4,872 consecutive type 2 diabetic patients (male-to-female ratio 3,422:1,450, mean (+/-SD...

    journal_title:Diabetes care

    pub_type: 杂志文章

    doi:10.2337/diacare.28.5.1019

    authors: Viswanathan V,Madhavan S,Rajasekar S,Chamukuttan S,Ambady R

    更新日期:2005-05-01 00:00:00

  • Diabetes and impaired fasting glycemia in the tribes of Khagrachari hill tracts of Bangladesh.

    abstract:OBJECTIVE:To determine the prevalence of type 2 diabetes and impaired fasting glycemia (IFG) in a tribal population of Bangladesh. RESEARCH DESIGN AND METHODS:A cluster sampling of 1,287 tribal subjects of age > or =20 years was investigated. They live in a hilly area of Khagrachari in the far northeast of Bangladesh....

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    pub_type: 杂志文章

    doi:10.2337/diacare.27.5.1054

    authors: Abu Sayeed M,Mahtab H,Akter Khanam P,Abul Ahsan K,Banu A,Rashid AN,Azad Khan AK

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  • Treatment with dietary trans10cis12 conjugated linoleic acid causes isomer-specific insulin resistance in obese men with the metabolic syndrome.

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    journal_title:Diabetes care

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.2337/diacare.25.9.1516

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    pub_type: 临床试验,杂志文章,评审

    doi:10.2337/diacare.13.7.776

    authors: Lipton R,LaPorte RE,Becker DJ,Dorman JS,Orchard TJ,Atchison J,Drash AL

    更新日期:1990-07-01 00:00:00

  • Anti-insulin antibodies are a cause of hypoglycemia following pancreas transplantation.

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    pub_type: 临床试验,杂志文章

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    更新日期:1994-09-01 00:00:00

  • Effects of BAYm 1099, new alpha-glucosidase inhibitor, on acute metabolic responses and metabolic control in NIDDM over 1 mo.

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    journal_title:Diabetes care

    pub_type: 临床试验,杂志文章,随机对照试验

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    更新日期:1988-04-01 00:00:00