Modern approaches to the definition, classification and diagnosis of diabetic polyneuropathy. Pathogenetic aspects of treatment

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Abstract

Diabetic neuropathy (DPN) is the most common complication of diabetes mellitus (DM) and the most common form of all peripheral neuropathies in the world. All patients with diabetes, regardless of the presence or absence of specific complaints, it is necessary to carry out an annual screening for DPN. There are the typical and atypical DPN. The reference method for the study of nerve conduction is electroneuromyography, which helps to establish the cash flow in the early stages. With a view to the diagnosis of atypical lesion unmyelinated with DPN and weakly myelinated nerve fibers of small caliber used quantitative sensory testing temperature/pain sensitivity, skin biopsy study of thin fibers of corneal confocal microscopy. The pathogenetic treatment of DPN include α-lipoic acid, B vitamins (thiamine, cyanocobalamin, pyridoxine), gemoderivat; tricyclic antidepressants, serotonin reuptake inhibitors and noradrenaline or α-2-β-ligands: to alleviate neuropathic pain by use of adjuvant analgesics can be recommended. Vitamins B1, B6 and B12 constitute a group of so-called neurotropic vitamins to ensure the normal structure and function of nerve cells, preventing them from damage in diabetes. For the treatment of DPN used with good effect Neyromultivit which comprises a combination of essential vitamins in therapeutic dosages, namely 100 mg of thiamine hydrochloride (vitamin B1), pyridoxine hydrochloride 200 mg (vitamin B6) and 200 mg of cyanocobalamin (vitamin B12). When using Neyromultivita there is a restoration of sensitivity of different types of nerve fibers, as well as a decrease in symptoms.

About the authors

I. V Guriva

Federal Bureau of Medico-Social Examination of the Ministry of Labor of the Russian Federation; Russian Medical Academy of Continuous Professional Education of the Ministry of Health of the Russian Federation

Email: igurieva@mail.ru
д-р мед. наук, проф., ФГБУ ФБ МСЭ, ФГБОУ ДПО РМАНПО 127486, Russian Federation, Moscow, ul. Ivana Susanina, d. 3; 125993, Russian Federation, Moscow, ul. Barrikadnaia, d. 2/1

Yu. S Onuchina

Federal Bureau of Medico-Social Examination of the Ministry of Labor of the Russian Federation

науч. сотр., ФГБУ ФБ МСЭ 127486, Russian Federation, Moscow, ul. Ivana Susanina, d. 3

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