Пациент с диабетической полиневропатией на амбулаторном приеме
Пациент с диабетической полиневропатией на амбулаторном приеме
Захаров В.В., Сосина В.Б. Пациент с диабетической полиневропатией на амбулаторном приеме. Consilium Medicum. 2017; 19 (2.2. Неврология и Ревматология): 45–51.
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Zakharov V.V., Sosina V.B. Patient with diabetic polyneuropathy on an outpatient visit. Consilium Medicum. 2017; 19 (2.2. Neurology and Rheumatology): 45–51.
Пациент с диабетической полиневропатией на амбулаторном приеме
Захаров В.В., Сосина В.Б. Пациент с диабетической полиневропатией на амбулаторном приеме. Consilium Medicum. 2017; 19 (2.2. Неврология и Ревматология): 45–51.
________________________________________________
Zakharov V.V., Sosina V.B. Patient with diabetic polyneuropathy on an outpatient visit. Consilium Medicum. 2017; 19 (2.2. Neurology and Rheumatology): 45–51.
Сахарный диабет приводит к разнообразным заболеваниям периферической нервной системы, самым распространенным из которых является хроническая, преимущественно сенсорная симметричная дистальная полиневропатия. Она развивается у 30–50% пациентов и существенно снижает качество жизни из-за хронической невропатической боли, других неприятных сенсорных ощущений и автономной недостаточности. Адекватный метаболический контроль снижает вероятность развития невропатии, особенно при сахарном диабете типа 1. Патогенетическая антиоксидантная терапия препаратами a-липоевой кислоты приводит к достоверному регрессу выраженности неврологических симптомов. С целью симптоматического лечения невропатической боли используются антидепрессанты и антиконвульсанты.
Diabetes mellittus leads to different disorders of peripheral nervous system, but the most prevalent one is chronic predominantly sensory symmetrical distal polyneuropathy. It is developed in 30–50% of patients and significantly decreases quality of life because of neuropathic pain, other unpleasant sensations and autonomic insufficiency. Appropriate metabolic control decrease the risk of neuropathy development especially in diabettismellittis type 1. Antioxidant therapy with a-lipoic acid is also proven from pathogenetic position and had shown efficacy with regard to diminish of neurological symptoms. Symptomatic therapy of neuropathic pain includes antidepressants and anticonvulsants.
1. Callagyan BC, Cheng H, Stables C et al. Diabetic neuropathy: clinical manifestation and current treatment. Lancet Neurology 2012; 11 (6): 521–34.
2. Dyck PJ, Karnes JL, O’Brien PC. The Rochester Diabetic Neuropathy Study: reassessment of tests and criteria for diagnosis and staged severity. Neurology 1992; 42: 1164–70.
3. Dyck PJ, Litchy WJ, Lehman NA et al. Variables influences neuropathic endpoints. The Rochester Diabetic Neuropathy Study of Healthy Subjects. Neurology 1995; 45: 1115–21.
4. Zilliox L, Russell JW. Treatment of diabetic sensory polyneuropathy. Curr Treat Options Neurol 2011; 13 (2): 143–59.
5. Edwards JL, Vincent AM, Cheng HT, Feldman EL. Diabetic neuropathy: mechanisms to management. Pharmacol Ther 2008; 120: 1–34.
6. Burns T, Mauermann M. The evaluation of poluneuropathies. Neurology 2011; 76: 6–13.
7. Котов С.В., Калинин А.П., Рудакова И.Г. Диабетическая нейропатия. М.: Медицина, 2000; с. 439. / Kotov S.V., Kalinin A.P., Rudakova I.G. Diabeticheskaia neiropatiia. M.: Meditsina, 2000; s. 439. [in Russian]
8. Tesfaye S, Vileikyte L, Rayman G et al. Painful diabetic peripheral neuropathy: consensus recommendations on diagnosis, assessment and management. Diabetes Metab Res Rev 2011; 27 (7): 629–38.
