DIABETIC NEUROPHATY INFORMATIONS CENTER COMUNICATIONS FORUM

 

DIABETIC NEUROPHATY INFORMATIONS CENTER COMUNICATIONS FORUM

editor and consultan

 

Dr Iwan suwandy,MHA

EDITOR NOTES

THIS SPOCIAL FOR GERIATRY DIABETIC NEUROPHATY DIABETIC TYPE 2 ONLY,NOT FOR YOUNG OR OTHER TYPE DIABETIC TYPE ONE . THIS FORUM DISCUSS ABOUT HOW THE SENIOR AFTER 65 YEAR WITH DIABETIC NEUROPATHY WILL STILL LFIFE HEALTHY AND HAPINESS WITH THE CONTROL OF THE BLOOD SUGAR WITH DIET CONRTROL,EXERCISE ETC

PLEASE ALL THE SENIOR PEOPLE AND THE RESEARCES JOIN THIS FORUM,THSI INFO AND COMMUNICATION FREE.

THANKS FOR YOUR ATTANTIONS

DIABETIC NEUROPATHY STILL CAN LIVE HEALTY UNTIL UPPER THAT 80 YESR OLD.

 

Diabetic Info

NATIONAL DIABETES EDUCATION educator INDONESIA
Jakarta, 21 April 2012

 

Minister of Health, represented by Director General of Disease Control and Environmental Health (PP and PL), Prof. dr. Tjandra Yoga Aditama, Sp.P (K), MARS, DTM & H, DTCE
  officially opened the National Training Diabetes Educator Indonesia’s 10th organized by the Association of Diabetes Educators Indonesia (Pedi) in Jakarta (4/20/12).

Ministry of Health welcomes this training, because of 4 things, the first of Diabetes Mellitus (DM) is an important health problem in Indonesia, because DM is a leading cause of death to 6, the urban prevalence of DM 5.7%, and prevalence of Impaired Glucose Tolerance 10.2% .

The second reason for DM control should be the continum care, where education is one important factor.

  Then those who were already trained will immediately be able to handle the DM patients and their families so they can stay healthy, fit and independent.

  While the latter is a real form of training is active participation with the government’s public health to tackle health problems in Indonesia, in this Diabetes Mellitus.

The training lasted for 3 days and followed more than 200 participants, consisting of doctors, nurses, diietesien, and other officers. Training has been running 10 years and have three levels, namely basic, advanced and sustainable.

Training methods in the form: theory, workshops, and simulations.

This information is published by the Center for Public Communication, Secretariat General of the Ministry of Health.

 THE COMMENT SEND TO EDITOR
 

PATHOGENESIS OF DIABET

welcome

 

Dear Dr iwan suwandy,MHA

 

Welcome to Diabetic Living Online! Congratulations on taking control now — we’re glad you’re here! We have the information to help you make the best choices for your health. You can live well with diabetes. Get immediate access and must-have information:

 

•More than 1,000 delicious recipes guaranteed by the Better Homes and Gardens® Test Kitchen.

 

•Practical and clear answers to your questions about carb counting, weight loss, diabetes meal plans, medications, and much more!

 

•FREE recipes and tips delivered to your in-box each week.

 

•FREE quick-start diabetes education course on What to Eat with Diabetes.

 

•Great deals on Diabetic Living Magazine subscriptions.

 

Be sure to find our page on Facebook and join our community of people with diabetes for support, information, and day-to-day tips on living well with diabetes.

 

Here’s to our good health,

Martha Miller Johnson

Editor of Diabetic Living®, wife, mother, friend, PWD type 1

 

 

Type 2 diabetes

Definition

Type 2 diabetes is a lifelong (chronic) disease in which there are high levels of sugar (glucose) in the blood. Type 2 diabetes is the most common form of diabetes.

Alternative Names

Noninsulin-dependent diabetes; Diabetes – type 2;

 

 Adult-onset diabetes

 

 

Causes, incidence, and risk factors

Diabetes is caused by a problem in the way your body makes or uses insulin. Insulin is needed to move blood sugar (glucose) into cells, where it is stored and later used for energy.

 

When you have type 2 diabetes, your fat, liver, and muscle cells do not respond correctly to insulin.

 

This is called insulin resistance.

 

 As a result, blood sugar does not get into these cells to be stored for energy.

 

When sugar cannot enter cells, high levels of sugar build up in the blood. This is called hyperglycemia.

 

Type 2 diabetes usually occurs slowly over time. Most people with the disease are overweight when they are diagnosed. Increased fat makes it harder for your body to use insulin the correct way.

 

Type 2 diabetes can also develop in people who are thin. This is more common in the elderly.

 

Family history and genes play a large role in type 2 diabetes.

Low activity level, poor diet, and excess body weight around the waist increase your risk.

 

See also: Type 2 diabetes for a list of risk factors.

Symptoms

Often, people with type 2 diabetes have no symptoms at first. They may not have symptoms for many years.

The early symptoms of diabetes may include:

  • Bladder, kidney, skin, or other infections that are more frequent or heal slowly
  • Fatigue
  • Hunger
  • Increased thirst
  • Increased urination

The first symptom may also be:

Signs and tests

Your health care provider may suspect that you have diabetes if your blood sugar level is higher than 200 mg/dL. To confirm the diagnosis, one or more of the following tests must be done.

Diabetes blood tests:

Diabetes screening is recommended for:

  • Overweight children who have other risk factors for diabetes, starting at age 10 and repeated every 2 years
  • Overweight adults (BMI greater than 25) who have other risk factors
  • Adults over age 45 every 3 years

You should see your health care provider every 3 months. At these visits, you can expect your health care provider to:

  • Check your blood pressure
  • Check the skin and bones on your feet and legs
  • Check to see if your feet are becoming numb
  • Examine the back part of the eye with a special lighted instrument called an ophthalmoscope

The following tests will help you and your doctor monitor your diabetes and prevent problems:

  • Have your blood pressure checked at least every year (blood pressure goals should be 130/80 mm/Hg or lower).
  • Have your hemoglobin A1c test (HbA1c) every 6 months if your diabetes is well controlled; otherwise every 3 months.
  • Have your cholesterol and triglyceride levels checked yearly (aim for LDL levels below 70-100 mg/dL).
  • Get yearly tests to make sure your kidneys are working well (microalbuminuria and serum creatinine).
  • Visit your eye doctor at least once a year, or more often if you have signs of diabetic eye disease.
  • See the dentist every 6 months for a thorough dental cleaning and exam. Make sure your dentist and hygienist know that you have diabetes.

Treatment

The goal of treatment at first is to lower high blood glucose levels. The long-term goals of treatment are to prevent problems from diabetes.

 

The main treatment for type 2 diabetes is exercise and diet.

 

 

LEARN THESE SKILLS

You should learn basic diabetes management skills. They will help prevent problems and the need for medical care. These skills include:

  • How to test and record your blood glucose (See: Blood glucose monitoring)
  • What to eat and when
  • How to take medications, if needed
  • How to recognize and treat low and high blood sugar
  • How to handle sick days
  • Where to buy diabetes supplies and how to store them

It may take several months to learn the basic skills. Always keep learning about diabetes, its complications, and how to control and live with the disease. Stay up-to-date on new research and treatments.

 

 

MANAGING YOUR BLOOD SUGAR

Self testing means that you check your blood sugar at home yourself. Checking your blood sugar levels at home and writing down the results will tell you how well you are managing your diabetes.

 

A device called a glucometer can give you an exact blood sugar reading.

 

There are different types of devices. Usually, you prick your finger with a small needle called a lancet. This gives you a tiny drop of blood. You place the blood on a test strip and put the strip into the device. Results are given in 30 – 45 seconds.

A health care provider or diabetes educator will help set up an at-home testing schedule for you. Your doctor will help you set your blood sugar goals.

  • Most people with type 2 diabetes only need to check their blood sugar once or twice a day.
  • If your blood sugar levels are under control, you may only need to check them a few times a week.
  • You may test yourself when you wake up, before meals, and at bedtime.
  • You may need to test more often when you are sick or under stress.

The results of the test can be used to change your meals, activity, or medications to keep your blood sugar levels in the right range. Testing can identify high and low blood sugar levels before you have serious problems.

 

Keep a record of your blood sugar for yourself and your health care provider. This will help if you are having trouble managing your diabetes.

 

DIET AND WEIGHT CONTROL

Work closely with your doctor, nurse, and dietitian to learn how much fat, protein, and carbohydrates you need in your diet. Your meal plans should fit your daily lifestyle and habits, and should try to include foods that you like.

Managing your weight and eating a well-balanced diet are important. Some people with type 2 diabetes can stop taking medications after losing weight (although they still have diabetes).

See also:

Very overweight patients whose diabetes is not well managed with diet and medicine may consider bariatric (weight loss) surgery.

See:

REGULAR PHYSICAL ACTIVITY

Regular exercise is important for everyone. It is even more important you have diabetes. Exercise in which your heart beats faster and you breathe faster helps lower your blood sugar level without medication. It also burns extra calories and fat so you can manage your weight.

