• The Korean Journal of Pain
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• v.31 no.4
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• pp.253-260
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• 2018

Background: One of the most frequent problems caused by diabetes is the so called painful diabetic neuropathy. This condition can be treated through numerous types of therapy. The purpose of this study was to analyze, as a meta-analysis, different treatments used to alleviate painful diabetic neuropathy, with the aim of generating results that help making decisions when applying such treatments to tackle this pathology. Methods: A search was conducted in the main databases for Health Sciences, such as PUBMED, Web of Science (WOS), and IME biomedicina (Spanish Medical Reports in Biomedicine), to gather randomized controlled trials about treatments used for painful diabetic neuropathy. The analyzed studies were required to meet the inclusion criteria selected, especially those results related to pain intensity. Results: Nine randomized controlled trials were chosen. The meta-analysis shows significant positive effects for those treatments based on tapentadol [g: -1.333, 95% CI (-1.594; -1.072), P < 0.05], duloxetine [g: -1.622, 95 % CI (-1.650; -1.594), P < 0.05], pregabalin [g: -0.607, 95% CI (-0.980; -0.325), P < 0.05], and clonidine [g: -0.242, 95 % CI (-0.543; -0.058), P < 0.05]. Conclusions: This meta-analysis indicates the effectiveness of the treatments based on duloxetine, gabapentin and pregabalin, as well as other drugs, such as tapentadol and topic clonidine, whose use is better prescribed in more specific situations. The results provided can help increase the knowledge about the treatment of painful diabetic neuropathy and also in the making of clinical practice guidelines for healthcare professionals.

• Journal of the Korean Academy of Clinical Electrophysiology
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• v.4 no.1
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• pp.13-25
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• 2006

This study aims to suggest clinical basis of physical therapy of neuromuscular system complication in type diabetic patients through a variety II of analysis methods including echogenicity using ultrasound image and measurement of peripheral nerve function to their neuromuscular system and provide basic materials for preparing evaluation of physical therapy and intervention program. Subjects of this study were 75 type II diabetic patients between 40 and 80 years old and it obtained the following results through echogenisity and function of peripheral nerve. Incidence of neuropathy in type II diabetes was 55.8% in men and 53.1% in women, and total incidence of neuropathy was 54.7%. Echogenicity of patients with neuropathy was significantly increased compared to that of patients with neuropahty. It was also found that there were correlations between function of peripheral nerve and echogenicity of tibialis anterior and gastrocnemius muscle. In addition, it will be important for physical therapists to divide type II diabetic patients into neuropathy and myopathy and interpret and approach changes of neuro-muscular system from comprehensive side.

• Journal of Yeungnam Medical Science
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• v.40 no.4
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• pp.328-334
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• 2023

An aging population and changes in dietary habits have increased the incidence of diabetes, resulting in complications such as diabetic foot ulcers (DFUs). DFUs can lead to serious disabilities, substantial reductions in patient quality of life, and high financial costs for society. By understanding the etiology and pathophysiology of DFUs, their occurrence can be prevented and managed more effectively. The pathophysiology of DFUs involves metabolic dysfunction, diabetic immunopathy, diabetic neuropathy, and angiopathy. The processes by which hyperglycemia causes peripheral nerve damage are related to adenosine triphosphate deficiency, the polyol pathway, oxidative stress, protein kinase C activity, and proinflammatory processes. In the context of hyperglycemia, the suppression of endothelial nitric oxide production leads to microcirculation atherosclerosis, heightened inflammation, and abnormal intimal growth. Diabetic neuropathy involves sensory, motor, and autonomic neuropathies. The interaction between these neuropathies forms a callus that leads to subcutaneous hemorrhage and skin ulcers. Hyperglycemia causes peripheral vascular changes that result in endothelial cell dysfunction and decreased vasodilator secretion, leading to ischemia. The interplay among these four preceding pathophysiological factors fosters the development and progression of infections in individuals with diabetes. Charcot neuroarthropathy is a chronic and progressive degenerative arthropathy characterized by heightened blood flow, increased calcium dissolution, and repeated minor trauma to insensate joints. Directly and comprehensively addressing the pathogenesis of DFUs could pave the way for the development of innovative treatment approaches with the potential to avoid the most serious complications, including major amputations.

