Beshyah Salem A, Jayyousi Amin, Al-Mamari Ali Saif, Shaaban Ashraf, Ozairi Ebaa Al, Nafach Jalal, Jallo Mahir Khalil Ibrahim, Khader Said, Evans Marc
Department of Medicine, NMC Royal, MBZ, Abu Dhabi, United Arab Emirates.
Department of Medicine, College of Medicine and Health Sciences, Khalifa University, Abu Dhabi, UAE.
Diabetes Ther. 2024 Dec;15(12):2455-2474. doi: 10.1007/s13300-024-01658-8. Epub 2024 Oct 26.
Peripheral neuropathy (PN) significantly impacts the quality of life, causing substantial morbidity and increased mortality, as well as escalating healthcare costs. While PN can have various causes, the most common form, diabetic peripheral neuropathy, poses considerable risks for potential complications. Diabetic peripheral neuropathy (DPN) affects over 50% of people with prediabetes and diabetes. Despite its prevalence, a global gap in diagnosis and management exists, exacerbated by the COVID-19 pandemic. This expert consensus was formulated through a comprehensive evaluation by a panel of experts, informed by a focused literature review, aiming to establish a clinically robust approach to diagnosing and managing pre- and diabetic PN with the early utilization of neurotropic B vitamins. This document offers a consensus perspective on the existing challenges in diagnosing and managing PN, focusing on DPN. The expert panel proposes measures to address this underdiagnosed burden, highlighting the importance of early intervention through innovative screening methods, integrated care approaches, and therapeutic strategies. The document advocates for increased awareness, targeted campaigns, and proactive care strategies to bridge gaps in the patient care of individuals with diabetes, emphasizing the importance of early detection and timely management to improve overall health outcomes. Specific recommendations include incorporating simplified questionnaires and innovative screening methods into routine care, prioritizing neurotropic B vitamin supplementation, optimizing glucagon-like peptide 1 (GLP-1) receptor agonist treatments, and adopting a holistic approach to neuropathy management. The consensus underscores the urgent need to address the underdiagnosis and undertreatment of PN, offering practical measures to enhance early detection and improve health outcomes for individuals with DPN.
周围神经病变（PN）对生活质量有显著影响，会导致大量发病和死亡率上升，同时医疗费用也不断增加。虽然PN可能有多种病因，但最常见的形式——糖尿病性周围神经病变，会带来潜在并发症的重大风险。糖尿病性周围神经病变（DPN）影响超过50%的糖尿病前期和糖尿病患者。尽管其患病率很高，但在诊断和管理方面存在全球差距，而新冠疫情使这一差距进一步加剧。本专家共识是由专家小组通过全面评估制定的，参考了重点文献综述，旨在建立一种临床上强有力的方法，利用神经营养性B族维生素早期诊断和管理糖尿病前期和糖尿病性PN。本文献就PN诊断和管理中存在的现有挑战提供了共识观点，重点关注DPN。专家小组提出了应对这一诊断不足负担的措施，强调了通过创新筛查方法、综合护理方法和治疗策略进行早期干预的重要性。本文献倡导提高认识、开展针对性宣传活动和采取积极护理策略，以弥合糖尿病患者的患者护理差距，强调早期检测和及时管理对改善整体健康结果的重要性。具体建议包括将简化问卷和创新筛查方法纳入常规护理、优先补充神经营养性B族维生素、优化胰高血糖素样肽1（GLP-1）受体激动剂治疗，以及采用整体方法管理神经病变。该共识强调迫切需要解决PN诊断不足和治疗不足的问题，提供切实可行的措施以加强早期检测并改善DPN患者的健康结果。
