ssmuБюллетень сибирской медициныBulletin of Siberian Medicine1682-03631819-3684Siberian State Medical University, the Ministry of Healthcare of the Russian Federation10.20538/1682-0363-2013-1-101-108ssmu-46Research ArticleОБЗОР ЛИТЕРАТУРЫLITERATURE REVIEWНОВЫЕ МЕТОДЫ ДИАГНОСТИКИ ДИАБЕТИЧЕСКОЙ НЕВРОПАТИИNEW METHODS OF DIAGNOSIS DIABETIC NEUROPATHYЦыренжаповаР. Б.TsyrenzhapovaR. B.

Цыренжапова Рада Батуевна – аспирант кафедры неврологии и нейрохирургии 

tz.rada@yandex.ruАлифироваВ. М.AlifirovaV. M.

Алифирова Валентина Михайловна – доктор медицинских наук, профессор, зав. кафедрой неврологии и нейрохирургии 

tz.rada@yandex.ruСибирский государственный медицинский университет, ТомскРоссияSiberian State Medical University, TomskRussian Federation201328022013121101108Copyright © Цыренжапова Р.Б., Алифирова В.М., 20132013Цыренжапова Р.Б., Алифирова В.М.Tsyrenzhapova R.B., Alifirova V.M.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://bulletin.ssmu.ru/jour/article/view/46

Диабетическая невропатия относится к наиболее распространенным осложнениям сахарного диабета и является одной из главных причин инвалидизации больных. По данным эпидемиологических исследований, в зависимости от используемых методов обследования частота развития диабетической невропатии среди больных варьирует от 5 до 100%. Данное заболевание значительно снижает качество жизни больных и является одним из основных факторов риска развития язвенных дефектов стоп, гангрены и развития синдрома диабетической стопы.

Diabetic neuropathy is the most common complications of diabetes and is a leading cause of disability of patients. According to epidemiological studies, depending on the methods of examination frequency of diabetic neuropathy among the patients ranged from 5 to 100%. The disease significantly reduces the quality of life of patients and is one of the major risk factors for foot ulcers, burns, frostbite, gangrene and diabetic foot syndrome.The main objective of this publication – to make a review of the literature in recent years to a wider circle of local doctors with the most modern methods of early diagnosis of diabetic neuropathy.

диабетическая невропатиясахарный диабетдиагностикааксонопатияде-миелинизацияретинальная конфокальная микроскопияоптическая когерентная томографияdiabetic neuropathydiabetesdiagnosisaxonopathydemyelinatingretinal сonfocal microscopyoptical coherent tomographyReferencesАметов А.С. Сахарный диабет. Проблемы и решения. М.: ГЭОТАР-Медиа, 2011. 680 с.Ametov A.S. Diabetes mellitus. Problems and decisions. Moscow , Media. Publ., 2011. 680 p. (in Russian).Баранцевич Е.Р. Посохина О.В. Подходы к терапии неврологических проявлений сахарного диабета // Журн. неврологии и психиатрии. 2010. № 4. С. 63–66.Barancevich E.R. Posohina O.V. Journal of neurology and psychiatry, 2010, no. 4, pp. 63–66 (in Russian).Браун М.Ж., Грин Д.А. Диабетическая невропатия: патофизиология и лечение // Заболевания периферической нервной системы / под ред. А.К Эсберн, Р.У. Джиллиата. М., 1987. С. 163–194.Braun M.Zh., Grin D.A. Diabetic neuropathy: pathophysio-logy and treatment: In books Diseases of the peripheral nervous system. Ed.: A.K. Jesbern, R.U. Dzhilliata. Moscow. 1987, pp. 163–194 (in Russian).Галстян Г.Р. Диабетическая нейропатия: особенности клинического течения, современные возможности терапии // Эффективная фармакотерапия в эндокринологии. 2009. № 4. С. 20–26.Galstyan G.R. Effective pharmacotherapy in endocrinology, 2006, no. 4, pp. 20–26 (in Russian).Гехт Б.М. Теоретическая и клиническая электромиография. 1990. С. 240–250.Geht B.M. Theoretical and clinical elektromiography. St. Petersburg, Nauka Publ., 1990. pp. 240–250 (in Russian).Дедов И.