New Perspective in Diabetic Neuropathy: From the Periphery to the Brain, a Call for Early Detection, and Precision Medicine
Diabetic peripheral neuropathy (DPN) is a common chronic complication of diabetes mellitus. It leads to distressing and expensive clinical sequelae such as foot ulceration, leg amputation, and neuropathic pain (painful-DPN). Unfortunately, DPN is often diagnosed late when irreversible nerve injury h...
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doaj-9d932a153da54400a9e302ddbeccdcd12020-11-24T21:43:11ZengFrontiers Media S.A.Frontiers in Endocrinology1664-23922020-01-011010.3389/fendo.2019.00929503723New Perspective in Diabetic Neuropathy: From the Periphery to the Brain, a Call for Early Detection, and Precision MedicineHeng Yang0Gordon Sloan1Yingchun Ye2Shuo Wang3Bihan Duan4Solomon Tesfaye5Ling Gao6Endocrinology Department, Renmin Hospital of Wuhan University, Wuhan, ChinaDiabetes Research Unit, Sheffield Teaching Hospitals, Royal Hallamshire Hospital, Sheffield, United KingdomEndocrinology Department, Renmin Hospital of Wuhan University, Wuhan, ChinaEndocrinology Department, Renmin Hospital of Wuhan University, Wuhan, ChinaEndocrinology Department, Renmin Hospital of Wuhan University, Wuhan, ChinaDiabetes Research Unit, Sheffield Teaching Hospitals, Royal Hallamshire Hospital, Sheffield, United KingdomEndocrinology Department, Renmin Hospital of Wuhan University, Wuhan, ChinaDiabetic peripheral neuropathy (DPN) is a common chronic complication of diabetes mellitus. It leads to distressing and expensive clinical sequelae such as foot ulceration, leg amputation, and neuropathic pain (painful-DPN). Unfortunately, DPN is often diagnosed late when irreversible nerve injury has occurred and its first presentation may be with a diabetic foot ulcer. Several novel diagnostic techniques are available which may supplement clinical assessment and aid the early detection of DPN. Moreover, treatments for DPN and painful-DPN are limited. Only tight glucose control in type 1 diabetes has robust evidence in reducing the risk of developing DPN. However, neither glucose control nor pathogenetic treatments are effective in painful-DPN and symptomatic treatments are often inadequate. It has recently been hypothesized that using various patient characteristics it may be possible to stratify individuals and assign them targeted therapies to produce better pain relief. We review the diagnostic techniques which may aid the early detection of DPN in the clinical and research environment, and recent advances in precision medicine techniques for the treatment of painful-DPN.https://www.frontiersin.org/article/10.3389/fendo.2019.00929/fulldiabetic neuropathypainful diabetic neuropathystratified medicinediagnosis diabetic neuropathypainful diabetic neuropathy treatment |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Heng Yang Gordon Sloan Yingchun Ye Shuo Wang Bihan Duan Solomon Tesfaye Ling Gao |
spellingShingle |
Heng Yang Gordon Sloan Yingchun Ye Shuo Wang Bihan Duan Solomon Tesfaye Ling Gao New Perspective in Diabetic Neuropathy: From the Periphery to the Brain, a Call for Early Detection, and Precision Medicine Frontiers in Endocrinology diabetic neuropathy painful diabetic neuropathy stratified medicine diagnosis diabetic neuropathy painful diabetic neuropathy treatment |
author_facet |
Heng Yang Gordon Sloan Yingchun Ye Shuo Wang Bihan Duan Solomon Tesfaye Ling Gao |
author_sort |
Heng Yang |
title |
New Perspective in Diabetic Neuropathy: From the Periphery to the Brain, a Call for Early Detection, and Precision Medicine |
title_short |
New Perspective in Diabetic Neuropathy: From the Periphery to the Brain, a Call for Early Detection, and Precision Medicine |
title_full |
New Perspective in Diabetic Neuropathy: From the Periphery to the Brain, a Call for Early Detection, and Precision Medicine |
title_fullStr |
New Perspective in Diabetic Neuropathy: From the Periphery to the Brain, a Call for Early Detection, and Precision Medicine |
title_full_unstemmed |
New Perspective in Diabetic Neuropathy: From the Periphery to the Brain, a Call for Early Detection, and Precision Medicine |
title_sort |
new perspective in diabetic neuropathy: from the periphery to the brain, a call for early detection, and precision medicine |
publisher |
Frontiers Media S.A. |
series |
Frontiers in Endocrinology |
issn |
1664-2392 |
publishDate |
2020-01-01 |
description |
Diabetic peripheral neuropathy (DPN) is a common chronic complication of diabetes mellitus. It leads to distressing and expensive clinical sequelae such as foot ulceration, leg amputation, and neuropathic pain (painful-DPN). Unfortunately, DPN is often diagnosed late when irreversible nerve injury has occurred and its first presentation may be with a diabetic foot ulcer. Several novel diagnostic techniques are available which may supplement clinical assessment and aid the early detection of DPN. Moreover, treatments for DPN and painful-DPN are limited. Only tight glucose control in type 1 diabetes has robust evidence in reducing the risk of developing DPN. However, neither glucose control nor pathogenetic treatments are effective in painful-DPN and symptomatic treatments are often inadequate. It has recently been hypothesized that using various patient characteristics it may be possible to stratify individuals and assign them targeted therapies to produce better pain relief. We review the diagnostic techniques which may aid the early detection of DPN in the clinical and research environment, and recent advances in precision medicine techniques for the treatment of painful-DPN. |
topic |
diabetic neuropathy painful diabetic neuropathy stratified medicine diagnosis diabetic neuropathy painful diabetic neuropathy treatment |
url |
https://www.frontiersin.org/article/10.3389/fendo.2019.00929/full |
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