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Diabetic Autonomic Neuropathy: From Research to Clinical Practice
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Diabetic Autonomic Neuropathy: From Research to Clinical Practice

A special issue of Life (ISSN 2075-1729). This special issue belongs to the section "Medical Research".

Deadline for manuscript submissions: closed (20 September 2023) | Viewed by 3902

Special Issue Editor

Dr. Carla Greco

E-Mail Website
Guest Editor
Unit of Endocrinology, Dept. of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
Interests: diabetes mellitus; complications of diabetes; diabetic neuropathy; metabolism

Special Issue Information

Dear Colleagues,

Diabetic autonomic neuropathy (DAN) is a widespread disorder of diabetes mellitus (DM) or pre-diabetes state, of which cardiovascular autonomic neuropathy (CAN) is the most common form. CAN has a definite prognostic role for mortality and cardiovascular morbidity. Furthermore, DAN causes a constellation of symptoms and signs affecting not only cardiovascular but also urogenital, gastrointestinal, pupillomotor, thermoregulatory, and sudomotor systems.

Today, DAN remains an under-recognized complication and efforts to overcome this under-diagnosis are needed by promoting screening for symptoms and signs, by simplifying cardiovascular reflex tests, and by selecting the candidates for screening.

Considering therapeutic approaches, glycemic control is able to prevent CAN in type 1 DM, whereas multifactorial intervention might be effective in type 2 DM. Moreover, while there is no conclusive evidence for a disease-modifying therapy, treatment of DAN manifestations is available.

The present issue deals with novelty in epidemiology, pathophysiology, clinical manifestations, diagnosis, and complications of autonomic dysfunction in DM and pre-diabetes, as well as current treatment options.

The Special Issue is now open for submissions. Prospective authors should first send a short abstract or tentative title to the Editorial Office. If the editors deem the topic to be appropriate for inclusion in the Special Issue, the author will be encouraged to submit a full manuscript.

Dr. Carla Greco
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Life is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • autonomic dysfunction
  • cardiac autonomic neuropathy
  • diabetes

Published Papers (2 papers)