И. Новые возможности терапии сахарного диабета 2 типа // Сахарный диабет. 2009. Спец. выпуск. С. 1–3.Dedov I.I. Diabetes. Special Release, 2009, pp. 1–3 (in Russian).Котов С.В., Калинин А.П., Рудакова И.Г. Диабетическая нейропатия. М.: МИА, 2011. С. 56–79.Kotov S.V., Kalinin A.P., Rudakova I.G. Diabetic neuropa-thy. Moscow, MIA Publ., 2011. pp. 56–79 (in Russian).Свирин А.В., Кийко Ю.И., Обруч Б.В., Богомолов А.В. Спектральная оптическая когерентная томография: принципы и возможности метода. URL: http://www.far-manotes.ru/spektralnaya- opticheskaya- kogerentnaya- tomo-grafiya-principy-i-vozmozhnosti-metoda (дата обращения: 04.12.11).Svirin A.V., Kijko Ju.I., Obruch B.V., Bogomolov A.V. Spectral optical coherent tomography: principles and possibilities of a method. URL: http://www.farmanotes.ru/ spektralnaya-opticheskaya-kogerentnaya-tomografiya-principy-i-vozmozhnosti-metoda (Accessed: 04 December 2011) (in Russian).Строков И.А., Аметов А.С., Козлова Н.А., Галеев И.В. Клиника диабетической невропатии // Рус. мед. журн. 1998. Т. 6, № 12. C. 797–801.Strokov I.A., Ametov A.S., Kozlova N.A., Galeev I.V. Rus-sian Medical Journal, 1998, vol. 6, no. 12, pp. 797–801 (in Russian).Строков И.А., Новосадова М.В., Баринов А.Н., Яхно Н.Н. Клинические методы оценки диабетической полинейропатии // Неврол. журн. 2000. № 5. С. 14–18.Strokov I.A., Novosadova M.V., Barinov A.N., Jahno N.N. Journal of Neurology, 2000, no. 5, pp. 14–18 (in Russian).Celicer R., Basgoze O., Bayraktar M. Early detection of neurological involvement in diabetes mellitus // Electromyogr. Clin. Neurophysiol. 1996. V. 36. P. 29–35.Celicer R., Basgoze O., Bayraktar M. Early detection of neu-rological involvement in diabetes mellitus. Electromyogr. Clin. Neurophysiol., 1996, vol. 36, pp. 29–35.Dipika V Patel., Charles Nj McGhee. Contemporary in vivo confocal microscopy of the living human cornea using white light and laser scanning techniques:major review // Clinical and Experimental Opthalmology. 2007. V. 35. P. 71–88.Dipika V Patel., Charles Nj McGhee Contemporary in vivo confocal microscopy of the living human cornea using white light and laser scanning techniques: major review. Clinical and Experimental Opthalmology, 2007, vol. 35, pp. 71–88.DCCT Reserch Group: The effect of intensive diabetes treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus // N. Engl. J. Med. 1993. V. 329. P. 997–1005.DCCT Reserch Group: The effect of intensive diabetes treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes melli-tus. N. Engl. J. Med., 1993, vol. 329, pp. 997–1005.DCCT Reserch Group. Factors in development of diabetes therapy on the development and progression of neuropathy // Diabetes. 1998. V. 37. P. 476–483.DCCT Reserch Group. Factors in development of diabetes therapy on the development and progression of neuropathy. Diabetes, 1998, vol. 37, pp. 476–483.Dyck P.J. Detection, characterization, and staging of poly-neuropathy: assessed in diabetics // Muscle and Nerve. 1998. V. 11. P. 21–32.Dyck P.J. Detection, characterization, and staging of poly-neuropathy: assessed in diabetics. Muscle and Nerve, 1998, vol. 11, pp. 21–32.Dyck P.J., Albers J.W., Andersen H., Arezzo J.C., Biessels G.J. Diabetic Polyneuropathies: Update on Research Definition, Diagnostic Criteria and Estimation of Severity // Diabetes Metab. Res. Rev. 2011. P. 2456–2466.Dyck P.J., Albers J.W., Andersen H., Arezzo J.C., Biessels G.J. Diabetic Polyneuropathies: Update on Research Definition, Diagnostic Criteria and Estimation of Severity. Diabetes Metab. Res. Rev., 2011, pp. 2456–2466.Efron N. The Glenn A. Fry award lecture 2010: Ophthalmic markers of diabetic neuropathy // Optom. Vis. Sci. 2011. V. 88(6). P. 661–683.Efron N. The Glenn A. Fry award lecture 2010: Ophthalmic markers of diabetic neuropathy. Optom. Vis. Sci., 2011, 88(6), pp. 661–683.Ites K.I., Anderson E.J., Cahill M.L., Kearney J.A., Post E.C., Gilchrist L.S. Balance interventions for diabetic peripheral neuropathy: a systematic review // J. Geriatr. Phys. Ther. 2011. Jul.