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2 . 2022

Pathogenetic therapy of diabetic polyneuropathy

Abstract

The aim of the study was to evaluate the effectiveness of alpha-lipoic acid (ALA) course therapy for diabetic polyneuropathy in patients with type 2 diabetes mellitus (T2DM).

Material and methods. The study involved 31 patients aged 51–70 years with a diagnosis of T2DM with distal sensorimotor diabetic polyneuropathy. The patients were prescribed course therapy with ALA 600 mg intravenously for 10 days (10 infusions) with a 6-month interval.

Results and discussion. At the start of the study, a decrease in the level of antioxidant enzymes was observed in 1/4 of the patients. A statistically significant decrease in the clinical manifestations of diabetic polyneuropathy according to the TSS and NIS-LL scales was observed against the background of course treatment of DPN with ALA (p<0.05). There was also an improvement in electrophysiological parameters of sensory and motor nerves of lower extremities. The use of ALA contributed to a statistically significant increase in level of antioxidant enzyme GPO (p<0.05).

Conclusion. Course treatment of DPN with ALA helps to increase level of antioxidant enzymes, reduce clinical manifestations of DPN and normalize electrophysiological parameters of sensory and motor nerves of lower extremities.

Keywords:diabetic polyneuropathy; pathogenetic therapy of diabetic polyneuropathy; alpha-lipoic acid; thioctacid; antioxidant enzymes

Funding. The study had no sponsor support.

Conflict of interest. The authors declare no conflict of interest.

For citation: Ametov A.S., Kosyan A.A., Strokov I.A. Pathogenetic therapy of diabetic polyneuropathy. Endokrinologiya: novosti, mneniya, obuchenie [Endocrinology: News, Opinions, Training]. 2022; 11 (2): 47–55. DOI: https://doi.org/10.33029/2304-9529-2022-11-2-47-55 (in Russian)

REFERENCES

1. International Diabetes Federation. Diabetes atlas IDF. 10th ed. International Diabetes Federation; 2021.

2. Global report on diabetes. Geneva: World Health Organization, 2016.

3. American Diabetes Association; 11. Microvascular complications and foot Care: Standards of medical care in diabete-2020. Diabetes Care. 2020; 43 (Suppl 1): 135–51. DOI: https://doi.org/10.2337/dc20-S 011

4. Ziegler D., Papanas N., Vinik A.I., et al. Epidemiology of polyneuropathy in diabetes and prediabetes. Handb Clin Neurol. 2014; 126: 3–22. DOI: https://doi.org/10.1016/B 978-0-444-53480-4.00001-1

5. Ziegler D., Tesfaye S., Spallone V., Gurieva I., et al. Screening, diagnosis and management of diabetic sensorimotor polyneuropathy in clinical practice: International expert consensus recommendations, Diabetes Res Clin Pract. 2022; 186:109063. DOI: https://doi.org/10.1016/j.diabres.2021.109063

6. Pop-Busui R., Ang L., Boulton A.J.M. Diagnosis and Treatment of Painful Diabetic Peripheral Neuropathy. American Diabetes Association. Nevro. 2022; (1): 1–32.

7. Callaghan B.C., Little A.A., Feldman E.L., et al. Enhanced glucose control for preventing and treating diabetic neuropathy. Cochrane Database Syst Rev. 2012; (6): CD 007543,

8. Dluhy R.G., McMahon G.T. Intensive glycemic control in the ACCORD and ADVANCE trials. N Engl J Med. 2008; 358 (24): 2630–3.

9. Strokov I.A., Manukhina E.B., Bakhtina L. Yu. The state of endogenous protective systems in patients with insulin-dependent diabetes mellitus with polyneuropathy: the effect of antioxidant therapy. Bull experiment biol and medical. 2000; 130 (10): 437–41. (in Russian)

10. Ziegler D., Nowak H., Kempler P., et al. Treatment of symptomatic diabetic polyneuropathy with antioxidant α-lipoic acid: a meta-analysis. Diabet Med. 2004; (21): 114–21.

11. Strokov I.A., Melnichenko G.A., Albekova Zh.S. Prevalence and risk factors for the development of diabetic polyneuropathy in hospitalized patients with type 1 diabetes mellitus. Nervno-myšečnye bolezni [Neuromuscular Diseases]. 2012; 1: 25–31. (in Russian)

12. Ziegler D., Ametov A., Barinov A. et al. Oral treatment with alpha-lipoic acid improves symptomatic diabetic polyneuropathy. The SYDNEY 2 trial. Diabetes Care. 2006; 29 (11): 2365–70.

13. Hicks C.W., Selvin E. Epidemiology of peripheral neuropathy and lower extremity disease in diabetes. Curr Diab Rep. 2019; 19 (10): 86.

14. Ziegler D., Low P.A., Boulton A.J.M. Effect of a 4-year antioxidant treatment with alpha-lipoic acid in diabetic polyneuropathy: the NATHAN-1 trial. Abstract 0007-OR, presented at 67th ADA Congress, Chicago, 22–26 June, 2007.

15. Dyck P.J. Detection, characterization and staging of polyneuropathy: assessed in diabetics. Muscle Nerve. 1988; 11 (1): 21–32.

16. Brownlee M. The pathobiology of diabetic complications: a unifying mechanism. Diabetes. 2005; 54 (6): 1615–25.

CHIEF EDITOR
CHIEF EDITOR
Ametov Alexander S.
Honored Scientist of the Russian Federation, Doctor of Medical Sciences, Professor, Head of Subdepartment of Endocrinology, Head of the UNESCO Network Chair on the subject «Bioethics of diabetes as a global problem» of the Russian Medical Academy of Continuous Professional Education (Moscow)
Вскрытие
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