Painful diabetic neuropathy is associated with increased nerve regeneration in patients with type 2 diabetes undergoing intensive glycemic control
Abstract Aims/Introduction Painful diabetic peripheral neuropathy (pDPN) is associated with small nerve fiber degeneration and regeneration. This study investigated whether the presence of pDPN might influence nerve regeneration in patients with type 2 diabetes undergoing intensive glycemic control....
| Main Authors: | , , , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2021-09-01
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| Series: | Journal of Diabetes Investigation |
| Subjects: | |
| Online Access: | https://doi.org/10.1111/jdi.13544 |
| _version_ | 1819148918820175872 |
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| author | Georgios Ponirakis Muhammad A Abdul‐Ghani Amin Jayyousi Mahmoud A Zirie Murtaza Qazi Hamad Almuhannadi Ioannis N Petropoulos Adnan Khan Hoda Gad Osama Migahid Ayman Megahed Salma Al‐Mohannadi Fatema AlMarri Fatima Al‐Khayat Ziyad Mahfoud Hanadi Al Hamad Marwan Ramadan Ralph DeFronzo Rayaz A Malik |
| author_facet | Georgios Ponirakis Muhammad A Abdul‐Ghani Amin Jayyousi Mahmoud A Zirie Murtaza Qazi Hamad Almuhannadi Ioannis N Petropoulos Adnan Khan Hoda Gad Osama Migahid Ayman Megahed Salma Al‐Mohannadi Fatema AlMarri Fatima Al‐Khayat Ziyad Mahfoud Hanadi Al Hamad Marwan Ramadan Ralph DeFronzo Rayaz A Malik |
| author_sort | Georgios Ponirakis |
| collection | DOAJ |
| description | Abstract Aims/Introduction Painful diabetic peripheral neuropathy (pDPN) is associated with small nerve fiber degeneration and regeneration. This study investigated whether the presence of pDPN might influence nerve regeneration in patients with type 2 diabetes undergoing intensive glycemic control. Materials and Methods This exploratory substudy of an open‐label randomized controlled trial undertook the Douleur Neuropathique en 4 questionnaire and assessment of electrochemical skin conductance, vibration perception threshold and corneal nerve morphology using corneal confocal microscopy in participants with and without pDPN treated with exenatide and pioglitazone or basal–bolus insulin at baseline and 1‐year follow up, and 18 controls at baseline only. Results Participants with type 2 diabetes, with (n = 13) and without (n = 28) pDPN had comparable corneal nerve fiber measures, electrochemical skin conductance and vibration perception threshold at baseline, and pDPN was not associated with the severity of DPN. There was a significant glycated hemoglobin reduction (P < 0.0001) and weight gain (P < 0.005), irrespective of therapy. Participants with pDPN showed a significant increase in corneal nerve fiber density (P < 0.05), length (P < 0.0001) and branch density (P < 0.005), and a decrease in the Douleur Neuropathique en 4 score (P < 0.01), but no change in electrochemical skin conductance or vibration perception threshold. Participants without pDPN showed a significant increase in corneal nerve branch density (P < 0.01) and no change in any other neuropathy measures. A change in the severity of painful symptoms was not associated with corneal nerve regeneration and medication for pain. Conclusions This study showed that intensive glycemic control is associated with greater corneal nerve regeneration and an improvement in the severity of pain in patients with painful diabetic neuropathy. |
| first_indexed | 2024-12-22T13:53:21Z |
| format | Article |
| id | doaj.art-c8479784d7174503828ff16492e6b5cf |
| institution | Directory Open Access Journal |
| issn | 2040-1116 2040-1124 |
| language | English |
| last_indexed | 2024-12-22T13:53:21Z |
| publishDate | 2021-09-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Diabetes Investigation |
| spelling | doaj.art-c8479784d7174503828ff16492e6b5cf2022-12-21T18:23:37ZengWileyJournal of Diabetes Investigation2040-11162040-11242021-09-011291642165010.1111/jdi.13544Painful diabetic neuropathy is associated with increased nerve regeneration in patients with type 2 diabetes undergoing intensive glycemic controlGeorgios Ponirakis0Muhammad A Abdul‐Ghani1Amin Jayyousi2Mahmoud A Zirie3Murtaza Qazi4Hamad Almuhannadi5Ioannis N Petropoulos6Adnan Khan7Hoda Gad8Osama Migahid9Ayman Megahed10Salma Al‐Mohannadi11Fatema AlMarri12Fatima Al‐Khayat13Ziyad Mahfoud14Hanadi Al Hamad15Marwan Ramadan16Ralph DeFronzo17Rayaz A Malik18Weill Cornell Medicine‐Qatar Qatar Foundation Education City Doha QatarNational Diabetes Center Hamad General Hospital Hamad Medical Corporation Doha QatarNational Diabetes Center Hamad General Hospital Hamad Medical Corporation Doha QatarNational Diabetes Center Hamad General Hospital Hamad Medical Corporation Doha QatarWeill Cornell Medicine‐Qatar Qatar Foundation