• Asian-Australasian Journal of Animal Sciences
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• v.23 no.5
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• pp.672-679
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• 2010

Diabetes mellitus is a worldwide epidemic with high mortality. As concern over this disease rises, the number and value of research grants awarded by the National Research Foundation of Korea (NRF) have increased. Diabetes mellitus is classified into two groups. Type 1 diabetes requires insulin treatment, whereas type 2 diabetes, which is characterized by insulin resistance, can be treated using a variety of therapeutic approaches. Hyperglycemia is thought to be a primary factor in the onset of diabetes, although hyperlipidemia also plays a role. The major organs active in the regulation of blood glucose are the pancreas, liver, skeletal muscle, adipose tissue, intestine, and kidney. Diabetic complications are generally classified as macrovascular (e.g., stroke and heart disease) or microvascular (i.e., diabetic neuropathy, nephropathy, and retinopathy). Several animal models of diabetes have been used to develop oral therapeutic agents, including sulfonylureas, biguanides, thiazolidinediones, acarbose, and miglitol, for both type 1 and type 2 diseases. This review provides an overview of diabetes mellitus, describes oral therapeutic agents for diabetes and their targets, and discusses new developments in diabetic drug research.

• Korean Journal of Psychosomatic Medicine
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• v.1 no.1
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• pp.52-58
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• 1993

Before studying the effectiveness of amitriptyline in alleviating the pain of diabetic neuropathy, this study was designed to compare the severity and nature of depressive symtoms of diabetic patients with neuropathy with those of diabetic patients without neuropathy and patients with somatoform disorder whose complaints were mainly somatic pain, respectively. The authors administered Beck Depression Inventory(BDI) to the three groups of patients. The mean total scores of BDI were relatively low in all groups and not significantly different among the three groups. The mean scores of four subscales of BDI were also not significantly different among the three groups. These results might suggest that the pain of diabetic neuropathy did not influence on the severity and the nature of depressive symptoms of preexisting diabetes.

• Diabetes and Metabolism Journal
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• v.42 no.6
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• pp.519-528
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• 2018

Background: Clinical manifestations of diabetic peripheral neuropathy (DPN) vary along the course of nerve damage. Nerve conduction studies (NCS) have been suggested as a way to confirm diagnoses of DPN, but the results have limited utility for evaluating clinical phenotypes. The current perception threshold (CPT) is a complementary method for diagnosing DPN and assessing DPN symptoms. We compared NCS variables according to clinical phenotypes determined by CPT measurements. Methods: We retrospectively enrolled patients with type 2 diabetes mellitus who underwent both NCS and CPT tests using a neurometer. CPT grades were used to determine the clinical phenotypes of DPN: normoesthesia (0 to 1.66), hyperesthesia (1.67 to 6.62), and hypoesthesia/anesthesia (6.63 to 12.0). The Michigan Neuropathy Screening Instrument (MNSI) was used to determine a subjective symptom score. DPN was diagnosed based on both patient symptoms (MNSI score ${\geq}3$) and abnormal NCS results. Results: A total of 202 patients (117 men and 85 women) were included in the final analysis. The average age was 62.6 years, and 71 patients (35.1%) were diagnosed with DPN. The CPT variables correlated with MNSI scores and NCS variables in patients with diabetes. Linear regression analyses indicated that hypoesthesia was associated with significantly lower summed velocities and sural amplitudes and velocities, and higher summed latencies, than normoesthesia. Sural amplitude was significantly lower in patients with hyperesthesia than in patients with normoesthesia. Conclusion: NCS variables differed among patients with diabetes according to clinical phenotypes based on CPT and decreased sural nerve velocities was associated with hyperesthesia.

