Diabetic neuropathy in patients with type 2 diabetes: role of chronic inflammation
AbstractAim - evaluate the effectiveness of therapy diabetic neuropathy in patients with T2DM, by the impact of a chronic systemic infLammation with fenofibrate.
Material and methods. 87 patients with T2DM and DN were divided into two groups: main group (n=42, received 145 mg of micronized fenofibrate in addition to the OADs), and comparison group (n=45, no adjustments to the treatment regimen). We evaLuate the status of the peripheral nervous system (PNS) using common scale Totalsymptom score (TSS) to determine the intensity and frequency of numbness; paresthesias prickling; burning sensation, shooting pain; scale Neuropathy Impairment Score in the Lower Limbs (NIS-LL), electroneuromyography of the Lower Limbs; parameters of glycemic control, lipid, and purine metabolism, a marker of chronic inflammation (TNFα).
Results. We found statistically significant correlation between the severity of neuroLogicaL symptoms and LeveL of TNFα in patients with T2DM. We found statistically significant differences between the main group and comparison group at the end of treatment: nerve conduction velocity on n. suralis S1-S2 was significantly higher in the main group (p=0.0082) and the NIS-LL scale was significantly lower in the main group (p=0.0478). Disorders, measured by TSS scaLe are the most important clinical manifestation of peripheral nerve involvement in patients with T2DM and DN.
Conclusion. Chronic systemic inflammation is important pathogenetic factor of the diabetic neuropathy in T2DM patients which is confirmed by benefits of treatment with fenofibrate, promotes the improvement of the functional state of peripheral nervous system.
Keywords:type 2 diabetes mellitus, diabetic neuropathy, fenofibrate, chronic low-grade inflammation
Endocrinology: News, Opinions, Training. 2016; (2): 52–58.