Периферическая полинейропатия при предиабете и метаболическом синдроме (обзор и клинический случай)

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.

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