 

Exercise can help your health by improving blood flow and blood pressure. Exercise also increases the body’s energy level, lowers tension, and improves your ability to handle stress.

 

Ask your health care provider before starting any exercise program. People with type 2 diabetes must take special steps before, during, and after intense physical activity or exercise. See also: Diabetes and exercise

 

MEDICATIONS TO TREAT DIABETES

If diet and exercise do not help keep your blood sugar at normal or near-normal levels, your doctor may prescribe medication. Since these drugs help lower your blood sugar levels in different ways, your doctor may have you take more than one drug.

Some of the most common types of medication are listed below. They are taken by mouth or injection.

  • Alpha-glucosidase inhibitors (such as acarbose)
  • Biguanides (Metformin)
  • Injectable medicines (including exenatide, mitiglinide, pramlintide, sitagliptin, and saxagliptin)
  • Meglitinides (including repaglinide and nateglinide)
  • Sulfonylureas (like glimepiride, glyburide, and tolazamide)
  • Thiazolidinediones (such as rosiglitazone and pioglitazone). (Rosiglitazone may increase the risk of heart problems. Talk to your doctor.)

These drugs may be given with insulin, or insulin may be used alone. You may need insulin if you continue to have poor blood glucose control. It must be injected under the skin using a syringe or insulin pen device. It cannot be taken by mouth. See also: Type 1 diabetes

 

It is not known whether hyperglycemia medications taken by mouth are safe for use in pregnancy. Women who have type 2 diabetes and become pregnant may be switched to insulin during their pregnancy and while breast-feeding.

 

 

PREVENTING COMPLICATIONS

Your doctor may prescribe medications or other treatments to reduce your chances of developing eye disease, kidney disease, and other conditions that are more common in people with diabetes.

See also:

FOOT CARE

People with diabetes are more likely to have foot problems. Diabetes can damage nerves, which means you may not feel an injury to the foot until you get a large sore or infection. Diabetes can also damage blood vessels.

Diabetes also decreases the body’s ability to fight infection.

 

Small infections can quickly get worse and cause the death of skin and other tissues.

 

To prevent injury to your feet, check and care for your feet every day. See also: Diabetes foot care

Support Groups

For more information, see diabetes resources.

 

 

 

 

Expectations (prognosis)

After many years, diabetes can lead to serious problems with your eyes, kidneys, nerves, heart, blood vessels, or other areas in your body.

 

If you have diabetes, your risk of a heart attack is the same as that of someone who has already had a heart attack. Both women and men with diabetes are at risk. You may not even have the normal signs of a heart attack.

 

If you control your blood sugar and blood pressure, you can reduce your risk of death, stroke, heart failure, and other diabetes problems.

 

Some people with type 2 diabetes no longer need medicine if they lose weight and become more active.

 

When they reach their ideal weight, their body’s own insulin and a healthy diet can control their blood sugar levels.

 

 

 

 

 

 

Complications

After many years, diabetes can lead to serious problems:

  • You could have eye problems, including trouble seeing (especially at night), and light sensitivity. You could become blind.
  • Your feet and skin can develop sores and infections. After a long time, your foot or leg may need to be removed. Infection can also cause pain and itching in other parts of the body.
  • Diabetes may make it harder to control your blood pressure and cholesterol. This can lead to a heart attack, storke, and other problems. It can become harder for blood to flow to your legs and feet.
  • Nerves in your body can get damaged, causing pain, tingling, and a loss of feeling.
  • Because of nerve damage, you could have problems digesting the food you eat. You could feel weakness or have trouble going to the bathroom. Nerve damage can make it harder for men to have an erection.
  • High blood sugar and other problems can lead to kidney damage. Your kidneys may not work as well, and they may even stop working.

Infections of the skin, female genital tract, and urinary tract are also more common.

 

To prevent problems from diabetes, visit your health care provider or diabetes educator at least four times a year. Talk about any problems you are having.

 

Calling your health care provider

Call 911 right away if you have:

  • Chest pain or pressure
  • Fainting or unconsciousness
  • Seizure
  • Shortness of breath

These symptoms can quickly get worse and become emergency conditions (such as convulsions or hypoglycemic coma).

Call your doctor if you have:

  • Numbness, tingling, or pain in your feet or legs
  • Problems with your eyesight
  • Sores or infections on your feet
  • Symptoms of high blood sugar (being very thirsty, having blurry vision, having dry skin, feeling weak or tired, needing to urinate a lot)
  • Symptoms of low blood sugar (feeling weak or tired, trembling, sweating, feeling irritable, having trouble thinking clearly, fast heartbeat, double or blurry vision, feeling uneasy)

Prevention

You can help prevent type 2 diabetes by keeping a healthy body weight and an active lifestyle.

 

Stay up-to-date with all your vaccinations and get a flu shot every year.

 

References

American Diabetes Association. Standards of medical care in diabetes–2011. Diabetes Care. 2011;34 Suppl 1:S11-S61.

Eisenbarth GS, Polonsky KS, Buse JB. Type 1 Diabetes Mellitus. In: Kronenberg HM, Melmed S, Polonsky KS, Larsen PR. Kronenberg: Williams Textbook of Endocrinology. 11th ed. Philadelphia, Pa: Saunders Elsevier; 2008:chap 31.

Pignone M, Alberts MJ, colwell JA, Cushman M, Inzucchi SE, Mukherjee D, et al. Aspirin for primary prevention of cardiovascular events in people with diabetes: a position statement of the American Diabetes Association, a scientific statement of the American Heart Association, and an expert consensus document of the American College of Cardiology Foundation. Circulation. 2010;121:2694-2701.

Buchwald H, Estok R, Fahrbach K, Banel D, Jensen MD, Pories WJ, Bantle JP, Sledge I. Weight and type 2 diabetes after bariatric surgery: systematic review and meta-analysis. Am J Med. 2009 Mar;122(3):248-256.e5. Review. PubMed PMID: 19272486.

ACCORD Study Group, Gerstein HC, Miller ME, Genuth S, Ismail-Beigi F, Buse JB, et al. Long-term effects of intensive glucose lowering on cardiovascular outcomes. N Engl J Med. 2011;364:818-828.

Alemzadeh R, Ali O. Diabetes Mellitus. In: Kliegman R, ed. 19th ed. Nelson Textbook of Pediatrics. Philadelphia, Pa: Saunders Elsevier; 2011: chap 583.

Review Date:

6/28/2011

 

Diabetic Diva ~

The triglyceride has been referred to as the “ugly fat” but that is more of an emotional response than one that is firmly anchored in scientific fact.

 

Nonetheless its association with diabetes cannot be ignored.

 

Cholesterol has already been identified as a risk factor for heart disease. There are countless adverts and information outlets which confirm the problems that are associated with an uncontrolled diet.

 

Likewise there are pills and food choices which are promoted as part of the solution.

 

Consumers get variable results depending on their genetic makeup and the stage at which the condition is arrested.

 

Exercise programs are also recommended as part of a healthy living process.

The question remains as to whether all these interventions have been effective or whether they are simply a way for the advertizing agencies to make even more money.

  • Bundles of fat that can cause havoc: By consensus, triglycerides are small bundles of fat which are found in the blood stream. They increase in number after we consume food. The body will manufacture these fats from the foods which we eat especially if they are fatty in nature. It has been estimated that 90% of all the fat content in non-lean meat consists of triglyceride.  Therefore the shopping habits of the risk groups have to reflect this imminent danger.
  • Triglycerides are not universally bad: A balanced diet should contain all the relevant elements. It has been estimated that triglyceride have a proportion of 99% of all the fat stored within the human body. You get long term energy sources from these fatty deposits. They are actually stored in a denser from than muscle protein or even starch.  Insulin is required in order to form fat. Between meals and overnight, the triglycerides are converted into energy. Fasting and low insulin levels will trigger this reaction. The fat cells have a very high storage capacity and this can lead to obesity in certain situations. If you are undergoing extensive fasting or there is absolutely no insulin in the body then the liver will convert the fat breakdown products into ketones.
  • The health complications and their manifestations: It is often the case the low levels of HDL or good cholesterol is associated with high levels of triglyceride. This is then diagnosed as diabetic dyslipidemia.  This is a combination of factors that can place the life of the patient in danger. Patients in this situation will have small, dense and ultimately harmful clusters of LDL or harmful cholesterol. The latter format is undesirable by virtue of its atherogenic properties. Eventually the person will develop central obesity. This is one of the defining features of the metabolic syndrome.
  • Around 80% of all the people with type 2 diabetes will have this condition. Eventually the person will die prematurely from heart disease.
  • Setting the benchmarks for a healthy person: It is imperative that you have some goals on how much triglyceride which you are going to record on the standard scale. This is an indicator of underlying healthy conditions. Therefore you will be in a position to implement a preventative strategy when required to do so. The normal levels of triglycerides are 150 mg/dl. The borderline figure is between 150 and 199. The high level is between 200 and 499 while anything over 500 is a matter of urgency. The normal fasting state will have levels reading between 100 and 150 mg/dl. After a normal meal the figure will rise to 300. Patients with type 2 diabetes will have elevated levels in both the fasting and even state.  Prior to the lipid panel test, you should have some overnight fasting for at least 12 hours. Likewise it is not advisable to take alcohol at least 24 hours prior to the test.
  • Managing the level of triglyceride in your body: It is to your advantage that you keep the levels of this substance relatively low. Patients with type 2 diabetes have high risk factors and need to work that bit extra to ensure that their levels are 150 mg/dl or even lower. This will help them reduce the possibility of developing cardiovascular diseases. Some people in this category have carried levels that are well over 400. Once you start hitting the 1000 mark then you will suffer skin lesions or xanthomas, memory loss, pancreatic and abdominal pain. Intervention is required at this stage in order to save your life.
  • The clinical response: A combination of medication and diet management can have positive results. First of all you have to aim for glucose control. A typical prescription will include Statins such as Zocor, Lipitor, Pravachol, Zetia, Crestor and Vytorin. These medications are meant to lower your cholesterol levels in general.Type 2 diabetes patients may require combination therapy in order to reach the safe levels of triglycerides. You also have to think of ways of lowering your LDL levels. Sometimes the clinician will recommend a series of Fibrates such as Lopid gemfibrozil, Trico fenofibrate and Nicotinic acid or niacin. It is also advisable to include fish oil in your diet.

