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Ponirakis G, Abdul-Ghani MA, Jayyousi A, et al. Painful diabetic neuropathy is associated with increased nerve regeneration in patients with type 2 diabetes undergoing intensive glycemic control. J Diabetes Investig. 2021;12(9):1642-1650doi: 10.1111/jdi.13544.
Ponirakis, G., Abdul-Ghani, M. A., Jayyousi, A., Zirie, M. A., Qazi, M., Almuhannadi, H., Petropoulos, I. N., Khan, A., Gad, H., Migahid, O., Megahed, A., Al-Mohannadi, S., AlMarri, F., Al-Khayat, F., Mahfoud, Z., Al Hamad, H., Ramadan, M., DeFronzo, R., & Malik, R. A. (2021). Painful diabetic neuropathy is associated with increased nerve regeneration in patients with type 2 diabetes undergoing intensive glycemic control. Journal of diabetes investigation, 12(9), 1642-1650. https://doi.org/10.1111/jdi.13544
Ponirakis, Georgios, et al. "Painful diabetic neuropathy is associated with increased nerve regeneration in patients with type 2 diabetes undergoing intensive glycemic control." Journal of diabetes investigation vol. 12,9 (2021): 1642-1650. doi: https://doi.org/10.1111/jdi.13544
Ponirakis G, Abdul-Ghani MA, Jayyousi A, Zirie MA, Qazi M, Almuhannadi H, Petropoulos IN, Khan A, Gad H, Migahid O, Megahed A, Al-Mohannadi S, AlMarri F, Al-Khayat F, Mahfoud Z, Al Hamad H, Ramadan M, DeFronzo R, Malik RA. Painful diabetic neuropathy is associated with increased nerve regeneration in patients with type 2 diabetes undergoing intensive glycemic control. J Diabetes Investig. 2021 Sep;12(9):1642-1650. doi: 10.1111/jdi.13544. Epub 2021 May 03. PMID: 33714226; PMCID: PMC8409832.
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J Diabetes Investig. 2021 Sep;12(9):1642-1650. doi: 10.1111/jdi.13544. Epub 2021 May 03.

Painful diabetic neuropathy is associated with increased nerve regeneration in patients with type 2 diabetes undergoing intensive glycemic control.

Journal of diabetes investigation

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

Affiliations

  1. Weill Cornell Medicine-Qatar, Qatar Foundation, Education City, Doha, Qatar.
  2. Faculty of Science and Engineering, Manchester Metropolitan University, Manchester, UK.
  3. National Diabetes Center, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar.
  4. Division of Diabetes, University of Texas Health Science Center, San Antonio, Texas, USA.
  5. Rumailah Hospital, Hamad Medical Corporation, Doha, Qatar.
  6. Institute of Cardiovascular Science, University of Manchester, Manchester, UK.

PMID: 33714226 PMCID: PMC8409832 DOI: 10.1111/jdi.13544

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.

© 2021 The Authors. Journal of Diabetes Investigation published by Asian Association for the Study of Diabetes (AASD) and John Wiley & Sons Australia, Ltd.

