Author Interviews, Diabetes, Neurology, Pain Research / 10.12.2020

MedicalResearch.com Interview with: William K. Schmidt, Ph.D. Senior VP Clinical Development Helixmith Co. Ltd. MedicalResearch.com: What is the background for this study? How common is diabetic peripheral neuropathy and how does it affect patients? Response: According to the Centers for Disease Control and Prevention (CDC), over 34 million people in the United States have diabetes (about 10% of the U.S. population) and about one in four patients do not know that they have it (https://www.cdc.gov/chronicdisease/resources/publications/factsheets/diabetes-prediabetes.htm). Diabetes can cause significant damage to nerves in the feet, hands, eyes, and other parts of the body. Diabetic peripheral neuropathy (DPN) is the most common form of nerve damage worldwide; it affects approximately half of the patients with diabetes (Iqbal et al., 2018). In many individuals, severe burning, tingling, “pins and needles,” or cramping pain can occur simultaneously in both feet without external evidence of foot damage. Despite the pain, symptoms may be accompanied by numbness or loss of sensation in the feet. This is called painful diabetic peripheral neuropathy (painful DPN or P-DPN) and may affect up to one-third of the general diabetic population (Yoo et al., 2013). P-DPN may cause increased anxiety and depression, sleep impairment, and difficulties with walking. Up to one-third of P-DPN patients may require the use of a cane, walker, or even a wheelchair due to extreme foot pain. Once P-DPN occurs, it may result in a lifetime of pain and disability. FDA-approved daily oral medications often used to treat P-DPN include Neurontin (gabapentin), Lyrica (pregabalin), Cymbalta (duloxetine), and Nucynta ER (tapentadol). While these “neuropathic pain” medications may dull the pain for some subjects, they produce significant side effects that may be troubling for many patients. Indeed, many patients stop using these pain killers due to lack of effectiveness at doses that they can tolerate (van Nooten et al., 2017) There is also a topical 8% capsaicin patch, but again with limited efficacy. It is well known that the most severely affected patients may require opioid analgesics to control P-DPN (Pesa et al., 2013). None of the currently used medications have disease-modifying effects. However, our new injectable medication is now in advanced clinical development that has the potential disease-modifying effects lasting months after each treatment, with limited or no side effects for most patients aside from brief injection site discomfort. (more…)
Accidents & Violence, Author Interviews, Diabetes, Neurology / 17.05.2019

MedicalResearch.com Interview with: foot-neuropathy Monica Perazzolo Research Centre for Musculoskeletal Science and Sports Medicine School of Healthcare Science, Faculty of Science and Engineering, Manchester Metropolitan University, Manchester, UK Department of Biomedical and Neuromotor Sciences University of Bologna, Bologna, Italy MedicalResearch.com: What is the background for this study? What are the main findings? Response: Our research on motor control in diabetes focussed on the effect of diabetic peripheral neuropathy on driving. Drivers with diabetic peripheral neuropathy showed a less well controlled use of the accelerator pedal and sometimes larger, faster steering corrections needed to stay in lane when driving a simulator compared to healthy drivers and people with diabetes but no neuropathy. Despite these negative findings, an important result is that drivers with diabetic peripheral neuropathy demonstrated an improvement in their driving with practice. (more…)
Author Interviews, Diabetes, Neurological Disorders / 06.03.2015

Dr. John A Kessler MD The Ken and Ruth Davee Professor of Stem Cell Biology Department of Neurology Professor, Department of Pharmacology Northwestern University Feinberg School of Medicine MedicalResearch.com Interview with: Dr. John A Kessler MD The Ken and Ruth Davee Professor of Stem Cell Biology Department of Neurology Professor, Department of Pharmacology Northwestern University Feinberg School of Medicine Medical Research: What is the background for this study? What are the main findings? Dr. Kessler: Painful diabetic neuropathy afflicts millions of patients. It interferes with sleep and many daily activities of living, and predisposes to depression. There is a loss of sensation in the legs which predisposes to foot/leg ulcers which may lead to amputation. The only currently available treatments, other than controlling glucose levels, are drugs including gabapentin, pregabalin, or antidepressants which have major side effects and which help only some patients. These are medications which must be taken daily or several times daily and are often poorly tolerated by patients. This study examined the effects of a nonviral gene therapy approach for using hepatocyte growth factor (HGF) to treat patients with painful diabetic neuropathy. HGF helps to support the health of neurons and it also helps to grow new blood vessels to support nerve function. Patients received two sets of treatments (injections) and were then followed for 9 months. The treatment was exceptionally well tolerated - literally without significant side effects. The patients had highly significant reductions in pain and improvement in the quality of life, and their ability to sense gentle pressure (touch) was improved. The benefits lasted months without additional treatment. (more…)
Diabetes / 17.09.2014

Steven Brown School of Healthcare Science Faculty of Engineering Manchester Metropolitan University UK MedicalResearch.com Interview with: Steven Brown School of Healthcare Science Faculty of Engineering Manchester Metropolitan University UK Medical Research: What are the main findings of the study? Answer: Our main findings were increased extremes of sideways sway in patients with diabetes and severe peripheral neuropathy during stair negotiation. Measured by an increase in the amount of lateral separation between the centre-of-mass and centre-of-pressure. Our results showed a 3cm increase in maximum sway in patients with diabetic peripheral neuropathy during both stair descent and stair ascent. (more…)
Author Interviews, Blood Pressure - Hypertension, Diabetes, Diabetes Care, Sleep Disorders / 08.07.2014

MedicalResearch.com Interview with:Vincenza Spallone MD PhD Endocrinology and Neurology Department of Systems Medicine Tor Vergata University, Rome, Italy Vincenza Spallone MD PhD Endocrinology and Neurology Department of Systems Medicine Tor Vergata University, Rome, Italy   Medical Research: What are the main findings of the study? Dr. Spallone:To investigate a possible relationship between painful diabetic polyneuropathy (PDPN) and the circadian pattern of blood pressure (BP), we performed ambulatory blood pressure monitoring in 113 diabetic patients with PDPN, with painless diabetic polyneuropathy (DPN) and without DPN. In addition, we evaluated neuropathic pain, sleep, risk for obstructive sleep apnoea (OSA), autonomic function, and in a subgroup of patients, depressive symptoms. The main finding was that patients with painful diabetic polyneuropathy displayed impaired nocturnal fall in BP compared to those without neuropathy, and higher nocturnal systolic blood pressure than the other two groups. Although the day-night change (∆) in blood pressure failed to reach a significant difference between painful diabetic polyneuropathy and DPN groups, nondipping (the loss of nocturnal fall in systolic BP) was more strictly associated with painful diabetic polyneuropathy than DPN and in multivariate analysis, including comorbidities and most potential confounders, neuropathic pain was an independent determinant of ∆ BP and nocturnal systolic blood pressure. In summary, we showed a novel association of peripheral diabetic neuropathic pain with nondipping and higher systolic nocturnal blood pressure, which was not entirely explained through pain dependent sleep problems or other pain- or diabetes-related comorbidities, like CAN, OSA and depression. (more…)