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Research

20 pages, 2578 KiB  
Article
Relationship between Cognitive Impairment and Depressive Symptoms with Somatosensory Functions in Diabetic and Non-Diabetic Older Adults and Its Impact on Quality of Life
by Mar Sempere-Bigorra, Iván Julián-Rochina, Pilar Pérez-Ros, Emmanuel Navarro-Flores, Francisco Miguel Martínez-Arnau and Omar Cauli
Life 2023, 13(9), 1790; https://doi.org/10.3390/life13091790 - 22 Aug 2023
Cited by 1 | Viewed by 1133
Abstract
Aging is an inevitable process that impacts the peripheral and central nervous systems and is considered one of the strongest risk factors for neurodegenerative diseases. In addition, when it also presents with diabetes mellitus, the risk of neurological damage may be further increased. [...] Read more.
Aging is an inevitable process that impacts the peripheral and central nervous systems and is considered one of the strongest risk factors for neurodegenerative diseases. In addition, when it also presents with diabetes mellitus, the risk of neurological damage may be further increased. This current study aimed to explore the relationships between peripheral sensory system decline and cognitive functions, the symptoms of depression, and quality of life (QoL) as metrics of central nervous system impairment in institutionalized older adults. A total of 95 individuals participated in this case-control study, which included diabetics and non-diabetics. The superficial sensory pathway was assessed in terms of thermal sensation, nociception, and non-discriminative touch, and the deep sensory pathway was evaluated by assessing vibration and light touch-pressure sensations. To assess function at the intellectual level, the Mini-Mental State Examination (MMSE) and Trail Making Test (TMT) cognitive functional tests were used, while the symptoms of depression and QoL were explored by employing the Yesavage Geriatric Depression Scale and EuroQol 5D questionnaire (EQ-5D), respectively. In the overall population analyses, altered thermal sensation was significantly associated with cognitive impairment (CI; p < 0.05). In turn, bivariate analyses and a binary logistic regression showed that the symptoms of depression and QoL were significantly related to altered vibratory sensation when assessed using a medical tuning fork (p < 0.05). In the group of diabetic patients, those with CI also had significantly lower thermal sensation (p < 0.05) and non-discriminative touch sensation, although this was only a trend (p = 0.055). Diabetics with depression had a significantly worse non-discriminative touch (p < 0.05) and vibratory sensation when tested with a tuning fork (p < 0.05). In addition, poorer QoL was associated with reduced sensitivity to heat (p < 0.05), light touch pressure (p < 0.05), and vibrations when assessed either with a tuning fork (p < 0.05) or a biothesiometer (p < 0.05). In contrast, no relationships were found between sensory functions and cognitive assessments in non-diabetic patients. These findings indicate that superficial sensitivity damage was related to CI, while deep sensation alterations were related to depression and poor QoL, with diabetes apparently further strengthening these relationships. Full article
(This article belongs to the Special Issue Diabetic Autonomic Neuropathy: From Research to Clinical Practice)
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11 pages, 567 KiB  
Article
Effectiveness of Epley–Canalith Repositioning Procedure versus Vestibular Rehabilitation Therapy in Diabetic Patients with Posterior Benign Paroxysmal Positional Vertigo: A Randomized Trial
by Mohammad Abu Shaphe, Mohammed M. Alshehri, Ramzi Abdu Alajam, Rashid Ali Beg, Najat Ibrahim A. Hamdi, Saravanakumar Nanjan, Vandana Esht, Mohammed A. Aljahni, Hashim Ahmed, Ausaf Ahmad, Aafreen, Ashfaque Khan and Abdur Raheem Khan
Life 2023, 13(5), 1169; https://doi.org/10.3390/life13051169 - 12 May 2023
Viewed by 2289
Abstract
Benign paroxysmal positional vertigo (BPPV) is a common inner ear disorder, characterized by brief episodes of vertigo caused by changes in head position. The condition can cause significant functional impairment and reduced quality of life. BPPV is especially common among diabetic patients. The [...] Read more.
Benign paroxysmal positional vertigo (BPPV) is a common inner ear disorder, characterized by brief episodes of vertigo caused by changes in head position. The condition can cause significant functional impairment and reduced quality of life. BPPV is especially common among diabetic patients. The Epley–canalith repositioning procedure (CRP) and vestibular rehabilitation therapy (VRT) are two commonly used interventions for the treatment of BPPV. The objective of this study is to compare the effectiveness of Epley–canalith repositioning procedure (ECRP) and Vestibular Rehabilitation (VR) therapy in the management of vertigo among Type 2 Diabetes Mellitus patients. A total of 30 subjects with Type 2 diabetes mellitus, aged between 40 and 65 years, were randomly allocated to either the ECRP or VR therapy groups using a lottery method, and then underwent Epley–canalith repositioning procedure or vestibular rehabilitation therapy, respectively. The outcomes measured by the study were Vertigo Symptom Scale–Short Form (VSS–sf) score and Berg Balance Scale (BBS) score, assessed pre-treatment (pre) and 4 weeks post-treatment (post). The results demonstrated that both ECRP and VR therapy led to improvements in VSS–sf and BBS scores. However, VR therapy was found to be more effective, resulting in a 13.6% higher improvement in VSS–sf scores (p = 0.03) and a 5.1% higher improvement in BBS scores (p = 0.51) compared to ECRP. Both Epley–canalith repositioning procedure and vestibular rehabilitation therapy are effective in managing BPPV in diabetic patients. Although the differences in BBS scores are not statistically significant, VRT demonstrated a trend towards greater improvement. Vestibular rehabilitation therapy can be used by clinicians as another rehabilitation technique for improving vertigo, postural stability, and activity of daily living in diabetic patients with BPPV. Full article
(This article belongs to the Special Issue Diabetic Autonomic Neuropathy: From Research to Clinical Practice)
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