Education City Doha QatarWeill Cornell Medicine‐Qatar Qatar Foundation Education City Doha QatarWeill Cornell Medicine‐Qatar Qatar Foundation Education City Doha QatarWeill Cornell Medicine‐Qatar Qatar Foundation Education City Doha QatarWeill Cornell Medicine‐Qatar Qatar Foundation Education City Doha QatarNational Diabetes Center Hamad General Hospital Hamad Medical Corporation Doha QatarNational Diabetes Center Hamad General Hospital Hamad Medical Corporation Doha QatarWeill Cornell Medicine‐Qatar Qatar Foundation Education City Doha QatarWeill Cornell Medicine‐Qatar Qatar Foundation Education City Doha QatarWeill Cornell Medicine‐Qatar Qatar Foundation Education City Doha QatarWeill Cornell Medicine‐Qatar Qatar Foundation Education City Doha QatarRumailah Hospital Hamad Medical Corporation Doha QatarRumailah Hospital Hamad Medical Corporation Doha QatarDivision of Diabetes University of Texas Health Science Center San Antonio Texas USAWeill Cornell Medicine‐Qatar Qatar Foundation Education City Doha QatarAbstract Aims/Introduction Painful diabetic peripheral neuropathy (pDPN) is associated with small nerve fiber degeneration and regeneration. This study investigated whether the presence of pDPN might influence nerve regeneration in patients with type 2 diabetes undergoing intensive glycemic control. Materials and Methods This exploratory substudy of an open‐label randomized controlled trial undertook the Douleur Neuropathique en 4 questionnaire and assessment of electrochemical skin conductance, vibration perception threshold and corneal nerve morphology using corneal confocal microscopy in participants with and without pDPN treated with exenatide and pioglitazone or basal–bolus insulin at baseline and 1‐year follow up, and 18 controls at baseline only. Results Participants with type 2 diabetes, with (n = 13) and without (n = 28) pDPN had comparable corneal nerve fiber measures, electrochemical skin conductance and vibration perception threshold at baseline, and pDPN was not associated with the severity of DPN. There was a significant glycated hemoglobin reduction (P < 0.0001) and weight gain (P < 0.005), irrespective of therapy. Participants with pDPN showed a significant increase in corneal nerve fiber density (P < 0.05), length (P < 0.0001) and branch density (P < 0.005), and a decrease in the Douleur Neuropathique en 4 score (P < 0.01), but no change in electrochemical skin conductance or vibration perception threshold. Participants without pDPN showed a significant increase in corneal nerve branch density (P < 0.01) and no change in any other neuropathy measures. A change in the severity of painful symptoms was not associated with corneal nerve regeneration and medication for pain. Conclusions This study showed that intensive glycemic control is associated with greater corneal nerve regeneration and an improvement in the severity of pain in patients with painful diabetic neuropathy.https://doi.org/10.1111/jdi.13544Corneal confocal microscopyExenatidePainful diabetic neuropathy |
| spellingShingle | Georgios Ponirakis Muhammad A Abdul‐Ghani Amin Jayyousi Mahmoud A Zirie Murtaza Qazi Hamad Almuhannadi Ioannis N Petropoulos Adnan Khan Hoda Gad Osama Migahid Ayman Megahed Salma Al‐Mohannadi Fatema AlMarri Fatima Al‐Khayat Ziyad Mahfoud Hanadi Al Hamad Marwan Ramadan Ralph DeFronzo Rayaz A Malik Painful diabetic neuropathy is associated with increased nerve regeneration in patients with type 2 diabetes undergoing intensive glycemic control Journal of Diabetes Investigation Corneal confocal microscopy Exenatide Painful diabetic neuropathy |
| title | Painful diabetic neuropathy is associated with increased nerve regeneration in patients with type 2 diabetes undergoing intensive glycemic control |
| title_full | Painful diabetic neuropathy is associated with increased nerve regeneration in patients with type 2 diabetes undergoing intensive glycemic control |
| title_fullStr | Painful diabetic neuropathy is associated with increased nerve regeneration in patients with type 2 diabetes undergoing intensive glycemic control |
| title_full_unstemmed | Painful diabetic neuropathy is associated with increased nerve regeneration in patients with type 2 diabetes undergoing intensive glycemic control |
| title_short | Painful diabetic neuropathy is associated with increased nerve regeneration in patients with type 2 diabetes undergoing intensive glycemic control |
| title_sort | painful diabetic neuropathy is associated with increased nerve regeneration in patients with type 2 diabetes undergoing intensive glycemic control |
| topic | Corneal confocal microscopy Exenatide Painful diabetic neuropathy |
| url | https://doi.org/10.1111/jdi.13544 |
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