Ahmed Ghazi Uddin, Ahmed Aliza, Raza Ahmed Asad, Bin Hameedullah Abdullah, Akhtar Syed Owais, Shakeel Amna, Bin Mobin Muhammad, Samadi Abedin
Department of Medicine, Jinnah Sindh Medical University, Karachi, Pakistan.
Department of Medicine, United Medical and Dental College, Karachi, Pakistan.
Ann Med Surg (Lond). 2025 May 30;87(7):4325-4335. doi: 10.1097/MS9.0000000000003441. eCollection 2025 Jul.
Diabetic neuropathy (DN) is a widespread complication of diabetes, affecting nearly 50% of individuals with the condition. It commonly begins with the gradual loss of sensation in the lower extremities, particularly in the feet. If left undetected and untreated, this loss of sensation can lead to serious consequences, such as foot ulcers and eventual amputations. Early detection is critical to preventing irreversible nerve damage and minimizing the risk of such severe outcomes. However, current diagnostic methods often fail to identify neuropathy at an early stage, when intervention could still halt or reverse nerve degeneration. The medial and lateral plantar nerves, responsible for sensory innervation in the foot, are among the first to show signs of damage in DN. Monitoring these nerves offers a potential avenue for early diagnosis. Techniques such as nerve conduction studies (NCS) and quantitative sensory testing (QST) allow for the assessment of nerve function in the distal extremities, where neuropathy typically begins. Early identification of nerve dysfunction through these methods can lead to timely intervention, significantly improving patient outcomes and reducing the risk of severe complications. Addressing the early signs of neuropathy is essential in managing the growing prevalence of diabetes-related complications.
糖尿病性神经病变(DN)是糖尿病常见的并发症,影响近50%的糖尿病患者。它通常始于下肢,尤其是足部感觉的逐渐丧失。如果未被发现和治疗,这种感觉丧失会导致严重后果,如足部溃疡和最终截肢。早期检测对于预防不可逆的神经损伤和降低此类严重后果的风险至关重要。然而,目前的诊断方法往往无法在早期阶段识别神经病变,而此时干预仍可阻止或逆转神经退化。负责足部感觉神经支配的足底内侧神经和外侧神经是DN中最早出现损伤迹象的神经之一。监测这些神经为早期诊断提供了一条潜在途径。神经传导研究(NCS)和定量感觉测试(QST)等技术可用于评估神经病变通常起始的远端肢体的神经功能。通过这些方法早期识别神经功能障碍可导致及时干预,显著改善患者预后并降低严重并发症的风险。应对神经病变的早期迹象对于控制糖尿病相关并发症日益增加的患病率至关重要。