9. Deli G, Bosnyak E et al. Diabetic Neuropathies: Diagnosis and management. Euroendocrinology 2013; 98: 267–80.
10. Строков И.А. Диабетическая нейропатия. В кн.: Сахарный диабет 2 типа. Под ред. А.С.Аметова. М.: ГЭОТАР-Медиа, 2013: 597–620. / Strokov I.A. Diabeticheskaia neiropatiia. V kn.: Sakharnyi diabet 2 tipa. Pod red. A.S.Ametova. M.: GEOTAR-Media, 2013: 597–620. [in Russian]
11. Котов С.В., Калинин А.П., Рудакова И.Г. Диабетическая нейропатия. М.: Медицина, 2000; с. 228. / Kotov S.V., Kalinin A.P., Rudakova I.G. Diabeticheskaia neiropatiia. M.: Meditsina, 2000; s. 228. [in Russian]
12. Строков И.А. Болевая форма диабетической полиневропатии. Фарматека. 2012; 7: 75–80. / Strokov I.A. Bolevaia forma diabeticheskoi polinevropatii. Farmateka. 2012; 7: 75–80. [in Russian]
13. Баринов А.Н. Неврологические осложнения сахарного диабета. Эффективная фармакотерапия. 2012; 28–35. / Barinov A.N. Nevrologicheskie oslozhneniia sakharnogo diabeta. Effektivnaia farmakoterapiia. 2012; 28–35. [in Russian]
14. Федорова О.С., Гурьева И.В., Строков И.А. и др. Роль диабетической дистальной полиневропатии в нарушении равновесия у пациентов с сахарным диабетом (обзор литературы). Эндокринология: новости, мнения, обучение. 2013; 1: 43–50. / Fedorova O.S., Gur'eva I.V., Strokov I.A. i dr. Rol' diabeticheskoi distal'noi polinevropatii v narushenii ravnovesiia u patsientov s sakharnym diabetom (obzor literatury). Endokrinologiia: novosti, mneniia, obuchenie. 2013; 1: 43–50. [in Russian]
15. Строков И.А., Фокина А.С., Строков К.И., Дроконова О.О. Современные принципы диагностики и лечения диабетической полинейропатии. Мед. совет. 2014; 5: 38–43. / Strokov I.A., Fokina A.S., Strokov K.I., Drokonova O.O. Sovremennye printsipy diagnostiki i lecheniia diabeticheskoi polineiropatii. Med. sovet. 2014; 5: 38–43. [in Russian]
16. Левин О.С. Принципы диагностики и лечения диабетической полиневропатии. Эффективная фармакотерапия. Неврология и психиатрия. 2011; 2: 52–60. / Levin O.S. Printsipy diagnostiki i lecheniia diabeticheskoi polinevropatii. Effektivnaia farmakoterapiia. Nevrologiia i psikhiatriia. 2011; 2: 52–60. [in Russian]
17. Malik RA, Tesfaye S, Thompson SD et al. Endoneuriallocalisation of microvascular damage in human diabetic neuropathy. Diabetologia 1993; 36 (5): 454–9.
18. Beulens JW, Hart HE, Kuijs R et al. Influence of duration and dose of metformin on cobalamin deficiency in type 2 diabetes patients using metformin. Acta Diabetol 2015; 52 (1): 47–53.
19. Gibbons CH, Freeman R. Treatment-induced diabetic neuropathy: a reversible painful autonomic neuropathy. Ann Neurol 2010; 67 (4): 534–41.
20. Ellenberg M. Diabetic neuropathic cachexia. Diabetes 1974; 23 (5): 418–23.
21. Tesfaye S, Malik R, Harris N et al. Arterio-venous shunting and proliferating new vessels in acute painful neuropathy of rapid glycaemic control (insulin neuritis). Diabetologia 1996; 39 (3): 329–35.
22. Gianni C, Dyck PJ. Pathologic alterations in human diabetic polyneuropathy. Diabetic neuropathy. Ed. by P.J.Dyck, P.K.Thomas. 2nd ed. Phyladelphia: Saun-ders W.B., 1999; p. 279–95.
23. Singh R, Kishore L, Kaur N. Diabetic peripheral neuropathy: current perspective and future directions. Pharmacol Res 2014; 80: 21–35.