–Sep. 34(3). P. 109–116.Ites K.I., Anderson E.J., Cahill M.L., Kearney J.A., Post E.C., Gilchrist L.S. Balance interventions for diabetic peripheral neuropathy: a systematic review. J. Geriatr. Phys. Ther., 2011, Jul.–Sep., 34(3), pp. 109–116.Feldman E.L. A practical two step quantitative clinical and electrophysiological assessment for the diagnosis and staging of diabetic neuropathy // Diabetes Care. 1994. V. 17, № 11. P. 1281–1289.Feldman E.L. A practical two step quantitative clinical and electrophysiological assessment for the diagnosis and staging of diabetic neuropathy. Diabetes Care. 1994, vol. 17, no. 11, pp. 1281–1289.Gomes A.A., Onodera A.N., Otuzi M.E., Pripas D., Mezzarane R.A., Sacco I.C. Electromyography and kinematic changes of gait cycle at different cadences in diabetic neu-ropathic individuals // Muscle Nerve. 2011. Aug. 44(2). P. 258–268.Gomes A.A., Onodera A.N., Otuzi M.E., Pripas D., Mezzarane R.A., Sacco I.C. Electromyography and kinematic changes of gait cycle at different cadences in diabetic neu-ropathic individuals. Muscle Nerve, 2011, Aug, 44(2), pp. 258–268.Grant J.A., O’Brien P., Dyck P.J. Neuropathy test and normative results // Diabetic Neuropathy. Philadelphia, 1999. P. 123–134.Grant J.A., O’Brien P., Dyck P.J. Neuropathy test and nor-mative results. Diabetic Neuropathy. Philadelphia, 1999. pp. 123–134.Harris M., Eastman R., Cowie C. Symptoms of sensory neuropathy in adults with NIDDM in the U.S. population // Dia-betes Care. 1993. V.16. P. 1446–1450.Harris M., Eastman R., Cowie C. Symptoms of sensory neu-ropathy in adults with NIDDM in the U.S. population. Dia-betes Care, 1993, vol. 16, pp. 1446–1450.King R.H. The role of glycation in the pathogebesis of diabetic polineuropathy // Mol. Pathol. 2001. № 54. P. 400–408.King R.H. The role of glycation in the pathogebesis of diabetic polineuropathy. Mol. Pathol., 2001, no. 54, pp. 400–408.Leeds J.S., Hopper A.D., Hadjivassiliou M., Tesfaye S., Sanders D.S. High prevalence of microvascular complications in adults with type 1 diabetes and newly diagnosed celiac disease // Diabetes Care. 2011. Oct. 34(10). P.2158–2163.Leeds J.S., Hopper A.D., Hadjivassiliou M., Tesfaye S., Sanders D.S. High prevalence of microvascular complications in adults with type 1 diabetes and newly diagnosed celiac disease. Diabetes Care, 2011, Oct; 34(10), pp. 2158–2163.Magri C.J., Calleja N., Buhagiar G., Fava S., Vassallo J. Predictors of vibration perception threshold in type 2 diabetic patients with proliferative retinopathy // Postgrad. Med. J. 2011. Oct. 87(1032). P. 658–63.Magri C.J., Calleja N., Buhagiar G., Fava S., Vassallo J. Predictors of vibration perception threshold in type 2 diabetic patients with proliferative retinopathy. Postgrad. Med. J., 2011, Oct; 87(1032), pp. 658–663.Maser R.E., Laudadio C., De Cherney G.S. The effects of age and diabetes mellituson nerve function // J. Am. Geriatr. Soc. 1993. V. 41 (11). P. 1202.Maser R.E., Laudadio C., De Cherney G.S. The effects of age and diabetes mellituson nerve function. J. Am. Geriatr. Soc., 1993, vol. 41(11), p. 1202.Mastropasqua L., Nubile M. Confocal Microscopy of the Cornea // SLACK Incorporated. USA. 2002. P. 122.Mastropasqua L., Nubile M. Confocal Microscopy of the Cornea. SLACK Incorporated, USA. 2002. P. 122.Nowicki M., Kosacka J., Serke H., Blüher M., Spanel-Borowski K. Altered sciatic nerve fiber morphology and endoneural microvessels in mouse models relevant for obesi-ty, peripheral diabetic polyneuropathy, and the metabolic syndrome // J. Neurosci. Res. 2011. P. 1226.Nowicki M., Kosacka J., Serke H., Blüher M., Spanel-Borowski K. Altered sciatic nerve fiber morphology and endoneural microvessels in mouse models relevant for obesi-ty, peripheral diabetic polyneuropathy, and the metabolic syndrome. J. Neurosci. Res., 2011, p. 1226.Oliveira-Soto L., Efron N. Morphology of corneal nerves us-ing confocal microscopy // Cornea. 