PDF(Pubmed)
Abstract：
Diabetes Mellitus is a public health problem associated with complications such as neuropathy; however, it has been proposed that these may begin to develop during prediabetes and may also be present in persons with obesity. Diabetic peripheral neuropathy is the presence of signs and/or symptoms of peripheral nerve dysfunction in people living with diabetes, which increases the risk of developing complications and has a deleterious impact on quality of life. As part of the therapeutic protocol for diabetes, screening tests to identify peripheral neuropathy are suggested, however, there are no recommendations for people with prediabetes and obesity without symptoms such as pain, numbness, or paresthesias. Moreover, clinical screening tests that are usually used to recognize this alteration, such as tendon reflex, temperature sensation, and pressure and vibration perception, might be subjective as they depend on the evaluator\'s experience thus the incorrect application of these tests may not recognize the damage to small or large-nerve fibers. Recent evidence suggests that an objective study such as the impairment of the rate-dependent depression of the H-reflex could be used as a biomarker of spinal disinhibition and hence may provide more information on sensorimotor integration.
摘要：
糖尿病是与神经病变等并发症相关的公共卫生问题；然而，有人提出，这些可能在糖尿病前期开始发展，也可能存在于肥胖患者中。糖尿病周围神经病变是指糖尿病患者存在周围神经功能障碍的体征和/或症状，这会增加发生并发症的风险，并对生活质量产生有害影响。作为糖尿病治疗方案的一部分，建议进行筛查测试以确定周围神经病变，然而,对于没有疼痛等症状的糖尿病前期和肥胖患者，没有任何建议，麻木,或感觉异常。此外，通常用于识别这种改变的临床筛查测试，如肌腱反射，温度感觉,压力和振动感知，可能是主观的，因为它们取决于评估者的经验，因此这些测试的不正确应用可能无法识别对小或大神经纤维的损害。最近的证据表明，诸如H反射的速率依赖性抑制的损害之类的客观研究可以用作脊髓抑制的生物标志物，因此可以提供有关感觉运动整合的更多信息。