24. Строков И.А., Строков К.И., Албекова Ж.С. Взгляд невролога и эндокринолога на вопросы лечения диабетической полиневропатии. Эффективная фармакотерапия. Журн. неврологии и психиатрии. 2011; 4: 4–13. / Strokov I.A., Strokov K.I., Albekova Zh.S. Vzgliad nevrologa i endokrinologa na voprosy lecheniia diabeticheskoi polinevropatii. Effektivnaia farmakoterapiia. Zhurn. nevrologii i psikhiatrii. 2011; 4: 4–13. [in Russian]
25. Аметов А.C., Строков И.А., Самигуллин Р. Антиоксидантная терапия диабетической полиневропатии. РМЖ. 2005; 13 (6): 339–43. / Ametov A.C., Strokov I.A., Samigullin R. Antioksidantnaia terapiia diabeticheskoi polinevropatii. RMZh. 2005; 13 (6): 339–43. [in Russian]
26. Балаболкин М.И., Креминская В.М., Клебанова Е.М. Роль окислительного стресса в патогенезе диабетической нейропатии и возможность его коррекции препаратами a-липоевой кислоты. Проблемы эндокринологии. 2005; 51 (3): 22–32. / Balabolkin M.I., Kreminskaia V.M., Klebanova E.M. Rol' okislitel'nogo stressa v patogeneze diabeticheskoi neiropatii i vozmozhnost' ego korrektsii preparatami a-lipoevoi kisloty. Problemy endokrinologii. 2005; 51 (3): 22–32. [in Russian]
27. Ziegler D, Hanefeld M, Ruhnau KJ et al. Treatment of symptomatic diabetic peripheral neuropathy with the antioxidant a-lipoic acid. A 3-week multicentre randomized controlled trial (ALADIN Study). Diabetologia 1995; 38: 1425–33.
28. Reljanovic M, Reichel G, Rett K et al. Treatment of diabetic polyneuropathy with the antioxidant thioctic acid (alpha-lipoic acid): a two year randomized double-blind placebo-controlled trial (ALADIN II). Free Radic Res 1999; 31: 171–9.
29. Ametov AS, Barinov A, Dyck PJ et al. SYDNEY Trial Study Group. Diabetes Care 2003; 26: 770–6.
30. Ziegler D, Ametov A, Barinov A et al. Oral treatment with a-lipoic acid improves symptomatic diabetic polyneuropathy: the SYDNEY 2 trial. Diabetes Care 2006; 29: 2365–70.
31. Аметов А.С., Строков И.А., Баринов А.Н. и др. Альфа-липоевая кислота в лечении симптомной диабетической полиневропатии: symptomatic diabetic neuropathy (SYDNEY) trial. Фарматека. 2004; 11 (88): 69–73. / Ametov A.S., Strokov I.A., Barinov A.N. i dr. Al'fa-lipoevaia kislota v lechenii simptomnoi diabeticheskoi polinevropatii: symptomatic diabetic neuropathy (SYDNEY) trial. Farmateka. 2004; 11 (88): 69–73. [in Russian]
32. Ziegler D, Schatz H, Conrad F et al. Effects of treatment with the antioxidant alpha-lipoic acid on cardiac autonomic neuropathy in NIDDM patients. A 4-month randomized controlled multicenter trial (DEKAN Study). Deutsche Kardiale Autonome Neuropathie. Diabetes Care 1997; 20: 369–73.
33. Данилов А.Б. Фармакотерапия болевого синдрома при диабетической полиневропатии. Consilium Medicum. 2006; 8 (9): 123–6. / Danilov A.B. Farmakoterapiia bolevogo sindroma pri diabeticheskoi polinevropatii. Consilium Medicum. 2006; 8 (9): 123–6. [in Russian]
34. Callaghan BC, Feldman EL. Painful diabetic neuropathy: many similarly effective therapies with widely dissimilar costs. Ann Intern Med 2014; 161 (9): 674–5.
35. Tesfaye S, Vileikyte L, Rayman G et al. Painful diabetic peripheral neuropathy: consensus recommendations on diagnosis, assessment and management. Diabetes Metab Res Rev 2011; 27 (7): 629–38.
36. Attal N, Crucci G, Haanpaa P et al. EFNS guidelines on pharmacological treatment of neuropathic pain. Eur J Neurol 2006; 13 (11): 1153–69.
37. Attal N, Crucci G, Haanpaa P et al. EFNS guidelines on pharmacological treatment of neuropathic pain: 2010 revision. Eur J Neurol 2010; 17 (9): 1113–88.
38. Bril V, England J, Franklin GM et al. Evidence-based guideline: treatment of pain full neuropathy: report of the American Academy of Neurology, the American Association of Neuromuscular and Electrodiagnostic Medicine, and the American Academy of Physical Medicine and Neurorehabilitation. Neurology 2011; 76 (20): 1758–65.
________________________________________________
1. Callagyan BC, Cheng H, Stables C et al. Diabetic neuropathy: clinical manifestation and current treatment. Lancet Neurology 2012; 11 (6): 521–34.