Having recognized the dangers that can arise from triglycerides in relation to diabetes, you should come up with practical lifestyle changes that will help you avoid the dangerous phases.

 

In some instances you may have to restrict your fat intake completely. The problem is that this step can cause you to take even more carbohydrates and therefore increase the level of triglyceride in your bloodstream.

 

 Some books recommend substitution healthy fats such as olive oil and other monounsaturated fats.

 Do not increase your intake of sugar or white flour products.  Alcohol intake should be kept to a minimum.

 

Take oily fish such as tuna, sardines, salmon, mackerel and anchovies.

 

They contain omega-3 fatty acids which are known to reduce triglycerides.

 

Genetic disorders such as hypothyroidism can combine with diseases in order to exacerbate the situation.

 

 

Taking drugs such as steroids, birth control pills and Tamoxifen can also be problematic. You are at risk if you suffer from kidney disease, liver failure and high blood pressure.

The writer of this article is a blogger of ayurvedic health care tips.

 

BEWARE ALWAYS  NO STARCHY FOOD

 

All food that you eat turns to sugar in your body.

 Carbohydrate-containing foods alter your sugar levels more than any other type of food.

Carbohydrates are found in starchy or sugary foods, such as

bread, rice, pasta, cereal, potatoes, peas, corn, fruit, fruit juice, milk, yogurt, cookies, candy, soda, and other sweets.

Simple carbohydrates are broken down quickly by the body to be used as energy. Simple carbohydrates are found naturally in foods such as fruits, milk, and milk products.

 They are also found in processed and refined sugars such as candy, table sugar, syrups, and soft drinks.

The majority of carbohydrate intake should come from complex carbohydrates (starches) and naturally occurring sugars rather than processed or refined sugars.

All food that you eat turns to sugar in your body. Carbohydrate-containing foods alter your sugar levels more than any other type of food.

Carbohydrates are found in starchy or sugary foods, such as bread, rice, pasta, cereal, potatoes, peas, corn, fruit, fruit juice, milk, yogurt, cookies, candy, soda, and other sweets.

Exercises

 

 

 

Food and insulin release

 

 

Insulin is a hormone secreted by the pancreas in response to increased glucose levels in the blood.

 

Glucose test

 

.

 

 

 

 

 

 

 

Monitor blood glucose – series

Part one

 

Set up the meter according to the specific directions that come with your meter. Get the supplies ready, including a new test strip and disposable lancet. Place the lancet into the lancing device.

 

 

 

Diabetic blood circulation in foot

 

 

People with diabetes are at risk for blood vessel injury, which may be severe enough to cause tissue damage in the legs and feet.

 

 

 

 

 

 diabetic type 2 different with  diabetic type 1

The type one

Isulin dependend diabetis mellitus

A person with diabetes constantly manages their blood’s sugar (glucose) levels. After a blood sample is taken and tested, it is determined whether the glucose levels are low or high.

 

If glucose levels are too low carbohydrates are ingested.

If glucose in the blood is too high, the appropriate amount of insulin is administered into the body such as through an insulin pump

We didnot discuss the diabetic type one because this type must have the medical serious management

IC  NEUUOROPATHY

 

Nerve Complications

 

Elevated blood sugars can damage the peripheral nerves.

Symptoms of neuropathy include:

  • pain, numbness, and tingling of hands and feet
  • muscle weakness such as trouble climbing stairs
  • nausea and vomiting
  • dizziness and lightheadedness

 

Elevated levels of blood sugar can injure the blood vessels supplying the peripheral nerves, irritating and damaging them in the process.

Such accumulated nerve damage is called diabetic neuropathy.

Better blood glucose control can help restore healthy nerve function.

Nerve Disease

The nervous system includes our brain (central nervous system) and all of the nerves going from the brain to the rest of the body (peripheral nervous system).

The nervous system is always at work.

Sometimes – when we move or feel something – we are aware of it.

 But much happens automatically, including the control of our heart rate, the movement of food through the stomach and intestines and regulation of our blood pressure.

Your health care provider can determine that your symptoms are related to diabetes and not to some other condition.

The best way to improve all forms of diabetic neuropathy is to

 control your blood sugar levels.

There are two categories of diabetic neuropathy:

  • Sensory and motor neuropathy
  • Autonomic neuropathy

Symptoms of neuropathy include:

  • Pain, numbness, and tingling of hands and feet
  • Muscle weakness such as foot drop, double vision, trouble climbing stairs and getting out of a chair
  • Stomach symptoms including bloating, nausea, vomiting of undigested food many hours after a meal, feeling full without eating much food. This is also referred to as gastroparesis.
  • Bowel trouble such as episodes of diarrhea especially at night
  • Difficulty with bladder emptying
  • Sexual dysfunction
  • Dizziness and lightheadedness from a very fast heart rate and trouble keeping the blood pressure high enough when sitting or standing up.

What is the treatment?

Before any treatment can be decided upon, you need to report any of these symptoms to your health provider.

Your provider needs to make sure that the symptoms are due to diabetic neuropathy and not something else.

Near normal blood sugar control will usually improve all forms of diabetic neuropathy.

Pain medications should be used as needed. Your provider may refer you to an doctor for specialized treatment and evaluation.

Foot Complications

 

Taking good care of your feet prevents serious complications.

  • Get regular foot exams that test for any nerve damage
  • Wash, dry and inspect your feet each day
  • Wear shoes and socks that fit
  • Control your blood glucose

 

Foot problems are caused by neuropathy, poor circulation or a combination of both.

 The loss of feeling that comes with neuropathy is especially dangerous, as you may not be aware of cuts, blisters and bruises.

The loss of sensation can change the way you walk or can damage bones and joints.

Delays in treatment can lead to serious problems. Poor blood circulation means that less oxygen and fewer white blood cells that fight infection can get to a wound.

It also means that antibiotic treatments that travel through the bloodstream are not as effective because they cannot get to the tissue in proper concentrations.

Foot problems

Foot problems include:

  • Changes in sensation from severe pain to numbness
  • Increased likelihood of infection (bacterial and fungal)
  • Slow wound healing
  • Deformation of the joints (Charcot joints, hammertoes, bunions, fallen arches)

Recommendations:

  • If you have foot problems, consult a doctor right away. Early diagnosis can make a dramatic difference. Treatment for infection includes antibiotics and regular wound dressing. Impaired circulation sometimes can be helped by blood vessel bypass. This procedure also may help heal wounds and ulcers in combination with skin or tissue growth factors.
  • Unfortunately, in advanced cases of poor circulation and uncontrolled infection, amputation may be necessary, usually just a toe or part of a bone is removed. In the most severe cases, it may necessary to remove part of the foot or leg.

It is important to:

  • Get regular foot exams that test for any nerve damage
  • Not go barefoot
  • Not use sharp objects or over-the-counter chemical treatments such as corn/wart removers
  • Not use excessively hot water, electric blankets or heating pads, hot water bottles
  • Not smoke
  • Wash, dry and inspect your feet each day
  • Check between your toes
  • Wear shoes and socks that fit
  • Make sure there is nothing sharp or irritating in your shoes
  • Report corns and calluses and injuries that don’t heal to your medical provider
  • Cut toenails straight across and not too close to the quick; this will help prevent ingrown nails and associated infections
  • Control your blood glucose

Eye Complications

 

Eye problems range from minor changes to significant visual loss.

Complications include:

  • Retinopathy
  • Cataracts
  • Macular edema
  • Glaucoma

 

People with diabetes are at risk of eye problems, ranging from minor changes with no effect on vision to significant visual loss.

With regular screening and eye exams by an eye doctor (ophthalmologist), and with stable and near normal blood glucose control, most of the serious complications can be avoided or successfully treated.

