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糖尿病神经病变的难题——过去、现在和未来。

The conundrum of diabetic neuropathies-Past, present, and future.

机构信息

Department of Internal Medicine, Division of Metabolism, Endocrinology, and Diabetes, University of Michigan, Ann Arbor, MI, United States of America.

Department of Internal Medicine, Division of Metabolism, Endocrinology, and Diabetes, University of Michigan, Ann Arbor, MI, United States of America; Ann Arbor Veteran Affairs Hospital, Ann Arbor, MI, United States of America.

出版信息

J Diabetes Complications. 2022 Nov;36(11):108334. doi: 10.1016/j.jdiacomp.2022.108334. Epub 2022 Oct 7.

Abstract

Diabetic neuropathy (DN) remains arguably the most prevalent chronic complication in people with both type 1 and type 2 diabetes, including in youth, despite changes in the current standards of clinical care. Additionally, emerging evidence demonstrates that neuropathy affects a large proportion of people with undiagnosed diabetes and/or prediabetes, as well as those with obesity. Here we summarize the latest epidemiology of DN, recent findings regarding the pathophysiology of the disease, as well as current outcome measures for screening and diagnosis, in research and clinical settings. The authors discuss novel perspectives on the impact of social determinants of health in DN development and management, and the latest evidence on effective therapies, including pharmacological and nonpharmacological therapies for neuropathic pain. Throughout the publication, we identify knowledge gaps and the need for future funding to address these gaps, as well as needs to advocate for a personalized care approach to reduce the burden of DN and optimize quality of life for all affected individuals.

摘要

糖尿病神经病变(DN)仍然是 1 型和 2 型糖尿病患者中最普遍的慢性并发症之一,包括在年轻人中,尽管临床护理标准发生了变化。此外,新出现的证据表明,神经病影响了很大一部分未确诊的糖尿病和/或糖尿病前期患者,以及肥胖患者。在这里,我们总结了 DN 的最新流行病学、疾病病理生理学的最新发现,以及研究和临床环境中用于筛查和诊断的当前结果衡量标准。作者讨论了健康的社会决定因素对 DN 发展和管理的影响的新观点,以及关于有效治疗方法的最新证据,包括用于治疗神经病理性疼痛的药理学和非药理学治疗方法。在整个出版物中,我们确定了知识空白和未来资金需求,以解决这些空白,并需要倡导个性化护理方法,以减轻 DN 的负担并优化所有受影响个体的生活质量。

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