2. Dyck PJ, Karnes JL, O’Brien PC. The Rochester Diabetic Neuropathy Study: reassessment of tests and criteria for diagnosis and staged severity. Neurology 1992; 42: 1164–70.
3. Dyck PJ, Litchy WJ, Lehman NA et al. Variables influences neuropathic endpoints. The Rochester Diabetic Neuropathy Study of Healthy Subjects. Neurology 1995; 45: 1115–21.
4. Zilliox L, Russell JW. Treatment of diabetic sensory polyneuropathy. Curr Treat Options Neurol 2011; 13 (2): 143–59.
5. Edwards JL, Vincent AM, Cheng HT, Feldman EL. Diabetic neuropathy: mechanisms to management. Pharmacol Ther 2008; 120: 1–34.
6. Burns T, Mauermann M. The evaluation of poluneuropathies. Neurology 2011; 76: 6–13.
7. Kotov S.V., Kalinin A.P., Rudakova I.G. Diabeticheskaia neiropatiia. M.: Meditsina, 2000; s. 439. [in Russian]
8. Tesfaye S, Vileikyte L, Rayman G et al. Painful diabetic peripheral neuropathy: consensus recommendations on diagnosis, assessment and management. Diabetes Metab Res Rev 2011; 27 (7): 629–38.
9. Deli G, Bosnyak E et al. Diabetic Neuropathies: Diagnosis and management. Euroendocrinology 2013; 98: 267–80.
10. Strokov I.A. Diabeticheskaia neiropatiia. V kn.: Sakharnyi diabet 2 tipa. Pod red. A.S.Ametova. M.: GEOTAR-Media, 2013: 597–620. [in Russian]
11. Kotov S.V., Kalinin A.P., Rudakova I.G. Diabeticheskaia neiropatiia. M.: Meditsina, 2000; s. 228. [in Russian]
12. Strokov I.A. Bolevaia forma diabeticheskoi polinevropatii. Farmateka. 2012; 7: 75–80. [in Russian]
13. Barinov A.N. Nevrologicheskie oslozhneniia sakharnogo diabeta. Effektivnaia farmakoterapiia. 2012; 28–35. [in Russian]
14. Fedorova O.S., Gur'eva I.V., Strokov I.A. i dr. Rol' diabeticheskoi distal'noi polinevropatii v narushenii ravnovesiia u patsientov s sakharnym diabetom (obzor literatury). Endokrinologiia: novosti, mneniia, obuchenie. 2013; 1: 43–50. [in Russian]
15. Strokov I.A., Fokina A.S., Strokov K.I., Drokonova O.O. Sovremennye printsipy diagnostiki i lecheniia diabeticheskoi polineiropatii. Med. sovet. 2014; 5: 38–43. [in Russian]
16. Levin O.S. Printsipy diagnostiki i lecheniia diabeticheskoi polinevropatii. Effektivnaia farmakoterapiia. Nevrologiia i psikhiatriia. 2011; 2: 52–60. [in Russian]
17. Malik RA, Tesfaye S, Thompson SD et al. Endoneuriallocalisation of microvascular damage in human diabetic neuropathy. Diabetologia 1993; 36 (5): 454–9.
18. Beulens JW, Hart HE, Kuijs R et al. Influence of duration and dose of metformin on cobalamin deficiency in type 2 diabetes patients using metformin. Acta Diabetol 2015; 52 (1): 47–53.
19. Gibbons CH, Freeman R. Treatment-induced diabetic neuropathy: a reversible painful autonomic neuropathy. Ann Neurol 2010; 67 (4): 534–41.
20. Ellenberg M. Diabetic neuropathic cachexia. Diabetes 1974; 23 (5): 418–23.
21. Tesfaye S, Malik R, Harris N et al. Arterio-venous shunting and proliferating new vessels in acute painful neuropathy of rapid glycaemic control (insulin neuritis). Diabetologia 1996; 39 (3): 329–35.
22. Gianni C, Dyck PJ. Pathologic alterations in human diabetic polyneuropathy. Diabetic neuropathy. Ed. by P.J.Dyck, P.K.Thomas. 2nd ed. Phyladelphia: Saun-ders W.B., 1999; p. 279–95.
23. Singh R, Kishore L, Kaur N. Diabetic peripheral neuropathy: current perspective and future directions. Pharmacol Res 2014; 80: 21–35.
