Cognitive impairment and distal polyneuropathy in a patient with diabetes mellitus in neurological outpatient practice
https://doi.org/10.14412/2074-2711-2020-3-111-116
Abstract
Cognitive impairment (CI) and distal polyneuropathy are the most common neurological complications of diabetes mellitus (DM) and depend not only on the severity and duration of hyperglycemia, but also on the presence of concomitant diseases. Patients with DM have one or more concomitant diseases that deteriorate the course of each other, and their joint correction improves the patient's status and quality of life. Management of DM patients requires a multidisciplinary approach at the time of diagnosis in order to prevent and identify major complications, to optimize drug therapy, and to use non-pharmacological treatments.
Keywords
diabetes mellitus,
neurological complications,
diabetic neuropathy,
moderate cognitive impairment,
dementia,
treatment,
alpha lipoic (thioctic) acid
Supporting agencies: This article has been supported by Kanonfarma prodakshn. The sponsor has participated in the development of the investigation project and supported the investigation program, as well as in the decision to submit the article for publication.
About the Authors
O. V. Kosivtsova
Department of Nervous System Diseases and Neurosurgery, N.V. Sklifosofsky Institute of Clinical Medicine, A.Ya. Kozhevnikov Clinic of Nervous System Diseases, I.M. Sechenov First Moscow State Medical University (Sechenov University), Ministry of Health of Russia
Russian Federation
Competing Interests:
Russian Federation
Olga Vladimirovna Kosivtsova.
11, Rossolimo St., Build. 1, Moscow 119021.
Competing Interests:
The conflict of interest has not affected the results of the investigation. The authors are solely responsible for submitting the final version of the manuscript for publication. All the authors have participated in developing the concept of the article and in writing the manuscript. The final version of the manuscript has been approved by all the authors.
M. P. Platov
City Polyclinic Forty-Six, Moscow Healthcare Department
Russian Federation
Competing Interests:
Russian Federation
17A, Kazakov St., Build. 1, Moscow 105064.
Competing Interests:
The conflict of interest has not affected the results of the investigation. The authors are solely responsible for submitting the final version of the manuscript for publication. All the authors have participated in developing the concept of the article and in writing the manuscript. The final version of the manuscript has been approved by all the authors.
S. A. Kochetov
City Polyclinic Forty-Six, Moscow Healthcare Department
Russian Federation
Competing Interests:
Russian Federation
17A, Kazakov St., Build. 1, Moscow 105064.
Competing Interests:
The conflict of interest has not affected the results of the investigation. The authors are solely responsible for submitting the final version of the manuscript for publication. All the authors have participated in developing the concept of the article and in writing the manuscript. The final version of the manuscript has been approved by all the authors.
References
1. Mercer SW, Smith SM, Wyke S, et al. Multimorbidity in primary care: developing the research agenda. Fam Pract. 2009 Apr;26(2): 79-80. doi: 10.1093/fampra/cmp020.
2. Barnett K, Mercer SW, Norbury M, et al. Epidemiology of multimorbidity and implications for health care, research, and medical education: a cross-sectional study. Lancet. 2012 Jul 7;380(9836):37-43. doi: 10.1016/S0140-6736(12)60240-2. Epub 2012 May 10.
3. Guiding principles for the care of older adults with multimorbidity: an approach for clinicians. Guiding principles for the care of older adults with multimorbidity: an approach for clinicians: American Geriatrics Society Expert Panel on the Care of Older Adults with Multimorbidity. J Am Geriatr Soc. 2012 Oct;60(10):E1-E25. doi: 10.1111/j.1532-5415.2012.04188.x. Epub 2012 Sep 19.
4. Dunlay SM, Givertz MM, Aguilar D, et al. Type 2 Diabetes Mellitus and Heart Failure: A Scientific Statement From the American Heart Association and the Heart Failure Society of America: This statement does not represent an update of the 2017 ACC/AHA/HFSA heart failure guideline update. Circulation. 2019 Aug 13;140(7):e294-e324. doi: 10.1161/CIR.0000000000000691. Epub 2019 Jun 6.
5. Wild S, Roglic G, Green A, et al. Global prevalence of diabetes: estimates for the year 2000 and projections for 2030. Diabetes Care. 2004 May;27(5):1047-53. doi: 10.2337/diacare.27.5.1047.
6. Global Burden of Disease Study 2013 Collaborators. Global, regional, and national incidence, prevalence, and years lived with disability for 301 acute and chronic diseases and injuries in 188 countries, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet. 2015 Aug 22;386(9995):743-800. doi: 10.1016/S0140-6736(15)60692-4. Epub 2015 Jun 7.