Vision complications

Putting off an eye exam is very risky. Usually there are few or no symptoms at the time the damage is occurring.

Exams will reveal the problem and allow your eye doctor to treat it. Treatment can slow down the progression and maintain vision even in those who have developed significant eye complications.

 

Eye complications include:

Healthy eyes require that you:

  • Control your blood sugar
  • Control your blood pressure
  • Control your cholesterol
  • Don’t smoke and avoid second hand smoke
  • Use Ultra-violet protected eye glasses
  • See your ophthalmologist regularly and get retinal exams and eye pressure checked

Symptoms of eye emergencies:

  • Loss of vision,
  • Holes in vision,
  • Showers of sparking white lights,
  • Black curtains over vision,
  • Spots of fuzzy print, hazy vision,

If you have symptoms of any of the eye emergencies, seek medical care or contact your eye doctor immediately

 

Self-assessment Quiz

Self assessment quizzes are available for topics covered in this website. To find out how much you have learned about  Diabetes Complications, take our self assessment quiz when you have completed this section. 

 The quiz is multiple choice. Please choose the single best answer to each question.

At the end of the quiz, your score will display.

If your score is over 70% correct, you are doing very well. If your score is less than 70%, you can return to this section and review the information

Quizzes

 

Take quizzes!

Test your knowledge about diabetes management, treatment, complications, and more.

 

You may want to see how much you have learned using this website. Below are a series of self assessment quizzes. The questions cover the most important teaching points in each section. If you have trouble with a quiz, you may want to go back and review the section in the website.

Read each section of the site and then take one of our self-assessment quizzes to test your new skills!

 

Diabetes and Exercise

 

Take the Diabetes and Exercise quiz.

Test your knowledge about how exercise can help people with diabetes.

 

// //  

Top of Form

The benefits of exercise include:

 

Improved insulin sensitivity

Lowered risk of heart disease

Reduced stress and enhanced quality of life

All of the above

All of the answers are correct. Aerobic exercise, including brisk walking, swimming and cycling, has a long list of health benefits. Other benefits include reduced body fat, preserved bone mass and improved circulation.

 

 

 

 

Managing Your Weight

 

Take the Managing Your Weight quiz.

Test your knowledge about tips and techniques for managing your weight.

 

// //  

Top of Form

If you are overweight or obese, the health benefits of losing weight through diet and exercise include:

 

Improved sensitivity to the action of insulin and improved blood sugar levels

Lowered risk of developing heart disease, like heart attacks and stroke

Prevention or delaying of serious health conditions, like breathing problems, joint and bone disorders

All of the above.

All of the answers are correct. However, the best answer is “All of the above”. While weight loss may prevent or delay serious health conditions, weight loss also lowers your risk for heart disease, decreases insulin resistance and improves blood sugar levels. Bottom of Form

Bottom of Form

 

 

Understanding Carbohydrates

 

Take the Understanding Carbohydrates quiz.

Test your knowledge about carbohydrates.

 

// //  

Top of Form

Carbohydrates are found in which foods?

 

Starch, fruit, milk, starchy vegetables

Cheese, steak, chicken

Olive oil, butter and fish

Starch, fruit, milk, and starchy vegetables contain carbohydrate. Cheese, steak, chicken, and fish are types of protein, while olive oil and butter are types of fat.

 

 

 

 

 

Understanding Food

 

Take the Understanding Food quiz.

Test your knowledge about food.

 

// //  

Top of Form

What are the 3 primary sources of nutrition in a balanced diet?

 

Carbohydrate, protein and fat

Carbohydrate, protein and alcohol

Fat, protein and leafy vegetables

Carbohydrate, protein and fat are the 3 primary sources of nutrition in a balanced diet. While alcohol has calories, it is not one of the 3 main sources of nutrition in the diet. Leafy vegetables also have some carbohydrates, but they do not supply all of your daily carbohydrate requirements.

 

 

Monitoring Your Type 1 Diabetes

 

Take the Monitoring Your Type 1 Diabetes quiz.

Test your knowledge about monitoring type 1 diabetes.

Monitoring your blood glucose will:

 

Ensure that your blood glucose levels stay normal

Give you the feedback you need to keep your blood glucose in target range

Not be necessary, as long as you eat right

Monitoring alone does not change the blood glucose level, but the only way to know if you are keeping your blood glucose levels in the target range is to monitor your blood glucose. While it is important to eat a healthy diet, diet alone may not be sufficient. Monitoring your blood glucose will give you the feedback you need.

 

Monitoring Your Type 2 Diabetes

 

Take the Monitoring Your Type 2 Diabetes quiz.

Test your knowledge about monitoring type 2 diabetes.

 

// //  

Top of Form

Monitoring your blood glucose will:

 

Ensure that your blood glucose levels stay normal

Give you the feedback you need to keep your blood glucose in target range

Not be necessary, as long as you eat right

Bottom of Form

 

Monitoring alone does not change the blood sugar level, but it does help you know if your treatment plan is successful. The only way to find out if you are keeping your blood sugar levels in the target range is to monitor your blood sugar.

 

Self-management Solutions for Type 1 Diabetes

 

Take the Self-management Solutions for Type 1 Diabetes quiz.

Test your knowledge about self-management solutions for type 1 diabetes.

 

// //  

Top of Form

When your blood sugar is not well controlled, it is helpful to:

 

Monitor your blood sugar at different times of the day such as before and after meals, bedtime, middle of the night, and whenever feeling low

Keep a logbook of your blood sugar test results, food, activity/exercise and medication doses

Discuss the problem with your medical provider

All of the above

All of the above

All of the answers are correct. However, the best answer is “All of the above”. When your blood sugar is not well controlled, it is useful to monitor your blood sugar more frequently throughout the day including overnight.

Also, keep a logbook of your blood sugar results, exercise/activity, the carbohydrate content of the food, and the insulin dose. You can review the log book with your medical provider to problem solve why you are having difficulty controlling your blood sugar.

Self-management Solutions for Type 2 Diabetes

 

Take the Self-management Solutions for Type 2 Diabetes quiz.

Test your knowledge about self-management solutions for type 2 diabetes.

 

// //  

Top of Form

When your blood sugar is not well controlled, it is helpful to:

 

Monitor your blood sugar at different times during the day

Keep a logbook of your blood sugar test results, food, exercise and medication doses

Discuss the problem with your medical provider

All of the above

All of the answers are correct. However, the best answer is “All of the above”. When your blood sugar is not well controlled, it is useful to monitor your blood sugar more frequently and at different times of the day. Also, keep a logbook of your blood sugar results, exercise/activity, the carbohydrate content of the food, and medication doses (including insulin). You can review the log book with your medical provider to problem solve why you are having difficulty controlling your blood sugar.Bottom of Form

 

Bottom of Form

 

Monitoring alone does not change the blood glucose level, but the only way to know if you are keeping your blood glucose levels in the target range is to monitor your blood glucose. While it is important to eat a healthy diet, diet alone may not be sufficient. Monitoring your blood glucose will give you the feedback you need.

Monitor your blood glucose more frequently when:

 

You are sick

You are traveling

Your routine changes

Your diabetes medication changes

You are more active or exercising

All of the above

All of the answers are correct. However, the best answer is “All of the above”. Illness, traveling, lifestyle changes, diabetes medication, and increased activity can all impact your blood glucose control. Monitor your blood glucose more frequently on these occasions to be sure your blood sugar levels are on target.

Alternative site testing is NOT recommended when:

 

You feel like your blood glucose might be low

You have eaten or exercised within the last 2 hours

You have hypoglycemia unawareness and don’t feel the symptoms of low blood glucose

All of the above

All of the choices are correct. However, the best answer is “All of the above”. Fingerstick testing is the most accurate reflection of sugar levels in the blood stream. Alternative site testing lags behind fingerstick testing by 20 minutes or more. Alternative site testing is similar to fingerstick testing only when the blood sugar is steady, and not moving rapidly up or rapidly down. If you really had a low blood sugar, the alternative site testing result might be misleadingly high. This could lead to making the wrong decision to reach your target blood glucose level by not eating a carbohydrate-containing snack (PDF) or taking other corrective action.

Using a continuous glucose monitor means:

 

You won’t have to do fingerstick testing with a meter anymore

Readings can be used for making immediate treatment decisions

You will have trend information that can help you manage your blood glucose more effectively

Many people find the information about their blood glucose trends very helpful in managing their care, and have been able to increase the time their blood sugars are in the target range. Before making any immediate treatment decisions, you will still need to do traditional blood glucose testing to verify a glucose level determined by a sensor. The sensors still have to be calibrated or reconciled with blood glucose readings obtained with a blood glucose meter, and the continuous glucose sensor results have to be verified before you change your therapy.

Diabetic Neurophaty treatment

Research Front Maps

Research front maps are diagrammatic representations of the core papers comprising each front. They are selected from the current Research Front set that are relevant to the featured special topic.

 

The title for this Research Front Map is “DIABETIC NEUROPATHIC PAIN TREATMENT,” containing 30 core papers. Source dates: 1999-February 28, 2009 (first bimonthly period 2009).