24. Strokov I.A., Strokov K.I., Albekova Zh.S. Vzgliad nevrologa i endokrinologa na voprosy lecheniia diabeticheskoi polinevropatii. Effektivnaia farmakoterapiia. Zhurn. nevrologii i psikhiatrii. 2011; 4: 4–13. [in Russian]
25. Ametov A.C., Strokov I.A., Samigullin R. Antioksidantnaia terapiia diabeticheskoi polinevropatii. RMZh. 2005; 13 (6): 339–43. [in Russian]
26. Balabolkin M.I., Kreminskaia V.M., Klebanova E.M. Rol' okislitel'nogo stressa v patogeneze diabeticheskoi neiropatii i vozmozhnost' ego korrektsii preparatami a-lipoevoi kisloty. Problemy endokrinologii. 2005; 51 (3): 22–32. [in Russian]
27. Ziegler D, Hanefeld M, Ruhnau KJ et al. Treatment of symptomatic diabetic peripheral neuropathy with the antioxidant a-lipoic acid. A 3-week multicentre randomized controlled trial (ALADIN Study). Diabetologia 1995; 38: 1425–33.
28. Reljanovic M, Reichel G, Rett K et al. Treatment of diabetic polyneuropathy with the antioxidant thioctic acid (alpha-lipoic acid): a two year randomized double-blind placebo-controlled trial (ALADIN II). Free Radic Res 1999; 31: 171–9.
29. Ametov AS, Barinov A, Dyck PJ et al. SYDNEY Trial Study Group. Diabetes Care 2003; 26: 770–6.
30. Ziegler D, Ametov A, Barinov A et al. Oral treatment with a-lipoic acid improves symptomatic diabetic polyneuropathy: the SYDNEY 2 trial. Diabetes Care 2006; 29: 2365–70.
31. Ametov A.S., Strokov I.A., Barinov A.N. i dr. Al'fa-lipoevaia kislota v lechenii simptomnoi diabeticheskoi polinevropatii: symptomatic diabetic neuropathy (SYDNEY) trial. Farmateka. 2004; 11 (88): 69–73. [in Russian]
32. Ziegler D, Schatz H, Conrad F et al. Effects of treatment with the antioxidant alpha-lipoic acid on cardiac autonomic neuropathy in NIDDM patients. A 4-month randomized controlled multicenter trial (DEKAN Study). Deutsche Kardiale Autonome Neuropathie. Diabetes Care 1997; 20: 369–73.
33. Danilov A.B. Farmakoterapiia bolevogo sindroma pri diabeticheskoi polinevropatii. Consilium Medicum. 2006; 8 (9): 123–6. [in Russian]
34. Callaghan BC, Feldman EL. Painful diabetic neuropathy: many similarly effective therapies with widely dissimilar costs. Ann Intern Med 2014; 161 (9): 674–5.
35. Tesfaye S, Vileikyte L, Rayman G et al. Painful diabetic peripheral neuropathy: consensus recommendations on diagnosis, assessment and management. Diabetes Metab Res Rev 2011; 27 (7): 629–38.
36. Attal N, Crucci G, Haanpaa P et al. EFNS guidelines on pharmacological treatment of neuropathic pain. Eur J Neurol 2006; 13 (11): 1153–69.
37. Attal N, Crucci G, Haanpaa P et al. EFNS guidelines on pharmacological treatment of neuropathic pain: 2010 revision. Eur J Neurol 2010; 17 (9): 1113–88.
38. Bril V, England J, Franklin GM et al. Evidence-based guideline: treatment of pain full neuropathy: report of the American Academy of Neurology, the American Association of Neuromuscular and Electrodiagnostic Medicine, and the American Academy of Physical Medicine and Neurorehabilitation. Neurology 2011; 76 (20): 1758–65.
Авторы
В.В.Захаров*1, В.Б.Сосина2
1 ФГАОУ ВО «Первый Московский государственный медицинский университет им. И.М.Сеченова» Минздрава России. 119991, Россия, Москва, ул. Трубецкая, д. 8, стр. 2;
2 ГБУЗ «Городская клиническая больница №51» Департамента здравоохранения города Москвы. 121309, Россия, Москва, ул. Алябьева, д. 7/33 *zakharovenator@gmail.com
________________________________________________
V.V.Zakharov*1, V.B.Sosina2
1 I.M.Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation. 119991, Russian Federation, Moscow, ul. Trubetskaia, d. 8, str. 2;
2 City Clinical Hospital №51. 121309, Russian Federation, Moscow, ul. Aliab'eva, d. 7/33 *zakharovenator@gmail.com