2001. V. 20, no. 4. P. 374–384.Oliveira-Soto L., Efron N. Morphology of corneal nerves us-ing confocal microscopy. Cornea, 2001, vol. 20, no. 4, pp. 374–384.Patel S., McLaren J., Hodge D. et al. Normal human keratocyte density and corneal thickness measurement by us-ing confocal microscopy in vivo // Invest. ophthalmol.Vis. Sci. 2001. V. 42. № 2. Р. 333–339.Patel S., McLaren J., Hodge D., et al. Normal human keratocyte density and corneal thickness measurement by us-ing confocal microscopy in vivo. Invest. ophthalmol. Vis. Sci., 2001, vol. 42, no. 2, pp. 333–339.Periquet M.I., Novak V., Collins M.P. et al. Paiful sensory neuropathy. Prospective evalution using skin biopsy // Neurology. 1999. P. 1641–1647.Periquet M.I., Novak V., Collins M.P et al. Paiful sensory neuropathy. Prospective evalution using skin biopsy. Neurology, 1999, pp. 1641–1647.Podwall D., Gooch C. Diabetic neuropathy: Сlinical features, etiology, and therapy // Curr. Neurol. Neurosci. Rep. 2004. Jan. 4(1). P. 55–61.Podwall D., Gooch C. Diabetic neuropathy: Сlinical features, etiology, and therapy. Curr. Neurol. Neurosci. Rep., 2004, Jan; 4(1), pp. 55–61.Quatrini C., Tavakoli M., Jeziorska. M, Kallinikos P., Tesfaye S., Finigan J. et al. Surrogate markers of small fiber damage in human diabetic neuropathy // Diabetes. 2007. P. 2148–2154.Quatrini C., Tavakoli M., Jeziorska. M, Kallinikos P., Tesfaye S., Finigan J., et al. Surrogate markers of small fiber damage in human diabetic neuropathy. Diabetes, 2007, pp. 2148–2154.Rendell M.S., Katims J.J., Richter R., Rowland F.A. A comparison of nerve conduction velocities and current perception thresholds as correlates of clinical severity of diabetic sensory neuropathy // J. Neurol. Neurosurg. Psychiatr. 1989. V. 52. P. 502–511.Rendell M.S., Katims J.J., Richter R., Rowland F.A A com-parison of nerve conduction velocities and current perception thresholds as correlates of clinical severity of diabetic sensory neuropathy. J. Neurol. Neurosurg. Psychiatr., 1989, vol. 52, pp. 502–511.Somodi S., Hahnel C., Slowic C. et al. Confocal in vivo microscopy and confocal laser–scanning fluorescence micros-copy in keratoconus // Ger. J. Ophthalmol. 1996. V. 5, no. 6. Р. 518–525.Somodi S., Hahnel C., Slowic C. et al. Confocal in vivo mi-croscopy and confocal laser–scanning fluorescence micros-copy in keratoconus. Ger. J. Ophthalmol., 1996, vol. 5, no. 6, pp. 518–525.Sohn M.W., Whittle J., Pezzin L.E., Miao H., Dillingham T.R. Electrodiagnostic consultation and identification of neu-romuscular conditions in persons with diabetes // Muscle Nerve. 2011. 43(6). Р. 812–817.Sohn M.W., Whittle J., Pezzin L.E., Miao H., Dillingham T.R. Electrodiagnostic consultation and identification of neuromuscular conditions in persons with diabetes. Muscle Nerve, 2011, 3(6), pp. 812–817.Sugimoto K., Murakawa Y., Sima A.A. Diabetic neuropathy-continuing enigma // Diabetes Metab. Res. Rev. 2000. 16. P. 408–433.Sugimoto K., Murakawa Y., Sima A.A. Diabetic neuropathy-continuing enigma. Diabetes Metab. Res. Rev., 2000, 16, pp. 408–433.Tavakoli M., Marshal A., Thompson L., Efron N., Malik R. Corneal confocal microscopy: A novel noninvasive means to diagnose neuropathy in patients with fabry disease // Muscle and Nerve. 