• Genomics & Informatics
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• v.20 no.3
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• pp.26.1-26.19
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• 2022

Diabetes and its related complications are associated with long term damage and failure of various organ systems. The microvascular complications of diabetes considered in this study are diabetic retinopathy, diabetic neuropathy, and diabetic nephropathy. The aim is to identify the weighted co-expressed and differentially expressed genes (DEGs), major pathways, and their miRNA, transcription factors (TFs) and drugs interacting in all the three conditions. The primary goal is to identify vital DEGs in all the three conditions. The overlapped five genes (AKT1, NFKB1, MAPK3, PDPK1, and TNF) from the DEGs and the co-expressed genes were defined as key genes, which differentially expressed in all the three cases. Then the protein-protein interaction network and gene set linkage analysis (GSLA) of key genes was performed. GSLA, gene ontology, and pathway enrichment analysis of the key genes elucidates nine major pathways in diabetes. Subsequently, we constructed the miRNA-gene and transcription factor-gene regulatory network of the five gene of interest in the nine major pathways were studied. hsa-mir-34a-5p, a major miRNA that interacted with all the five genes. RELA, FOXO3, PDX1, and SREBF1 were the TFs interacting with the major five gene of interest. Finally, drug-gene interaction network elucidates five potential drugs to treat the genes of interest. This research reveals biomarker genes, miRNA, TFs, and therapeutic drugs in the key signaling pathways, which may help us, understand the processes of all three secondary microvascular problems and aid in disease detection and management.

• Journal of Korean Biological Nursing Science
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• v.24 no.3
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• pp.171-180
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• 2022

Purpose: The purpose of this study was to investigate the nutritional intake status, according to the risk of diabetic complications in Type 2 diabetes patients. Methods: This was a secondary data analysis study that included 83 patients. The nutritional intake was assessed, using 24-hour dietary recall. The risk of diabetic complications was measured, using the Framingham Risk Score (FRS) and Michigan Neuropathy Screening Instrument Questionnaire (MNSIQ). The nutritional intake was analyzed using the CAN-pro 4.0 program. Data were analyzed using descriptive statistics, Chi-square test, and Independent t-test, using the SPSS WIN 26.0 program. Results: The mean FRS and MNSIQ scores for the participants was 14.46± 4.09 and 2.30± 2.22, respectively. Thirty two participants (38.6%) were in the high-risk groups for cardiovascular disease and peripheral neuropathy. The participants consumed high amounts of grain and low amounts of vegetables, fruits, and dairy products when compared to the recommended intake. However, the nutritional intake did not differ according to FRS or MNSIQ levels. Consumption of vegetables and fruits were significantly different between high and low risk groups of MNSIQ. Conclusion: It is necessary to consider the composition of dietary intake to improve the imbalanced diet in Type 2 diabetes patients and prevent diabetic complications. Type 2 diabetes patients should reduce the intake of grains and sodium, and increase vegetable intake. More deliberate future studies are needed, to investigate the relationship between food intake and the risk status for diabetic complication.

• The Journal of Internal Korean Medicine
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• v.37 no.2
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• pp.232-236
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• 2016

Objective: Diabetic neuropathy is a common complication of diabetes mellitus. Patients with this disease suffer from various peripheral sensory symptoms that are not easily alleviated. We report on a case of a patient with diabetic neuropathy whose symptoms were alleviated after traditional Korean medical treatment.Methods: A patient with hand and foot numbness and coldness diagnosed with diabetic neuropathy was treated with Palmijihwang-tang (Bai Wei Di Huang Wa, 八味地黃湯) three times a day. The progress was evaluated with the numerical rating scale (NRS), neuropathy disability score (NDS), and neuropathy symptom score (NSS).Results: The improvement of symptoms appeared to be faster and more effective than that of conventional treatment. The improvement was observed from the second day of the treatment.Conclusions: This case study shows that Palmijihwang-tang may be an effective treatment for diabetic neuropathy.

• Advances in Traditional Medicine
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• v.5 no.2
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• pp.75-91
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• 2005

Great efforts have been made to improve both the quality of life and life expectancy of diabetes by treating problems associated with chronic complications such as neuropathy, retinopathy and nephropathy. In particular, diabetes is an increased risk of developing several types of kidney disease, and the predominant cause of end-stage renal disease in patients with this disorder is diabetic nephropathy. Therefore, prevention of the occurrence and progression of diabetes and its complications has become a very important issue. The scientific observations of an animal model of streptozotocin-induced diabetes, spontaneously occurring diabetes and diabetic nephropathy in this study suggest that one of the Kampo prescriptions, Hachimi-jio-gan comprising eight constituents, is a novel therapeutic agent.