medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/ms2026-107medsovet-9969Research ArticleЗАБОЛЕВАНИЯ ПЕРИФЕРИЧЕСКОЙ НЕРВНОЙ СИСТЕМЫPERIPHERAL NERVOUS SYSTEM DISEASESПериферическая полинейропатия при предиабете и метаболическом синдроме (обзор и клинический случай)Peripheral polyneuropathy in prediabetes and metabolic syndrome (review and clinical case)https://orcid.org/0000-0002-7465-0677ПизоваН. В.PizovaN. V.

Пизова Наталия Вячеславовна - д.м.н., профессор кафедры нервных болезней с медицинской генетикой и нейрохирургией.

150000, Ярославль, ул. Революционная, д. 5

Nataliia V. Pizova - Dr. Sci. (Med.), Professor of the Department of Nervous Diseases with Medical Genetics and Neurosurgery, Yaroslavl State Medical University.

5, Revolutsionnaya St., Yaroslavl, 150000

pizova@yandex.ruhttps://orcid.org/0000-0002-0522-675XПизовА. В.PizovA. V.

Пизов Александр Витальевич - к.б.н., доцент кафедры методики преподавания естественно-математических дисциплин в начальной школе.

150000, Ярославль, ул. Республиканская, д. 108/1

Aleksandr V. Pizov - Cand. Sci. (Biol.), Associate Professor of the Department of Methods of Teaching Natural Sciences and Mathematics in Primary Schools, Yaroslavl State Pedagogical University named after K.D. Ushinsky.

108/1, Respublikanskaya St., Yaroslavl, 150000

avpizov@yandex.ruЯрославский государственный медицинский университетРоссияYaroslavl State Medical UniversityRussian FederationЯрославский государственный педагогический университет имени К.Д. УшинскогоРоссияYaroslavl State Pedagogical University named after K.D. UshinskyRussian Federation20261904202603103112Copyright © Пизова Н.В., Пизов А.В., 20262026Пизова Н.В., Пизов А.В.Pizova N.V., Pizov A.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-sovet.pro/jour/article/view/9969

Растущая распространенность предиабета и метаболического синдрома представляет собой серьезную проблему для общественного здравоохранения как на региональном, так и на глобальном уровнях. Диабетические нейропатии являются наиболее частыми осложнениями сахарного диабета, способствуя высокой смертности, снижению качества жизни пациентов и увеличению расходов на здравоохранение. Предиабет характеризуется тем, что уровень глюкозы находится в промежуточном диапазоне – выше нормогликемии, но ниже диагностического порога сахарного диабета. Многие люди могут иметь нарушенную толерантность к глюкозе и повышенный уровень глюкозы натощак, при этом большинство из них не знают о возникших нарушениях. На протяжении последних десятилетий активно обсуждается вопрос о связи предиабета и метаболического синдрома с периферической полинейропатией. В данном обзоре представлены актуальные данные, подтверждающие повышенный риск развития дистальной полинейропатии у людей с предиабетом и метаболическим синдромом. В настоящее время диагностика и оценка тяжести периферической полинейропатии у пациентов с предиабетом и метаболическим синдромом базируются на клиническом обследовании и электрофизиологических исследованиях. Данные, представленные в обзоре, призваны повысить осведомленность врачей и способствовать применению современных знаний о периферических полинейропатиях у пациентов с предиабетом и метаболическим синдромом в клинической практике. Текущие рекомендации, согласно которым взрослые с избыточной массой тела или ожирением должны проходить скрининг на нарушения углеводного обмена и как можно раньше начинать профилактические мероприятия, в конечном итоге направлены на предотвращение развития периферической нейропатии. Лечение уже развившейся диабетической нейропатии включает коррекцию образа жизни, фармакотерапию, направленную на патогенетические звенья заболевания, симптоматическое лечение нейропатической боли и профилактику осложнений.

The increasing prevalence of prediabetes and metabolic syndrome poses a major public health challenge at both regional and global levels. Diabetic neuropathies are the most common complications of diabetes, contributing to high morbidity, increased mortality, reduced quality of life, and increased healthcare costs. Prediabetes is characterized by glucose levels in the intermediate range – above normoglycemia but below the diagnostic threshold for diabetes. Adults worldwide may have impaired glucose tolerance and impaired fasting glucose, yet most are unaware of prediabetes. Over the past decades, there has been considerable debate about whether prediabetes and metabolic syndrome are associated with peripheral polyneuropathy. This review and the accompanying case report examine current data confirming the increased risk of distal polyneuropathy in individuals with prediabetes and metabolic syndrome. Diagnosis and assessment of the severity of peripheral polyneuropathy in individuals with prediabetes and metabolic syndrome are primarily based on clinical assessments of neuropathy and electrophysiological studies. The data presented should help raise awareness and translate current knowledge about peripheral neuropathies in people with prediabetes and metabolic syndrome into clinical practice. The current recommendation that over-weight or obese adults be screened for prediabetes and metabolic syndrome and offered or referred preventive interventions should ultimately lead to the prevention of peripheral neuropathy. Treatment includes lifestyle modification, pharmacotherapy aimed at pathogenesis, symptomatic treatment of neuropathic pain and prevention of complications.

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The authors declare that there are no conflicts of interest present.