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Treatment induced neuropathy of diabetes.
Auton Neurosci. 2020 07; 226:102668.AN

Abstract

BACKGROUND

Treatment induced neuropathy of diabetes (TIND) is an iatrogenic painful sensory and autonomic neuropathy. Although the prevalence is not known, it is seen in up to 10% of tertiary cases referred for evaluation of diabetic neuropathy.

EVIDENCE

TIND is associated with a decrease in the glycosylated hemoglobin A1C in individuals with longstanding hyperglycemia. TIND is more common in individuals with type 1 diabetes, but can occur in anyone with diabetes through the use of insulin, oral hypoglycemic medications or diet control. There is an acute or subacute onset of neuropathy that is linked to the change in glucose control. Although the primary clinical manifestation is neuropathic pain there is a concurrent development of autonomic dysfunction, retinopathy and nephropathy.

CONCLUSION

TIND is more common than previously suspected. The number of cases reported over the past 10 years is much greater than historical literature predicted. Increased attention to target glucose control as a physician metric could suggest a possible explanation for the increased in TIND cases reported in recent years. At present, supportive care is the only recommended treatment. Future research is necessary to define the underlying mechanism, prevent development and to guide treatment recommendations.

Authors+Show Affiliations

Beth Israel Deaconess Medical Center, 185 Pilgrim Rd, Palmer 111, Boston, MA 02215, United States of America. Electronic address: cgibbons@bidmc.harvard.edu.

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

32247944

Citation

Gibbons, Christopher H.. "Treatment Induced Neuropathy of Diabetes." Autonomic Neuroscience : Basic & Clinical, vol. 226, 2020, p. 102668.
Gibbons CH. Treatment induced neuropathy of diabetes. Auton Neurosci. 2020;226:102668.
Gibbons, C. H. (2020). Treatment induced neuropathy of diabetes. Autonomic Neuroscience : Basic & Clinical, 226, 102668. https://doi.org/10.1016/j.autneu.2020.102668
Gibbons CH. Treatment Induced Neuropathy of Diabetes. Auton Neurosci. 2020;226:102668. PubMed PMID: 32247944.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Treatment induced neuropathy of diabetes. A1 - Gibbons,Christopher H, Y1 - 2020/03/23/ PY - 2019/09/13/received PY - 2020/01/31/revised PY - 2020/03/22/accepted PY - 2020/4/6/pubmed PY - 2020/4/6/medline PY - 2020/4/6/entrez KW - Complications KW - Diabetes KW - Neuropathy KW - TIND KW - Treatment SP - 102668 EP - 102668 JF - Autonomic neuroscience : basic & clinical JO - Auton Neurosci VL - 226 N2 - BACKGROUND: Treatment induced neuropathy of diabetes (TIND) is an iatrogenic painful sensory and autonomic neuropathy. Although the prevalence is not known, it is seen in up to 10% of tertiary cases referred for evaluation of diabetic neuropathy. EVIDENCE: TIND is associated with a decrease in the glycosylated hemoglobin A1C in individuals with longstanding hyperglycemia. TIND is more common in individuals with type 1 diabetes, but can occur in anyone with diabetes through the use of insulin, oral hypoglycemic medications or diet control. There is an acute or subacute onset of neuropathy that is linked to the change in glucose control. Although the primary clinical manifestation is neuropathic pain there is a concurrent development of autonomic dysfunction, retinopathy and nephropathy. CONCLUSION: TIND is more common than previously suspected. The number of cases reported over the past 10 years is much greater than historical literature predicted. Increased attention to target glucose control as a physician metric could suggest a possible explanation for the increased in TIND cases reported in recent years. At present, supportive care is the only recommended treatment. Future research is necessary to define the underlying mechanism, prevent development and to guide treatment recommendations. SN - 1872-7484 UR - https://www.unboundmedicine.com/medline/citation/32247944/Treatment_induced_neuropathy_of_diabetes L2 - https://linkinghub.elsevier.com/retrieve/pii/S1566-0702(19)30229-2 DB - PRIME DP - Unbound Medicine ER -
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