Keywords: Corneal confocal microscopy; Exenatide; Painful diabetic neuropathy

References

  1. Obes Surg. 2021 Feb;31(2):554-563 - PubMed
  2. Pain. 2012 Jun;153(6):1193-1198 - PubMed
  3. Lancet Diabetes Endocrinol. 2014 Aug;2(8):607-9 - PubMed
  4. Diabetes Res Clin Pract. 2007 Sep;77 Suppl 1:S184-9 - PubMed
  5. Diabetes Metab Res Rev. 2020 May;36(4):e3286 - PubMed
  6. Pain. 2005 Mar;114(1-2):29-36 - PubMed
  7. Diabetes Care. 2006 Feb;29(2):340-4 - PubMed
  8. Pain. 2017 Dec;158(12):2340-2353 - PubMed
  9. Brain. 2015 Jan;138(Pt 1):43-52 - PubMed
  10. Lancet. 2010 Aug 7;376(9739):419-30 - PubMed
  11. Saudi J Anaesth. 2017 May;11(Suppl 1):S31-S39 - PubMed
  12. Pain. 2021 Mar 1;162(3):778-786 - PubMed
  13. Diabetes. 2017 May;66(5):1380-1390 - PubMed
  14. Br J Clin Pharmacol. 2019 Nov;85(11):2512-2523 - PubMed
  15. Pain. 2014 Nov;155(11):2263-73 - PubMed
  16. Sci Rep. 2018 Feb 19;8(1):3283 - PubMed
  17. Muscle Nerve. 2015 Apr;51(4):505-13 - PubMed
  18. Diabetes Care. 2019 Jan;42(1):110-118 - PubMed
  19. Diabetes Care. 2017 Mar;40(3):325-331 - PubMed
  20. Eur J Neurol. 2021 May;28(5):1745-1751 - PubMed
  21. BMJ Open Diabetes Res Care. 2020 Jun;8(1): - PubMed
  22. Pain. 2014 Apr;155(4):828-832 - PubMed
  23. Med Image Anal. 2011 Oct;15(5):738-47 - PubMed
  24. J Peripher Nerv Syst. 2012 Sep;17(3):341-50 - PubMed
  25. Ann Intern Med. 1995 Apr 15;122(8):561-8 - PubMed
  26. J Neurosci. 2014 Apr 9;34(15):5322-34 - PubMed
  27. J Pharmacol Sci. 2008 Nov;108(3):341-7 - PubMed
  28. Diabetologia. 2019 Aug;62(8):1478-1487 - PubMed
  29. Diabetologia. 2017 Dec;60(12):2495-2503 - PubMed
  30. Lancet. 1998 Sep 12;352(9131):837-53 - PubMed
  31. Diabetes Care. 2013 Oct;36(10):3208-15 - PubMed
  32. J Pain. 2017 Jul;18(7):757-777 - PubMed
  33. Curr Diab Rep. 2013 Aug;13(4):533-49 - PubMed
  34. Cochrane Database Syst Rev. 2012 Jun 13;(6):CD007543 - PubMed
  35. J Diabetes Investig. 2019 Nov;10(6):1558-1564 - PubMed
  36. Diabetes. 2013 Jan;62(1):254-60 - PubMed
  37. Diabetologia. 1998 Nov;41(11):1321-6 - PubMed
  38. Mol Med. 2015 Mar 13;20:658-66 - PubMed
  39. Eur J Pain. 2018 Nov;22(10):1727-1734 - PubMed
  40. Diabetes Metab Res Rev. 2011 Oct;27(7):678-84 - PubMed
  41. Pain. 2018 Sep;159(9):1867-1876 - PubMed
  42. Neurosci Lett. 2007 May 1;417(2):149-54 - PubMed
  43. Diabetes Care. 2015 Aug;38(8):1502-8 - PubMed
  44. Pain. 2016 May;157(5):1132-1145 - PubMed
  45. Diabetes Technol Ther. 2013 Nov;15(11):948-53 - PubMed
  46. J Diabetes Investig. 2021 Apr;12(4):592-600 - PubMed
  47. J Pain. 2013 Sep;14(9):941-7 - PubMed
  48. Diabetes Care. 2013 Nov;36(11):3646-51 - PubMed
  49. Diabetes. 2007 Aug;56(8):2148-54 - PubMed
  50. J Neurochem. 2008 Jan;104(2):491-9 - PubMed
  51. Int Rev Neurobiol. 2016;127:287-317 - PubMed
  52. Diabetes Res Clin Pract. 1995 May;28(2):103-17 - PubMed
  53. Diabetes Care. 2014 May;37(5):1418-24 - PubMed
  54. Diabetes. 2011 Sep;60(9):2397-406 - PubMed
  55. Diabet Med. 2012 May;29(5):578-85 - PubMed
  56. J Diabetes Complications. 2015 Nov-Dec;29(8):1287-94 - PubMed
  57. J Diabetes Complications. 1999 Sep-Dec;13(5-6):307-13 - PubMed
  58. Diabetes Care. 1993 Aug;16(8):1187-9 - PubMed

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