Each circle represents a highly cited paper whose bibliographic information is displayed when the user clicks on the circle.

 

The solid lines between circles represent the strongest co-citation links for each paper (that is, indicating that the papers are frequently cited together); weaker links are indicated by dashed lines.

 

 Papers close to each other on the map are generally more highly co-cited. The most recent paper(s) are indicated in pink. Annotations may have been added to this map which represent the main research themes. These appear as labels attached to specific regions on the maps.

Note: For best results use the “landscape orientation” option when printing this page.

 

 

Treatment of Type 1 Diabetes

 

Take the Treatment of Type 1 Diabetes quiz.

Test your knowledge about type 1 diabetes treatment.

 

// //  

Top of Form

The ultimate goal of insulin therapy is to mimic normal insulin levels.

 

True

False

If you have type 1 diabetes, your body is no longer producing enough insulin. We try to mimic normal insulin levels with insulin injections or infusion through an insulin pump.

 

Treatment for Type 2 Diabetes

 

Take the Treatment quiz.

Test your knowledge about diabetes treatment.

 

// //  

Top of Form

Type 2 diabetes mellitus is treated with:

 

Lifestyle changes – a healthy diet, adequate activity/exercise and, as needed, losing weight

Pills that help return the blood sugar (plasma glucose) to the normal range

Pills that increase the secretion of insulin from the pancreas

Insulin

All of the above

All of the answers are correct. However, the best answer is “All of the above”.

There are many different treatments for type 2 diabetes mellitus. Every treatment regimen starts with lifestyle changes – a healthy diet, adequate activity/exercise, and, as needed, losing weight. If lifestyle changes are not sufficient to control the blood sugar, then medications are added.

Usually the first medication to be added is Metformin (a biguanide). It helps to return the blood sugar (plasma glucose) back to the normal, non-diabetic range.

Other medications, including insulin, may be added to the metformin and lifestyle therapy.

There is not a single treatment plan that is best for everyone. Talk with your provider about the best treatment plan for you.

 

REFRENCESBottom

Recognition of Any Warning Symptoms for Diabetic Neuropathy

By Hendra Excel

55.diabetic neuropathy symptoms Diabetic Neuropathy Symptoms

Recognition of any warning symptoms for DIABETIC NEUROPATHY happen to be for serious great importance given that that will lose him or her can get daily life switching or violent strikes.

Diabetic neuropathy is certainly because of any the wall surfaces within the problematic veins who supply any phobia being more powerful. The decreases the option within the phobia that will run impulses back in the brain. Sorbitol at the same time methods together with gathers during the Schwann debris inducing deeper sensors conduction disadvantages.

One can find several different types of neuropathies which can mode utilizing diabetes; polynueropathies together with mononeuropathies. When the warning symptoms seem to be would depend what precisely phobia components happen to be infected.

Any warning symptoms may vary among the consumers as well as being impacted by the sum of hurt finished into the phobia. Many other warning symptoms consist of some sort of soreness problems, a good eliminating or simply blasting impression, or simply becoming like your story own frigid your feet.

When the neuropathy progresses any warning symptoms consist of drunken sensations for problems, impression, environment, vibration, together with two-point discrimination. In order to remedy polyneuropathy is certainly thru direction within the diabetes again.

Mononeuropathies happen to be remoted gatherings the fact that change simple phobia. Any warning symptoms for this style of neuropathy happen to be wholly impacted by which unfortunately a sensor is certainly infected. They’ll change any coulometer sensors which unfortunately lead to annoyance, total eye problems together with some sort of failing to safely move a person’s eye in any focus.

Most of the victims of diabetes, irrespective of whether model 1 or simply model a pair of, have to pay attention to any warning symptoms for diabetic neuropathy. The sooner it is actually sent to the interest within the victims of diabetes health-related service providers the sooner it really is monitored thru adequate standard of living opportunities that will be devoted to eating routine, activity, together with adequate health related direction.

Diabetic Neuropathy Remedy?

Diabetic Neuropathy Symptoms 246x300 Diabetic Neuropathy Symptoms

The actual DIABETIC NEUROPATHY is actually neural harm to entire body extremities, your toes as well as fingers for instance, in addition neural harm to internal organs, digestive system and also the center for instance.

Here Are the Actual Diabetic Neuropathy Treatments

*The remedy with regard to diabetic neuropathy very first choice would be to manage the actual blood sugar amounts therefore you will find not really inconsistent levels as well as levels. Administration consists of diet plan as well as physical exercise, in addition medicine in the event that recommended.

* In order to avoid heartburn, physicians claim that diabetes sufferers ought to consume lower foods as well as restrict body fat as well as meals full of dietary fiber. Additionally bloodstream stress medicines probably will advantage the actual diabetic as well.

An average lotion is actually capsaicin lotion.

The Actual Diabetic Neuropathy Details

1 most unfortunate problems associated with diabetes may be the neural harm already been brought on by diabetes. The actual diabetes neuropathy may cause moderate uneasiness for many people, while with regard to other people this particular condition is actually disabling as well as sometimes crucial.

Here Are the Actual Diabetic Neuropathy Signs and Symptoms

The actual DIABETIC NEUROPATHY signs and symptoms tend to be based on the kind as well as which anxiety which obtained impacted. The actual signs and symptoms consist of muscle mass coordination difficulties, heartburn, weak point, numbness, discomfort or even tingling (usually within the ft or even fingers), nausea or vomiting as well as bladder difficulties. It might curiosity you to definitely realize that extended blood sugar levels extreme conditions blood sugar levels that is possibly excessive or even as well reduced with regard to too much time could cause numerous problems, which can result in the diabetic coma.

of Form

Bottom of Form

 

 Core Papers 


Label: Dworkin-2003
Title: Advances in neuropathic pain – Diagnosis, mechanisms, and treatment recommendations
Journal: ARCH NEUROL, 60 (11): 1524-1534 NOV 2003
Citations: 274
Authors: Dworkin, RH;Backonja, M;Rowbotham, MC;Allen, RR;Argoff, CR;Bennett, GJ;Bushnell, MC;Farrar, JT;Galer, BS;Haythornthwaite, JA;Hewitt, DJ;Loeser, JD;Max, MB;Saltarelli, M;Schmader, KE;Stein, C;Thompson, D;Turk, DC;Wallace, MS;Watkins, LR;Weinstein, SM
Addresses:
Univ Rochester, Sch Med & Dent, Dept Anesthesiol, 601 Elmwood Ave,Box 604, Rochester, NY 14642 USA
Univ Rochester, Sch Med & Dent, Dept Anesthesiol, Rochester, NY 14642 USA[Back to Map]     Label: Dworkin-2003
Title: Pregabalin for the treatment of postherpetic neuralgia – A randomized, placebo-controlled trial
Journal: NEUROLOGY, 60 (8): 1274-1283 APR 22 2003
Citations: 171
Authors: Dworkin, RH;Corbin, AE;Young, JP;Sharma, U;LaMoreaux, L;Bockbrader, H;Garofalo, EA;Poole, RM
Addresses:
Univ Rochester, Sch Med & Dent, 601 Elmwood Ave,Box 604, Rochester, NY 14642 USA
Univ Rochester, Sch Med & Dent, Rochester, NY 14642 USA
Pfizer Global Res & Dev, Ann Arbor, MI USA[Back to Map]     Label: Ballantyne-2003
Title: Opioid therapy for chronic pain
Journal: N ENGL J MED, 349 (20): 1943-1953 NOV 13 2003
Citations: 162
Authors: Ballantyne, JC;Mao, JR
Addresses:
Massachusetts Gen Hosp, Dept Anesthesia & Crit Care, Pain Ctr, 15 Parkman St,WACC 333, Boston, MA 02114 USA
Massachusetts Gen Hosp, Dept Anesthesia & Crit Care, Pain Ctr, Boston, MA 02114 USA
Harvard Univ, Sch Med, Boston, MA USA[Back to Map]     Label: Goldstein-2005
Title: Duloxetine vs. placebo in patients with painful diabetic neuropathy
Journal: PAIN, 116 (1-2): 109-118 JUL 2005
Citations: 144
Authors: Goldstein, DJ;Lu, YL;Detke, MJ;Lee, TC;Iyengar, S
Addresses:
Lilly Corp Ctr, Lilly Res Labs, Indianapolis, IN 46285 USA
Lilly Corp Ctr, Lilly Res Labs, Indianapolis, IN 46285 USA
PRN Consulting, Indianapolis, IN USA
Indiana Univ, Sch Med, Dept Pharmacol & Toxicol, Indianapolis, IN 46202 USA
Indiana Univ, Sch Med, Dept Psychiat, Indianapolis, IN 46202 USA
McLean Hosp, Dept Psychiat, Belmont, MA 02178 USA
Harvard Univ, Sch Med, Boston, MA USA[Back to Map]     Label: Finnerup-2005
Title: Algorithm for neuropathic pain treatment: An evidence based proposal
Journal: PAIN, 118 (3): 289-305 DEC 5 2005
Citations: 143
Authors: Finnerup, NB;Otto, M;McQuay, HJ;Jensen, TS;Sindrup, SH
Addresses:
Aarhus Univ Hosp, Danish Pain Res Ctr, Dept Neurol, Aarhus Sygehus, Norrebrogade 44, Aarhus 8000, Denmark
Aarhus Univ Hosp, Danish Pain Res Ctr, Dept Neurol, Aarhus Sygehus, Aarhus 8000, Denmark
Odense Univ Hosp, Dept Neurol, Odense 5000, Denmark
Churchill Hosp, Pain Relief Unit, Oxford OX3 7LJ, England[Back to Map]     