7. Dunlay SM, Givertz MM, Aguilar D, et al. Type 2 Diabetes Mellitus and Heart Failure: A Scientific Statement From the American Heart Association and the Heart Failure Society of America: This statement does not represent an update of the 2017 ACC/AHA/HFSA heart failure guideline update. Circulation. 2019 Aug 13;140(7):e294-e324. doi: 10.1161/CIR.0000000000000691. Epub 2019 Jun 6.
8. Furuta A, Ishii N, Nishihara Y, Horie A. Medullary arteries in aging and dementia. Stroke. 1991 Apr;22(4):442-6. doi: 10.1161/01.str.22.4.442.
9. Whitmer RA, Karter AJ, Yaffe K, et al. Hypoglycemic episodes and risk of dementia in older patients with type 2 diabetes mellitus. JAMA. 2009 Apr 15;301(15):1565-72. doi: 10.1001/jama.2009.460.
10. Livingston G, Sommerlad A, Orgeta V, et al. Dementia prevention, intervention, and care. Lancet. 2017 Dec 16;390(10113):2673-2734. doi: 10.1016/S0140-6736(17)31363-6. Epub 2017 Jul 20.
11. Chatterjee S, Peters SA, Woodward M, Mejia AS, Batty GD, Beckett N, et al. Type 2 diabetes as a risk factor for dementia in women compared with men: a pooled analysis of 2.3 million people comprising more than 100,000 cases of dementia. Diabetes Care. 2016 Feb; 39(2):300-7. doi: 10.2337/dc15-1588. Epub 2015 Dec 17.
12. Biessels GJ, Despa F. Cognitive decline and dementia in diabetes mellitus: mechanisms and clinical implications. Nat Rev Endocrinol. 2018 Oct;14(10):591-604. doi: 10.1038/s41574-018-0048-7.
13. Westermark P, Andersson A, Westermark GT. Islet amyloid polypeptide, islet amyloid, and diabetes mellitus. Physiol Rev. 2011 Jul;91(3):795-826. doi: 10.1152/phys-rev.00042.2009.
14. Lindsay ZA, Chadrasekaran K, Kwan JY, Russell JW. Diabetes and Cognitive Impairment. Curr Diab Rep. 2016 Sep;16(9):87. doi: 10.1007/s11892-016-0775-x.
15. Launer LJ, Miller ME, Williamson JD, et al. Effects of intensive glucose lowering on brain structure and function in people with type 2 diabetes (ACCORD MIND): a randomised open-label substudy. Lancet Neurol. 2011 Nov;10(11):969-77. doi: 10.1016/S1474-4422(11)70188-0. Epub 2011 Sep 28.
16. Erus G, Battapady H, Zhang T, et al. Spatial patterns of structural brain changes in type 2 diabetic patients and their longitudinal progression with intensive control of blood glucose. Diabetes Care. 2015 Jan;38(1):97-104. doi: 10.2337/dc14-1196. Epub 2014 Oct 21.
17. Boulton AJM. Diabetic neuropathy and foot complications. Handb Clin Neurol. 2014;126: 97-107. doi: 10.1016/B978-0-444-53480-4.00008-4.
18. Lobmann R. Diabetic foot syndrome. Internist (Berl). 2011 May;52(5):539-48. doi: 10.1007/s00108-010-2733-z.
19. Volmer-Thole M, Lobmann R. Neuropathy and Diabetic Foot Syndrome. Int J Mol Sci. 2016 Jun 10;17(6):917. doi: 10.3390/ijms17060917.
20. Malik RA, Tesfaye S, Newrick PG, et al. Sural nerve pathology in diabetic patients with minimal but progressive neuropathy. Diabetologia. 2005 Mar;48(3):578-85. doi: 10.1007/s00125-004-1663-5. Epub 2005 Feb 24.
21. Pfutzner A, Forst T, Engelbach M, et al. The influence of isolated small nerve fibre dysfunction on microvascular control in patients with diabetes mellitus. Diabet Med. 2001 Jun; 18(6):489-94. doi: 10.1046/j.1464-5491.2001.00524.x.
22. Cameron NE, Eaton SE, Cotter MA, Tesfaye S. Vascular factors and metabolic interactions in the pathogenesis of diabetic neuropathy. Diabetologia. 2001 Nov;44(11):1973-88. doi: 10.1007/s001250100001.
23. Brown MR, Dyck PJ, McClearn GE, et al. Central and peripheral nervous system complications. 1982;31(Suppl 1 Pt 2):65-70. doi: 10.2337/diab.31.1.s65.
