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Diabetic neuropathy

Patients with type 2 diabetes have an increased risk for developing Alzheimer's disease, and now researchers in Sweden may have discovered the molecular link that explains the association.

The research focused on amyloidosis -- the process by which misfolded amyloid proteins form insoluble fibril deposits -- which occurs in a host of diseases, including type 2 diabetes and Alzheimer's.

Details of a new method to detect diabetic neuropathy in patients in less than five minutes using their sweat glands was presented at the American Association of Clinical Endocrinologists (AACE) 22nd Annual Scientific and Clinical Congress in Phoenix, Arizona by Aaron I. Vinik, M.D., Ph.D., F.C.P., M.A.C.P., F.A.C.E., Professor of Medicine and Director of Research and the Neuroendocrine Unit at Eastern Virginia Medical School. The method, which has been recently approved by the Food and Drug Administration (FDA), identifies sweat dysfunction in the hands and feet by measuring the skin conductance response through the sweat glands. This device also helps diagnose what type of diabetic neuropathy they have, which can guide the treatment.

Obstructive sleep apnea is independently associated with diabetic peripheral neuropathy, even after adjustment for potential confounders, according to a study published online June 21 in the American Journal of Respiratory and Critical Care Medicine.

Diabetic neuropathy is a peripheral nerve disorder caused by diabetes or poor blood sugar control. The most common types of diabetic neuropathy result in problems with sensation in the feet. It can develop slowly after many years of diabetes or may occur early in the disease. The symptoms are numbness, pain, or tingling in the feet or lower legs. The pain can be intense and require treatment to relieve the discomfort. The loss of sensation in the feet may also increase the possibility that foot injuries will go unnoticed and develop into ulcers or lesions that become infected. In some cases, diabetic neuropathy can be associated with difficulty walking and some weakness in the foot muscles. There are other types of diabetic-related neuropathies that affect specific parts of the body. For example, diabetic amyotrophy causes pain, weakness and wasting of the thigh muscles, or cranial nerve infarcts that may result in double vision, a drooping eyelid, or dizziness. Diabetes can also affect the autonomic nerves that control blood pressure, the digestive tract, bladder function, and sexual organs. Problems with the autonomic nerves may cause lightheadedness, indigestion, diarrhea or constipation, difficulty with bladder control, and impotence.

Patients with diabetic peripheral neuropathy (DPN) or postherpetic neuralgia (PHN) treated with pregabalin have rapid, significant, and sustained improvement in sleep, according to a posthoc analysis of 16 placebo-controlled trials of pregabalin in 4,527 patients reported during the American Pain Society's 31st Annual Scientific Meeting.