Label: Gilron-2005
Title: Morphine, gabapentin, or their combination for neuropathic pain
Journal: N ENGL J MED, 352 (13): 1324-1334 MAR 31 2005
Citations: 142
Authors: Gilron, I;Bailey, JM;Tu, DS;Holden, RR;Weaver, DF;Houlden, RL
Addresses:
Queens Univ, Dept Anesthesiol, 76 Stuart St, Kingston, ON K7L 2V7, Canada
Queens Univ, Dept Anesthesiol, Kingston, ON K7L 2V7, Canada
Queens Univ, Dept Pharmacol & Toxicol, Kingston, ON K7L 2V7, Canada
Queens Univ, Dept Math & Stat, Kingston, ON K7L 2V7, Canada
Queens Univ, Dept Epidemiol & Community Hlth, Kingston, ON K7L 2V7, Canada
Queens Univ, Dept Psychol, Kingston, ON K7L 2V7, Canada
Queens Univ, Dept Med, Div Endocrinol, Kingston, ON K7L 2V7, Canada
Dalhousie Univ, Dept Med, Div Neurol, Halifax, NS, Canada
Dalhousie Univ, Dept Chem, Halifax, NS, Canada

[Back to Map]     

Label: Rosenstock-2004
Title: Pregabalin for the treatment of painful diabetic peripheral neuropathy: a double-blind, placebo-controlled trial
Journal: PAIN, 110 (3): 628-638 AUG 2004
Citations: 141
Authors: Rosenstock, J;Michael, TB;LaMoreaux, L;Sharma, U
Addresses:
Dallas Diabet & Endo Res Ctr, 7777 Forest Lane,C618, Dallas, TX 75230 USA
Dallas Diabet & Endo Res Ctr, Dallas, TX 75230 USA
Palm Beach Neurol Ctr, Palm Beach Gardens, FL USA
Pfizer Global Res & Dev, Ann Arbor, MI USA

[Back to Map]     

Label: Rowbotham-2003
Title: Oral opioid therapy for chronic peripheral and central neuropathic pain
Journal: N ENGL J MED, 348 (13): 1223-1232 MAR 27 2003
Citations: 127
Authors: Rowbotham, MC;Twilling, L;Davies, PS;Reisner, L;Taylor, K;Mohr, D
Addresses:
Univ Calif San Francisco, Sch Med, Pain Clin, Res Ctr,Dept Neurol, 1701 Divisadero St,Ste 480, San Francisco, CA 94115 USA
Univ Calif San Francisco, Sch Med, Pain Clin, Res Ctr,Dept Neurol, San Francisco, CA 94115 USA
Univ Calif San Francisco, Sch Med, Dept Anesthesia, San Francisco, CA 94115 USA
Univ Calif San Francisco, Sch Pharm, San Francisco, CA 94115 USA

[Back to Map]     

Label: Arnold-2004
Title: A double-blind, multicenter trial comparing duloxetine with placebo in the treatment of fibromyalgia patients with or without major depressive disorder
Journal: ARTHRITIS RHEUM, 50 (9): 2974-2984 SEP 2004
Citations: 122
Authors: Arnold, LM;Lu, YL;Crofford, LJ;Wohlreich, M;Detke, MJ;Iyengar, S;Goldstein, DJ;Duloxetine Fibromyalgia Trial Grp
Addresses:
Univ Cincinnati, Coll Med, Med Arts Bldg,Suite 8200,222 Piedmont Ave, Cincinnati, OH 45219 USA
Univ Cincinnati, Coll Med, Cincinnati, OH 45219 USA
Eli Lilly & Co, Indianapolis, IN 46285 USA
Univ Michigan, Ann Arbor, MI 48109 USA
Indiana Univ, Sch Med, Indianapolis, IN USA
Harvard Univ, Sch Med, Boston, MA 02115 USA
McLean Hosp, Belmont, MA 02178 USA
PRN Consulting, Indianapolis, IN USA

[Back to Map]     

Label: Kalso-2004
Title: Opioids in chronic non-cancer pain: systematic review of efficacy and safety
Journal: PAIN, 112 (3): 372-380 DEC 2004
Citations: 122
Authors: Kalso, E;Edwards, JE;Moore, RA;McQuay, HJ
Addresses:
Univ Helsinki, Pain Clin, Dept Anaesthesia & Intens Care Med, Cent Hosp, POB 340, FIN-00029 HUS, Finland
Univ Helsinki, Pain Clin, Dept Anaesthesia & Intens Care Med, Cent Hosp, FIN-00029 HUS, Finland
Univ Oxford, Oxford Radcliffe Hosp, Pain Res & Nuffield Dept Anaesthet, Oxford OX3 7LJ, England

[Back to Map]     

Label: Goldenberg-2004
Title: Management of fibromyalgia syndrome
Journal: JAMA-J AM MED ASSN, 292 (19): 2388-2395 NOV 17 2004
Citations: 119
Authors: Goldenberg, DL;Burckhardt, C;Crofford, L
Addresses:
Newton Wellesley Hosp, Dept Rheumatol, 2000 Washington St, Newton, MA 02462 USA
Newton Wellesley Hosp, Dept Rheumatol, Newton, MA 02462 USA
Tufts Univ, Sch Med, Dept Med, Boston, MA 02111 USA
Oregon Hlth & Sci Univ, Sch Nursing, Portland, OR USA
Univ Michigan, Sch Med, Dept Internal Med, Div Rheumatol, Ann Arbor, MI USA

[Back to Map]     

Label: Lesser-2004
Title: Pregabalin relieves symptoms of painful diabetic neuropathy – A randomized controlled trial
Journal: NEUROLOGY, 63 (11): 2104-2110 DEC 14 2004
Citations: 117
Authors: Lesser, H;Sharma, U;LaMoreaux, L;Poole, RM
Addresses:
1415 Portland Ave,Suite 480, Rochester, NY 14621 USA
Univ Rochester, Sch Med & Dent, Rochester, NY USA
Pfizer Global Res & Dev, Ann Arbor, MI USA
Pfizer Global Res & Dev, New London, CT USA

[Back to Map]     

Label: Crofford-2005
Title: Pregabalin for the treatment of fibromyalgia syndrome – Results of a randomized, double-blind, placebo-controlled trial
Journal: ARTHRITIS RHEUM, 52 (4): 1264-1273 APR 2005
Citations: 110
Authors: Crofford, LJ;Rowbotham, MC;Mease, PJ;Russell, IJ;Dworkin, RH;Corbin, AE;Young, JP;LaMoreaux, LK;Martin, SA;Sharma, U;Pregabalin 1008-15 Study Grp
Addresses:
Kentucky Clin, Room J-503,740 S Limestone St, Lexington, KY 40539 USA
Kentucky Clin, Lexington, KY 40539 USA
Univ Michigan, Ann Arbor, MI 48109 USA
Univ Calif San Francisco, San Francisco, CA 94143 USA
Rheumatol Associates, Seattle, WA USA
Swedish Med Ctr, Seattle, WA USA
Univ Texas, Ctr Hlth Sci, San Antonio, TX USA
Univ Rochester, Sch Med & Dent, Rochester, NY USA
Pfizer Global Res & Dev, Ann Arbor, MI USA

[Back to Map]     

Label: Sabatowski-2004
Title: Pregabalin reduces pain and improves sleep and mood disturbances in patients with post-herpetic neuralgia: results of a randomised, placebo-controlled clinical trial
Journal: PAIN, 109 (1-2): 26-35 MAY 2004
Citations: 108
Authors: Sabatowski, R;Galvez, R;Cherry, DA;Jacquot, F;Vincent, E;Maisonobe, P;Versavel, M;1008-045 Study Grp
Addresses:
Univ Cologne, Anasthesiol Klin, Dept Anaesthesiol, D-50924 Cologne, Germany
Univ Cologne, Anasthesiol Klin, Dept Anaesthesiol, D-50924 Cologne, Germany
Univ Hosp Virgen Nieves, Pain Clin, Granada, Spain
Flinders Med Ctr, Bedford Pk, SA, Australia
Pfizer Global Res & Dev, Fresnes, France

[Back to Map]     