24. Dyck PJ, Windebank AJ. Diabetic and nondiabetic lumbosacral radiculoplexus neuropathies: New insights into pathophysiology and treatment. Muscle Nerve. 2002 Apr;25(4):477-91. doi: 10.1002/mus.10080.
25. Pop-Busui R, Boulton AJ, Feldman EL, et al. Diabetic Neuropathy: A Position Statement by the American Diabetes Association. Diabetes Care. 2017 Jan;40(1):136-154. doi: 10.2337/dc16-2042.
26. Martin CL, Albers JW, Pop-Busui R; DCCT/EDIC Research Group. Neuropathy and related findings in the diabetes control and complications trial/epidemiology of diabetes interventions and complications study. Diabetes Care.2014;37(1):31-8. doi: 10.2337/dc13-2114.
27. Antithrombotic Trialists' Collaboration. Collaborative meta-analysis of randomised trials of antiplatelet therapy for prevention of death, myocardial infarction, and stroke in high risk patients. BMJ. 2002 Jan 12;324(7329):71-86. doi: 10.1136/bmj.324.7329.71.
28. Capodanno D, Angiolillo DJ. Aspirin for Primary Cardiovascular Risk Prevention and Beyond in Diabetes Mellitus. Circulation. 2016 Nov 15;134(20):1579-1594. doi: 10.1161/CIRCULATIONAHA.116.023164. Epub 2016 Oct 11.
29. American Diabetes Association. 10. Cardiovascular Disease and Risk Management: Standards of Medical Care in Diabetes-2020. Diabetes Care. 2020 Jan;43(Suppl 1):S111-S134. doi: 10.2337/dc20-S010.
30. Boer IH, Bakris G, Cannon CP. Individualizing Blood Pressure Targets for People With Diabetes and Hypertension: Comparing the ADA and the ACC/AHA Recommendations. JAMA. 2018 Apr 3;319(13): 1319-1320. doi: 10.1001/jama.2018.0642.
31. Gromova OA, Torshin IYu, Kalacheva AG, et al. The triple synergy of ethylmethylhydroxypyridine succinate, magnesium, and vitamin B6: Molecular mechanisms. Nevrologiya, neirop-sikhiatriya, psikhosomatika = Neurology, Neuropsychiatry, Psychosomatics. 2017;9(1): 42-9. (In Russ.). doi: 10.14412/2074-27112017-1-42-49
32. 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 Nov;29(11): 2365-70. doi: 10.2337/dc06-1216.
33. Strokov IA, Akhmetzhanova LT, Solokha OA. Effectiveness of treatment of diabetic polyneu ropathy with alpha-lipoic acid tablets. Trudnyi patsient. 2010;8(3):13-8. (In Russ.).
34. Ruhnau KJ, Meissner HP, Finn JR, et al. Effects of 3-week oral treatment with the antioxidant thioctic acid (alpha-lipoic acid) in symptomatic diabetic polyneuropathy. Diabet Med. 1999 Dec;16(12):1040-3. doi: 10.1046/j.1464-5491.1999.00190.x..
35. Ametov AS, Barinov A, Dyck PJ, et al. The sensory symptoms of diabetic polyneuropathy are improved with alpha-lipoic acid: the SYDNEY trial. Diabetes Care. 2003 Mar;26(3): 770-6. doi: 10.2337/diacare.26.3.770.
36. Ziegler D, Nowak H, Kempler P, et al. Treatment of symptomatic diabetic polyneuropathy with the antioxidant alpha-lipoic acid: a meta-analysis. Diabet Med. 2004 Feb;21(2): 114-21. doi: 10.1111/j.1464-5491.2004.01109.x.
37. 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 Nov;29(11): 2365-70. doi: 10.2337/dc06-1216.
38. Strokov IA, Zakharov VV, Strokov KI. Diabetic encephalopathy. Nevrologiya, neiropsikhiatriya, psikhosomatika = Neurology, Neuropsychiatry, Psychosomatics. 2012;4(2S): 30-40. (In Russ.). doi: 10.14412/2074-27112012-2506
39. Starchina YuA, Zakharov VV. Neurological complications of diabetes mellitus. Effektivnaya farmakoterapiya. 2019;15(19):30-7. (In Russ.).
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For citations:
Kosivtsova O.V., Platov M.P., Kochetov S.A. Cognitive impairment and distal polyneuropathy in a patient with diabetes mellitus in neurological outpatient practice. Neurology, Neuropsychiatry, Psychosomatics. 2020;12(3):111-116. (In Russ.) https://doi.org/10.14412/2074-2711-2020-3-111-116
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