Diabetic distal polyneuropathy: prevention, treatment and rehabilitation (review)

Abstract

Relevance. Due to lifestyle changes, the prevalence of diabetes mellitus is increasing worldwide. Diabetes can affect the nervous system in various forms in the form of cognitive disorders, mono- or polyneuropathies ending in trophic disorders and "diabetic foot"; and distal symmetrical sensory-motor polyneuropathy. In the modern literature there is a significant amount of research in the field of methods of prevention, treatment and rehabilitation of patients with diabetes mellitus, accompanied by damage to the nervous system, but there is no generalized information on a comprehensive analysis of currently available techniques.The purpose of study. To study the available and most modern methods of rehabilitation of patients with diabetic damage to the nervous system with subsequent systematization of information.Materials and methods. The most relevant domestic and foreign literature sources containing information on the types of diabetic lesions of the nervous system, pathogenesis and rehabilitation of patients with these pathologies were analyzed.Results. An analysis of modern literature has shown a great variability in the prevention, treatment and rehabilitation of patients with distal diabetic polyneuropathy. Drug therapy is effective, however, with long-term use, it can be accompanied by complications from the body systems. Physiotherapeutic therapy is not inferior in variety, affecting the nervous, vascular and epithelial tissue by various methods – electric current, magnetic field, laser beams or photochromo-radiation, you can get the desired analgesic effect. The need for lifestyle is also an important part of patient therapy: maintenance of normoglycemia, smoking cessation and special physical activity.Conclusion. Treatment and rehabilitation of patients with diabetic distal painful polyneuropathy is a big problem for a neurologist-clinician. In modern sources, there is a significant variety of methods for correcting this condition, both medication and physiotherapy. Drugs as the first line of correction of somatosensory disorders are a necessary point in the treatment plan, but it is necessary to remember the side effects of any prescribed drug, the slow onset of the desired analgesic effect. This is necessary for the competent preparation of the patient for a difficult and lengthy rehabilitation process. Among the most effective drugs are gabapentin and prebagalin, drugs of the anticonvulsant group and thioctic acid. A possible bypass of side effects from drug therapy is the appointment of physical therapy, adjusting drug treatment. A significant effect, based on the presented studies, is observed when using magnetotherapy in combination with infrared radiation, transcutaneous electrical nerve stimulation and impulse current with vacuum exposure.