Label: Goldstein-2004
Title: Duloxetine in the treatment of depression – A double-blind-placebo-controlled comparison with paroxetine
Journal: J CLIN PSYCHOPHARMACOL, 24 (4): 389-399 AUG 2004
Citations: 107
Authors: Goldstein, DJ;Lu, YL;Detke, MJ;Wiltse, C;Mallinckrodt, C;Demitrack, MA
Addresses:
Eli Lilly & Co, Lilly Corp Ctr, Lilly Res Labs, Indianapolis, IN 46285 USA
Eli Lilly & Co, Lilly Corp Ctr, Lilly Res Labs, Indianapolis, IN 46285 USA
PRN Consulting, Indianapolis, IN USA
Indiana Univ, Sch Med, Dept Pharmacol & Toxicol, Indianapolis, IN 46204 USA
Indiana Univ, Sch Med, Dept Psychiat, Indianapolis, IN 46204 USA
McLean Hosp, Dept Psychiat, Belmont, MA 02178 USA
Harvard Univ, Sch Med, Boston, MA 02115 USA
Neuronet Inc, Malvern, PA USA

[Back to Map]     

Label: Freynhagen-2005
Title: Efficacy of pregabalin in neuropathic pain evaluated in a 12-week, randomised, double-blind, multicentre, placebo-controlled trial of flexible- and fixed-dose regimens
Journal: PAIN, 115 (3): 254-263 JUN 2005
Citations: 97
Authors: Freynhagen, R;Strojek, K;Griesing, T;Whalen, E;Balkenohl, M
Addresses:
Univ Klinikum Dusseldorf, Anasthesiol Klin, Moorenstr 5, D-40225 Dusseldorf, Germany
Univ Klinikum Dusseldorf, Anasthesiol Klin, D-40225 Dusseldorf, Germany
Dept Internal Dis Diabetol & Nephrol, Zabrze, Poland
Pfizer Inc, New York, NY USA
Pfizer Global Pharamceut, Freiburg, Germany

[Back to Map]     

Label: Detke-2004
Title: Duloxetine in the acute and long-term treatment of major depressive disorder: a placebo- and paroxetine-controlled trial
Journal: EUR NEUROPSYCHOPHARMACOL, 14 (6): 457-470 DEC 2004
Citations: 89
Authors: Detke, MJ;Wiltse, CG;Mallinckrodt, CH;McNamara, RK;Demitrack, MA;Bitter, I
Addresses:
Eli Lilly & Co, Lilly Corp Ctr, Lilly Res Labs, Indianapolis, IN 46285 USA
Eli Lilly & Co, Lilly Corp Ctr, Lilly Res Labs, Indianapolis, IN 46285 USA
Indiana Univ, Sch Med, Dept Psychiat, Indianapolis, IN 46202 USA
McLean Hosp, Dept Psychiat, Belmont, MA 02178 USA
Harvard Univ, Sch Med, Dept Psychiat, Boston, MA 02115 USA
Neuronet Inc, Malvern, PA USA
Semmelweis Univ Med, Dept Psychiat & Psychotherapy, H-1085 Budapest, Hungary

[Back to Map]     

Label: Richter-2005
Title: Relief of painful diabetic peripheral neuropathy with pregabalin: A randomized, placebo-controlled trial
Journal: J PAIN, 6 (4): 253-260 APR 2005
Citations: 83
Authors: Richter, RW;Portenoy, R;Sharma, U;Lamoreaux, L;Bockbrader, H;Knapp, LE
Addresses:
Beth Israel Med Ctr, Dept Pain Med & Palliat Care, 1st Ave 16th St, New York, NY 10003 USA
Beth Israel Med Ctr, Dept Pain Med & Palliat Care, New York, NY 10003 USA
St Johns Hosp, Dept Neurol, Tulsa, OK USA
Pfizer Global Res & Dev, Ann Arbor, MI USA

[Back to Map]     

Label: Raskin-2005
Title: A double-blind, randomized multicenter trial comparing duloxetine with placebo in the management of diabetic peripheral neuropathic pain
Journal: PAIN MED, 6 (5): 346-356 SEP-OCT 2005
Citations: 78
Authors: Raskin, J;Pritchett, YL;Wang, FJ;D’Souza, DN;Waninger, AL;Iyengar, S;Wernicke, JF
Addresses:
Eli Lilly Canada, Lilly Res Labs, 3650 Danforth Ave, Toronto, ON MIN 2E8, Canada
Eli Lilly Canada, Lilly Res Labs, Toronto, ON MIN 2E8, Canada
Eli Lilly & Co, Lilly Corp Ctr, Lilly Res Labs, Indianapolis, IN 46285 USA

[Back to Map]     

Label: Eisenberg-2005
Title: Efficacy and safety of opioid agonists in the treatment of neuropathic pain of nonmalignant origin – Systematic review and meta-analysis of randomized controlled trials
Journal: JAMA-J AM MED ASSN, 293 (24): 3043-3052 JUN 22 2005
Citations: 75
Authors: Eisenberg, E;McNicol, ED;Carr, DB
Addresses:
Rambam Med Ctr, Pain Relief Unit, POB 9602, IL-31096 Haifa, Israel
Rambam Med Ctr, Pain Relief Unit, IL-31096 Haifa, Israel
Technion Israel Inst Technol, Haifa Pain Res Grp, Haifa, Israel
Tufts New England Med Ctr, Dept Anesthesia, Boston, MA USA
Tufts New England Med Ctr, Dept Pharm, Boston, MA USA
Tufts New England Med Ctr, Div Clin Care Res, Boston, MA USA
Tufts Univ, Sch Med, Boston, MA 02111 USA

[Back to Map]     

Label: Arnold-2005
Title: A randomized, double-blind, placebo-controlled trial of duloxetine in the treatment of women with fibromyalgia with or without major depressive disorder
Journal: PAIN, 119 (1-3): 5-15 DEC 15 2005
Citations: 68
Authors: Arnold, LM;Rosen, A;Pritchett, YL;D’Souza, DN;Goldstein, DJ;Iyengar, S;Wernicke, JF
Addresses:
Univ Cincinnati, Coll Med, Womens Hlth Res Program, Dept Psychiat, 222 Piedmont Ave,Suite 8200, Cincinnati, OH 45219 USA
Univ Cincinnati, Coll Med, Womens Hlth Res Program, Dept Psychiat, Cincinnati, OH 45219 USA
Lilly Res Labs, Indianapolis, IN USA
Indiana Univ, Sch Med, Indianapolis, IN 46204 USA
PRN Consulting, Indianapolis, IN 46204 USA

[Back to Map]     

Label: Furlan-2006
Title: Opioids for chronic noncancer pain: a meta-analysis of effectiveness and side effects
Journal: CAN MED ASSN J, 174 (11): 1589-1594 MAY 23 2006
Citations: 63
Authors: Furlan, AD;Sandoval, JA;Mailis-Gagnon, A;Tunks, E
Addresses:
Toronto Western Hosp, Comprehens Pain Program, 399 Bathurst St,Rm 4F811, Toronto, ON M5T 2S8, Canada
Toronto Western Hosp, Comprehens Pain Program, Toronto, ON M5T 2S8, Canada
Univ Toronto, Ctr Study Pain, Toronto, ON, Canada
Univ Toronto, Inst Work & Hlth, Toronto, ON, Canada
Toronto Western Hosp, Krembil Neurosci Ctr, Toronto, ON M5T 2S8, Canada
McMaster Univ, Chedoke Rehabil Ctr, Hamilton Hlth Sci Hosp, Hamilton, ON, Canada

[Back to Map]     

Label: Attal-2006
Title: EFNS guidelines on pharmacological treatment of neuropathic pain
Journal: EUR J NEUROLOGY, 13 (11): 1153-1169 NOV 2006
Citations: 50
Authors: Attal, N;Cruccu, G;Haanpaa, M;Hansson, P;Jensen, TS;Nurmikko, T;Sampaio, C;Sindrup, S;Wiffen, P
Addresses:
Hop Ambroise Pare, Ctr Evaluat & Traitement Douleur, EFNS Panel Neuropath Pain, Boulogne, France
Hop Ambroise Pare, Ctr Evaluat & Traitement Douleur, EFNS Panel Neuropath Pain, Boulogne, France
Hop Ambroise Pare, Ctr Evaluat & Traitement Douleur, INSERM, U792, Boulogne, France
Univ Versailles St Quentin, Boulogne, France
Univ Versailles St Quentin, Boulogne, France
Univ Roma La Sapienza, Dept Neurol Sci, Rome, Italy
Helsinki Univ Hosp, Dept Anaesthesiol, Pain Clin, Helsinki, Finland
Helsinki Univ Hosp, Dept Neurosurg, Pain Clin, Helsinki, Finland
Univ Hosp, Karolinska Inst, Dept Mol Med, Stockholm, Sweden
Univ Hosp, Karolinska Inst, Surg Sect Clin Pain Res, Stockholm, Sweden
Univ Hosp, Karolinska Inst, Pain Ctr, Dept Neurosurg, Stockholm, Sweden
Aarhus Univ Hosp, Dept Neurol, DK-8000 Aarhus, Denmark
Aarhus Univ Hosp, Danish Pain Res Ctr, DK-8000 Aarhus, Denmark
Univ Liverpool, Pain Res Inst, Div Neurol Sci, Sch Clin Sci, Liverpool L69 3BX, Merseyside, England
Univ Lisbon, Inst Farmacol & Terapeut Geral, Lisbon Sch Med, P-1699 Lisbon, Portugal
Odense Univ Hosp, Dept Neurol, DK-5000 Odense, Denmark
Cochrane Pain & Palliat Care Review Grp, Oxford, England