2009. P. 976–984.Tavakoli M., Marshal A., Thompson L., Efron N., Malik R. Corneal confocal microscopy: A novel noninvasive means to diagnose neuropathy in patients with fabry disease. Muscle and Nerve, 2009, pp. 976–984.Tavakoli M., Marshal A., Thompson L., Efron N., Malik R. Corneal confocal microscopy is reduced and relates to the severity of neuropathy in patients with diabetes // Diabetes care. 30. 2007. P. 1895–1897.Tavakoli M., Marshal A., Thompson L., Efron N., Malik R. Corneal confocal microscopy is reduced and relates to the severity of neuropathy in patients with diabetes. Diabetes care, 2007, 30, pp. 1895–1897.Tavakoli M., Asghar O., Alam U. et al. Novel insights on diagnosis, cause and treatment of diabetic neuropathy: focus on painful diabetic neuropathy // Therapeutic Advances in Endocrinology and Metabolism. 2010. P. 69–88.Tavakoli M., Asghar O., Alam U., et al Novel insights on di-agnosis, cause and treatment of diabetic neuropathy: focus on painful diabetic neuropathy. Therapeutic Advances in En-docrinology and Metabolism, 2010, pp. 69–88.Thomas P.K. Classifications, differential diagnosis, and stag-ing of diabetic peripheral neuropathy // Diabetes. 1997. V. 46. P. 54–57.Thomas P.K. Classifications, differential diagnosis, and stag-ing of diabetic peripheral neuropathy. Diabetes, 1997, vol. 46, pp. 54–57.Thomas P.K. Diabetic peripheral neuropathies: their cost to patient and society and the value of knowledge of risk factor for development of interventions // Eur. Neurol. 1999. V. 41. P. 35–43.Thomas P.K. Diabetic peripheral neuropathies: their cost to patient and society and the value of knowledge of risk factor for development of interventions. Eur. Neurol., 1999, vol. 41, pp. 35–43.Varano M., Scassa C., Ripandelli G. et al. New diagnostic tools for macular edema // Doc Opthalmol. 1999. V. 97. P. 373–379.Varano M., Scassa C., Ripandelli G. et al. New diagnostic tools for macular edema. Doc Opthalmol., 1999, vol. 97, pp. 373–379.Wang W., Balamurugan A., Biddle J., Rollins K.M. Diabetic neuropathy status and the concerns in underserved rural communities: challenges and opportunities for diabetes edu-cators // Diabetes Educ. 2011. P. 536–548.Wang W., Balamurugan A., Biddle J., Rollins K.M. Diabetic neuropathy status and the concerns in underserved rural communities: challenges and opportunities for diabetes edu-cators. Diabetes Educ., 2011, pp. 536–548.Wygledowska-Promienska D., Rokita-Wala I., Gierek-Ciaciura S. et al. The alterations in the corneal structure at III/IV stage of keratoconus by means of confocal microscopy and ultrasound biomicroscopy before penetrating keratoplasty // Klin. Oczna. 1999. V. 101, no. 6. Р. 427–432.Wygledowska-Promienska D., Rokita-Wala I., Gierek-Ciaciura S. et al. The alterations in the corneal structure at III/IV stage of keratoconus by means of confocal microscopy and ultrasound biomicroscopy before penetrating keratoplasty. Klin. Oczna, 1999, vol. 101, no. 6, pp. 427–432.Yoshida A. New examination methods for macular disorders-application of diagnosis and treatment // Nippon Ganka Zasshi. 2000. V.104. P.899–942.Yoshida A. New examination methods for macular disorders- application of diagnosis and treatment. Nippon Ganka Zasshi, 2000, vol. 104, pp. 899–942.Ziegler D. The design of clinical trials for treatment of diabetic neuropathy // Neuroscience Research Communications. 1997. V. 21. P. 83–91Ziegler D. The design of clinical trials for treatment of diabetic neuropathy. Neuroscience Research Communications, 1997, vol. 21, pp. 83–91.Ziegler D., Gries F.A. Nervenheilkunhe. 1993. P. 405–410.Ziegler D., Gries F.A. Nervenheilkunhe, 1993, pp. 405–410.

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