资源描述
Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,*,*,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,Pathophysiology of Diabetic,Neuropathy,Zhijie Xi, MD,Guanghua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,1,Pathophysiology of DiabeticZh,Diabetic Peripheral Neuropathy Can Progress Over Time,Symptoms (numbness, prickling, pain),Reflexes,Pressure Sensation (Monofilament),Vibratory Sensation,Nerve Conduction Abnormalities,Subclinical,Clinical,Time,Signs,Onset of,Clinical Diseases,Symptoms may occur any time and intermittently,Patients may or may not have symptoms of diabetic peripheral neuropathy,Patients frequently do not report symptoms to their physicians until the symptoms are severe,The majority of signs of diabetic peripheral neuropathy are not evident at the onset of diabetes,2,Diabetic Peripheral Neuropathy,Symptoms and Signs of Diabetic Peripheral Neuropathy,Symptoms,Numbness or loss of feeling (asleep or,“,bunched up sock under toes,”,sensation),Prickling/Tingling,Aching Pain,Burning Pain,Lancinating Pain,Unusual sensitivity or tenderness when feet are touched (allodynia),Signs,Diminished vibratory perception,Decreased knee and ankle reflexes,Reduced protective sensation such as pressure, hot and cold, pain,Diminished ability to sense position of toes and feet,Symptoms and signs,progress from distal,to proximal over time,3,Symptoms and Signs of Diabetic,Diabetic Peripheral Neuropathy Severity Scale,Rating,Description,0,No neuropathy,1,Subclinical diabetic peripheral neuropathy,2a,Clinical diabetic peripheral neuropathy with symptoms, mild to moderate,2b,Clinical diabetic peripheral neuropathy insensate foot, loss of feeling/negative symptoms,3,Disability/late stage,Diabetic Peripheral Neuropathy,Effects of Diabetic Peripheral Neuropathy,5,Effects of Diabetic Peripheral,Neuropathy,Motor,Sensory,Autonomic,nociception, Proprioception,Unawareness,of foot position,Reduced,sweating,Dry skin,Fissures and,cracks,Muscle wasting,Foot weakness,Postural deviation,Deformities, stress,and shear pressures,Trauma,Stress on bones & joints,Plantar pressure,Callus formation,Infection,Ulcer,6,NeuropathyMotorSensoryAutonomi,7,7,8,8,9,9,10,10,11,11,12,12,Simple Tests of Large-Fiber Function,13,Simple Tests of Large-Fiber Fu,The PNS is comprised of both neurons and SCs,14,The PNS is comprised of both n,Pathways Implicated in Diabetic Neuropathy Pathogenesis,15,Pathways Implicated in Diabeti,Bioenergetic Mechanisms of Nerve Injury in Diabetes,16,Bioenergetic Mechanisms of Ner,Peripheral Mechanisms Contributing to Neuropathic Pain in Diabetic Neuropathy,17,Peripheral Mechanisms Contribu,Thanks for your attention!,18,Thanks for your attention!18,
展开阅读全文