Title: Study of Prevalance of Small Fibre Neuropathy among Diabetic Population in DAE Hospital using Diabetic Foot Care Test
Author: Dr Sridevi Sitaraman MD (Internal Medicine)
DOI: https://dx.doi.org/10.18535/jmscr/v13i02.05
Abstract
Introduction
Diabetic neuropathy is defined as signs and symptoms of peripheral nerve dysfunction in whom other causes of neuropathy are excluded.DM is frequently complicated by neuropathy affecting about 50 percent of diabetic population .It leads to 2 important consequences which is foot ulceration and neuropathic pain. The prevalence in India is between 10.8 percent-32.2 percent. Early detection of neuropathy is important to reduce the complications. The longer the duration of diabetes and poor glycemic control increases the risk. Painful sensory neuropathy (Small Fibre Neuropathy) is a major burden in diabetic population which complicates the situation. Small diameter nerve fibres are the earliest fibres damaged in diabetes. Highly processed foods with added sugars, diary gluten and alcohol are confounding factors in neuropathy. Impaired glucose tolerance exhibited a lower mean nerve conduction velocity. Symptoms of muscle weakness sensation and autonomic neuropathy were found in DM. So the sensations of pinprick, vibration, temperature sensation, autonomic neuropathy test, Doppler and podia scan are done using diabetic foot care testing device which helps to pick up neuropathy at an earlier stage. Treatment would mainly focus on controlling the risk factors so early diagnosis of the same is necessary and strict control of DM is important .As its mostly linked with metabolic syndrome risk factors contributing to the syndrome is addressed for control of neuropathy. So annual screening of neuropathy in diabetic population will help in early diagnosis of the same and initiation of treatment
References
- Binns-Hall O, Selvarajah D, Sanger D, Walker J, Scott A, Tesfaye S. One-stop microvascular screening service: an effective model for the early detection of diabetic peripheral neuropathy and the high-risk foot. Diabet Med. 2018;35(7):887–894. doi: 10.1111/dme.13630.
- Sloan G, Selvarajah D, Tesfaye S. Pathogenesis, diagnosis and clinical management of diabetic sensorimotor peripheral neuropathy. Nat Rev Endocrinol. 2021;17(7):400–420. doi: 10.1038/s41574-021-00496-z.
- Abbott CA, Malik RA, van Ross ER, Kulkarni J, Boulton AJ. Prevalence and characteristics of painful diabetic neuropathy in a large community-based diabetic population in the U.K. Diabetes Care. 2011;34(10):2220–2224. doi: 10.2337/dc11-1108.
- Galer BS, Gianas A, Jensen MP. Painful diabetic polyneuropathy: epidemiology, pain description, and quality of life. Diabetes Res ClinPract. 2000;47(2):123–128. doi: 10.1016/s0168-8227(99)00112-6.
- Davies M, Brophy S, Williams R, Taylor A. The prevalence, severity, and impact of painful diabetic peripheral neuropathy in type 2 diabetes. Diabetes Care. 2006;29(7):1518–1522. doi: 10.2337/dc05-2228.
- Gore M, Brandenburg NA, Hoffman DL, Tai KS, Stacey B. Burden of illness in painful diabetic peripheral neuropathy: the patients' perspectives. J Pain. 2006;7(12):892–900. doi: 10.1016/j.jpain.2006.04.013.
- Williams SM, Eleftheriadou A, Alam U, Cuthbertson DJ, Wilding JPH. Cardiac autonomic neuropathy in obesity, the metabolic syndrome and prediabetes: a narrative review. Diabetes Ther. 2019;10:1995–2021.