[Back to Map]     

Label: Brannan-2005
Title: Duloxetine 60 mg once-daily in the treatment of painful physical symptoms in patients with major depressive disorder
Journal: J PSYCHIAT RES, 39 (1): 43-53 JAN 2005
Citations: 50
Authors: Brannan, SK;Mallinckrodt, CH;Brown, EB;Wohlreich, MM;Watkin, JG;Schatzberg, AF
Addresses:
Eli Lilly & Co, Lilly Res Labs, Indianapolis, IN 46285 USA
Eli Lilly & Co, Lilly Res Labs, Indianapolis, IN 46285 USA
Cyberon, Houston, TX 77058 USA
Stanford Univ, Dept Psychiat & Behav Sci, Stanford, CA 94305 USA

[Back to Map]     

Label: Martell-2007
Title: Systematic review: Opioid treatment for chronic back pain: Prevalence, efficacy, and association with addiction
Journal: ANN INTERN MED, 146 (2): 116-127 JAN 16 2007
Citations: 46
Authors: Martell, BA;O’Connor, PG;Kerns, RD;Becker, WC;Morales, KH;Kosten, TR;Fiellin, DA
Addresses:
Yale Univ, Sch Med, 333 Cedar St,POB 208025, New Haven, CT 06520 USA
Yale Univ, Sch Med, New Haven, CT 06520 USA
VA Connecticut Hlth Care Syst, West Haven, CT USA
Univ Penn, Sch Med, Philadelphia, PA 19104 USA

[Back to Map]     

Label: Ballantyne-2007
Title: Opioid dependence and addiction during opioid treatment of chronic pain
Journal: PAIN, 129 (3): 235-255 JUN 2007
Citations: 32
Authors: Ballantyne, JC;LaForge, KS
Addresses:
Massachusetts Gen Hosp, Div Pain Med, Pain Ctr, 15 Parkman St,WACC 333, Boston, MA 02114 USA
Massachusetts Gen Hosp, Div Pain Med, Pain Ctr, Boston, MA 02114 USA
Harvard Univ, Sch Med, Boston, MA 02115 USA
Univ Helsinki, Finnish Genome Ctr, FIN-00014 Helsinki, Finland

[Back to Map]     

Label: Ives-2006
Title: Predictors of opioid misuse in patients with chronic pain: a prospective cohort study
Journal: BMC HEALTH SERV RES, 6: art. no.-46 APR 4 2006
Citations: 29
Authors: Ives, TJ;Chelminski, PR;Hammett-Stabler, CA;Malone, RM;Perhac, JS;Potisek, NM;Shilliday, BB;DeWalt, DA;Pignone, MP
Addresses:
Univ N Carolina, Sch Med, Dept Med, Div Gen Internal Med, Chapel Hill, NC 27599 USA
Univ N Carolina, Sch Pharm, Div Pharmacotherapy & Expt Therapeut, Chapel Hill, NC USA
Univ N Carolina, Sch Med, Dept Pathol & Lab Med, Chapel Hill, NC USA
Univ N Carolina Hlth Syst, Ctr Excellence Chron Illness Care, Chapel Hill, NC USA

[Back to Map]     

Label: Arnold-2007
Title: Gabapentin in the treatment of fibromyalgia – A randomized, double-blind, placebo-controlled, multicenter trial
Journal: ARTHRITIS RHEUM, 56 (4): 1336-1344 APR 2007
Citations: 28
Authors: Arnold, LM;Goldenberg, DL;Stanford, SB;Lalonde, JK;Sandhu, HS;Keck, PE;Welge, JA;Bishop, F;Stanford, KE;Hess, EV;Hudson, JI
Addresses:
Univ Cincinnati, Coll Med, Med Arts Bldg,222 Piedmont Ave,Suite 8200, Cincinnati, OH 45219 USA
Univ Cincinnati, Coll Med, Cincinnati, OH 45219 USA
Newton Wellesley Hosp, Newton, MA USA
Tufts Univ, Sch Med, Boston, MA 02111 USA
McLean Hosp, Belmont, MA 02178 USA
Harvard Univ, Sch Med, Boston, MA 02115 USA

[Back to Map]     

Label: Vinik-2007
Title: Lamotrigine for treatment of pain associated with diabetic neuropathy: Results of two randomized, double-blind, placebo-controlled studies
Journal: PAIN, 128 (1-2): 169-179 MAR 2007
Citations: 28
Authors: Vinik, AI;Tuchman, M;Safirstein, B;Corder, C;Kirby, L;Wilks, K;Quessy, S;Blum, D;Grainger, J;White, J;Silver, M
Addresses:
Eastern Virginia Med Sch, Inst Diabet, 855 W Brandleton, Norfolk, VA 23510 USA
Eastern Virginia Med Sch, Inst Diabet, Norfolk, VA 23510 USA
Palm Beach Neurol Ctr, Palm Beach Gardens, FL USA
Baumel Eisner Neuromed Inst, Bay Harbor, FL USA
COR Clin Res, Oklahoma City, OK USA
Pivotal Res Ctr, Peoria, AZ USA
IMR, Towson, MD USA
GlaxoSmithKline Inc, Res Triangle Pk, NC USA

[Back to Map]     

Label: Raskin-2007
Title: Efficacy of duloxetine on cognition, depression, and pain in elderly patients with major depressive disorder: An 8-week, double-blind, placebo-controlled trial
Journal: AMER J PSYCHIAT, 164 (6): 900-909 JUN 2007
Citations: 17
Authors: Raskin, J;Wiltse, CG;Siegal, A;Sheikh, J;Xu, J;Dinkel, JJ;Rotz, BT;Mohs, RC
Addresses:
Eli Lilly Canada, Lilly Res Labs, 3650 Danforth Ave, Toronto, ON M1N 2E8, Canada
Eli Lilly Canada, Lilly Res Labs, Toronto, ON M1N 2E8, Canada
Eli Lilly & Co, Lilly Res Labs, Indianapolis, IN 46285 USA
Geriatr & Adult Psychiat LLC, Hamden, CT USA
Stanford Univ, Sch Med, Dept Psychiat & Behav Sci, Stanford, CA 94305 USA

[Back to Map]

KEYWORDS: NEUROPATHIC PAIN TREATMENT; RANDOMIZED MULTICENTER TRIAL COMPARING DULOXETINE; DIABETIC PERIPHERAL NEUROPATHIC PAIN; CENTRAL NEUROPATHIC PAIN; NEUROPATHIC PAIN EVALUATED.
[5770: (2002-2008_6) (CLI-NEU: ST Diabetes)]

Advertisements

11 responses to “DIABETIC NEUROPHATY INFORMATIONS CENTER COMUNICATIONS FORUM

  1. Pingback: Best Value rooCASE Med EVA Red | Ear Disorders

  2. Neuropathy can be remedied by high doses of vitamin-B. Vitamin b is really very useful in alleviating neuropathy. “”`*;

    Kind thanks http://www.healthmedicinelab.com/pain-under-left-rib-cage/

  3. Dear driwancybermuseum.wordpress.com,

    Siang,

    Kami dari Humas Merdeka.com bermaksud menawarkan content yang sesuai dengan tipikal blog Anda yang bisa digunakan secara gratis. Content ini sangat mudah aplikasinya dan sangat membantu Anda dalam Reblogging.
    Jika Anda berminat, silahkan kunjungi http://content.merdeka.com/ dan dapatkan contentnya.

    Terima kasih atensinya, kami menunggu kabar baik dari Anda.

    Salam,

    Humas Merdeka.com
    Selvie Chummairoch

    • hallo Humas Merdeka
      terima kasih atas tawrannya, Harian Merdeka memang sudah terkeanal sejak masa dahulu,saya memiliki koleksi surat kabar Medredka masa Revoludi kemerdekaan yang sangat langka. Berhubung karena kesibukan saya dalam menyusun Buku elektronik dari seluruh artikel yang sudah saya upload contohnya di Web blog saya,
      maka buat sementara saya belum dapat menerima tawarannya, dulu sudah saya coba di Kompasiana tetapi kemudian saya tinggalkan karena contentnya berbeda,sudart kabar Indonesia banyak
      memuat info politik,agama yang cenderung berakibat SARA, ini bukan bidang sya,saya khusus adalah suatu museum di dunia maya yang menampilkan koleksi informasi berupa ilustrasi dokumen rsip dan koleksi bersejarah saja.
      salam dari
      Dr Iwan suwandy,MHA

  4. I know this web site offers quality dependent posts and extra
    information, is there any other web site which provides these kinds of information in quality?

  5. I constantly spent my half an hour to read this blog’s articles daily along with a cup of coffee.

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s