糖尿病远距离对称性多神经病变:不仅仅是"脚"
David S H Bell1, Terri W Jerkins2
1Southside Endocrinology, Birmingham, Alabama, USA.
Diabetes, obesity & metabolism
|November 6, 2025
概括
糖尿病远距离对称性多神经病变 (DDSP) 是糖尿病的常见并发症,增加死亡风险. 早期查和了解其各种原因对于管理这种情况和预防足部至关重要.
科学领域:
- 内分泌学 在内分泌学.
- 神经学 神经学
- 糖尿病学 糖尿病学
背景情况:
- 糖尿病远距离对称多神经病变 (DDSP) 是最常见的糖尿病神经病变形式,显著增加死亡风险,特别是当与足部和截肢相关时.
- 这种情况影响的是1型和2型糖尿病,糖尿病前期和肥胖症患者,表明复杂的病理生理学超出了血糖控制.
- 患病率很高,在BARI 2D试验中,51%的2型糖尿病患者在基线时表现出周围神经病变,在DCCT/EDIC试验中,1型糖尿病患者13-14岁以上的患病率从6%增加到30%.
研究的目的:
- 审查糖尿病远距离对称多神经病变的诊断技术.
- 讨论当前对症状性DDSP,神经病痛和相关脚的预防/治疗的治疗策略.
- 突出了除了糖尿病之外,认识到多因素DDSP病因的重要性.
主要方法:
- 对糖尿病神经病变的诊断方法的审查.
- 对神经病痛的药理疗法的讨论.神经病痛.
- 关于足部的预防和管理策略的概述.
主要成果:
- 糖尿病远距离对称性多神经病症涉及感觉,运动和自主组件,增加足部的风险.
- 氧化应激,炎症和微血管疾病是关键的病理过程.
- 对DDSP的症状治疗仍然不理想.
结论:
- 根据ADA 2025护理标准,建议在诊断2型糖尿病时对糖尿病神经病变进行查,并在5年后对1型糖尿病进行查.
- 不同诊断是必不可少的,考虑到维生素缺乏 (B12,D),酒精摄入量,甲状腺功能低下症和偏蛋白质血症.
- 针对血糖控制,代谢异常和特定治疗干预的综合管理对于改善DDSP患者的治疗结果至关重要.
相关概念视频
Peripheral Arterial Disease II: Clinical Manifestations and Diagnostic Evaluation
339
Clinical manifestationsPeripheral Arterial Disease (PAD) manifests through a range of symptoms, from the characteristic intermittent claudication to atypical presentations and severe complications in advanced stages. Intermittent claudication, a hallmark symptom of PAD, presents as exercise-induced muscle pain that typically resolves within minutes of rest. This pain is reproducible and stems from inadequate blood flow, leading to the accumulation of lactic acid produced during anaerobic...
339
Diabetes: Symptoms, Diagnosis, and Complications
2.0K
For most patients, experiencing several weeks of polyuria, polydipsia, fatigue, and significant weight loss may indicate the presence of diabetes. Furthermore, adults displaying the phenotypic appearance of type 2 diabetes (particularly those who are obese and not initially insulin-requiring), may have islet cell autoantibodies, suggesting autoimmune-mediated β cell destruction and a diagnosis of latent autoimmune diabetes of adults (LADA). The categorization of glucose homeostasis is...
2.0K
Peripheral Artery Disease IV: Nursing Management
329
The nursing management of a patient with peripheral artery disease (PAD) begins with a thorough assessment of the patient’s health history and clinical manifestations.AssessmentHealth History: Evaluate the patient’s history of hypertension, hyperlipidemia, family history of cardiovascular issues, and lifestyle factors such as dietary patterns, smoking, and physical activity.Physical Examination:Assess the affected extremity for decreased or absent peripheral pulses,...
329
Peripheral Artery Disease I: Introduction
295
Peripheral artery disease (PAD) predominantly results from atherosclerosis, which involves the accumulation of fatty deposits, or plaques, within the walls of arteries. This causes them to narrow and harden, significantly reducing blood flow. PAD predominantly affects the legs, particularly the arteries supplying the thighs and calves. In rare cases, it may involve other arteries, including those in the arms.Etiology of PAD:The principal cause of PAD is atherosclerosis, which results from fatty...
295
Peripheral Artery Disease V: Postoperative Nursing Management
360
During the postoperative period, it is crucial to focus on maintaining circulation, identifying and managing potential complications, and planning for discharge.Nursing AssessmentVital signs monitoring: Regularly monitor vital signs, including blood pressure, heart rate, respiratory rate, and temperature, to detect early signs of complications such as bleeding and infection.Circulation assessment: Monitor pulses, perform Doppler assessments, and check capillary refill, color, temperature, and...
360
Diabetes Mellitus: Type 2 and Gestational
4.3K
Type 2 diabetes, characterized by insulin resistance, arises when the insulin receptors on cells lose responsiveness to insulin, diminishing the cell's capacity to take up glucose, resulting in elevated blood glucose levels. To receive a diagnosis of Type 2 diabetes, a series of blood glucose tests are necessary to assess whether the blood glucose falls within normal parameters. If the result is out of the normal range, a patient may be diagnosed as prediabetic or diabetic, depending on the...
4.3K


