A maior rede de estudos do Brasil

Grátis
16 pág.
Capítulo 03 - Neuropatia diabética autonômica

Pré-visualização | Página 5 de 5

na sudorese, nas pupilas
e nas respostas neuroendócrinas, com manifestações conforme as descritas na Tabela 1.
 
PREVENÇÃO DA NAD
Em pacientes com DM1 (DCCT), mas não no DM2 (UKPDS), foi observada diminuição da
velocidade de progressão da NAC com controle metabólico estrito. Presume-se que os benefícios
possam ocorrer no DM2 com controle de vários fatores de risco, pois eles ocorreram no estudo
STENO.
Além disso, os efeitos dos antioxidantes, dos inibidores da aldoseredutase, do ácido gamalinolênico,
dos inibidores da formação de produtos avançados da glicação, dos vasodilatadores, dos fatores
neurotróficos de crescimento e dos inibidores da proteino-quinase C sobre a ND têm sido avaliados.
Dados sobre a evolução da NAD após tratamento medicamentoso existem apenas com o ácido alfa-
/
lipóico, um potente antioxidante, testado porque há várias evidências sugerindo que o estresse
oxidativo aumentado tem importante papel na patogênese da neuropatia. O ácido alfalipóico parece
diminuir a velocidade de progressão da NAD, ou até revertê-la(24), mas em ensaio clínico
randomizado, recentemente realizado, com associação com outros dois anti-oxidantes (allopurinol e
nicotinamida) não foi evidenciada eficácia: o estudo envolveu 44 participantes (22 por grupo) e após
ajuste para idade, sexo, HbA1c, o regime antioxidante foi associado com leve, mas significativa
piora da avaliação global da inervação do ventrículo esquerdo utilizando em PET scan a
[(11)C]HED(26).
Referências Bibliográficas: Leitura recomendada
1. Stevens, M. Diabetic Autonomic Neuropathy. In May, 2005. Acessado em 01/10/2013
2. Anonymous: Consensus Statement. Report and recommendations of the San Antonio
Conference on diabetic neuropathy.American Diabetes Association, American Academy of
Neurology. Diabetes Care 1988;11:592-597.
3. Diabetic neuropathy. No livro Clinical Diabetes: translating research into practice/ Vivian Fonseca
, pp 129-155,1st ed Editora Saunders Elsevier, Philadelphia, 2006.
4. Vinik AI, Nevoret ML, Casellini C, Parson H. Diabetic neuropathies. Endocrinol Metab Clin North
Am. 2013 Dec;42(4):747-87.
5. Low PA, Benrud-Larson LM, Sletten DM, Opfer-Gehrking TL, Weigand SD, O'Brien PC, Suarez
GA, Dyck PJ. Autonomic Symptoms and diabetic neuropathy: a population based study. Diabetes
Care 2004;27: 2942-47.
6. Valensi P, Paries j, Attali JR, French Group for research and Study of Diabetic neuropathy.
Cardiac Autonomic Neuropathy in Diabetic Patients: influence of diabetes duration, obesity and
microangiopathic complications – The French Multicenter Study. Metabolism 2003;52: 815-20.
7. Witte DR, Tesfaye S, Chatuvedi N, Eaton SE, Kempler P, Fuller JH, EURODIAB Prospective
Complications Study Group. Risk factors for cardiac autonomic neuropathy in Type 1 diabetes
mellitus. Diabetologia 2005;48:164-71.
8. Maser RE, Steenkiste AR, Dorman JS, et al: Epidemiological correlates of diabetic neuropathy.
Report from Pittsburgh Epidemiology of Diabetes Complications Study. Diabetes
1989;38(11):1456-61.
9. O'Brien IA, Mcfadden JP, Corral RJM et al: The Influence of Autonomic Neuropathy on Mortality
in Insulin-dependent Diabetes. Quarterly Journal of Medicine 1991, New Series 79, No. 290, pp.
495-502. Acessado em 10/07/2007.
10. Martin CL et al: Neuropathy among the Diabetes Control and Complications Trial Cohort 8 years
after trial completion. Diabetes Care 2006;29: 340-344.
11. Buse, JB. Current and emerging adjunct therapies for diabetic microvascular complication control
. Acessado em 15/07/2007.
12. Vincent AM, et al. Oxidative stress in the pathogenesis of diabetic neuropathy. Endocr Rev
2004;25:612-628.
13. American Academy of Neurology. Assessment: clinical autonomic testing report of the
Therapeutics and Technlogy assessment Subcommitee of the American academy of Neurology.
Neurology 1996;46: 873-80.
14. Neumann C., Schmid H. Standardization Of A Computerized Method For Calculating Autonomic
Function Tests Responses In Healthy Subjects and Patients With Diabetes Mellitus. Braz J Med
Biol Res 1996;v.30, p.197 – 205.
15. Ewing, DJ: Recent advances in the non-invasive investigation of diabetic autonomic neuropathy.
In Autonomic Failure. A Textbook of Clinical Disorders of the Autonomic Nervous System, 2nd
edn (Bannister, R., ed.), pp. 667–689, Oxford University Press, New York,1988.
16. England JD, Gronseth GS, Franklin G, Carter GT, Kinsella LJ, Cohen JA, Asbury AK, Szigeti K,
Lupski JR, Latov N, Lewis RA, Low PA, Fisher MA, Hermann DN, Howard JF Jr, Lauria G, Miller
/
RG, Polydefkis M, Summer AJ, American Academy of Neurology. Practice parameter: evaluation
of distal Symmetric Polyneuropathy: role of autonomic testing, nerve biopsy and skin biopsy (an
evidence-based review): report of the American Academy of Neurology, American Association of
Neuromuscular and Electrodiagnostic Medicine, and American Academy of Physical Medicine
and Rheabilitation. Neurology 2009;72:177-84.
17. Boulton, AJ et al. Position Statement: Diabetic Neuropathies. Diabetes Care 2005;28:956-962.
18. Tesfaye S, Boulton AJM, Dyck PJ, Freeman R, Horowitz M, Kempler P, Lauria G, Malik RA,
Spallone V, Vinik A, Bernardi L, Valensi P, on behalf of the Toronto Diabetic Neuropathy Expert
Group. Diabetic Neuropathies: Update onDefinitions, Diagnostic Criteria, Estimation of Severity,
and Treatments. Diabetes Care 2010;33 (10), 2285-93.
19. Schnell O, Muhr D, Weiss M, et al. Three-year follow-up on scintigraphically assessed cardiac
sympathetic denervation in patients with long-term insulin-dependent (type 1) diabetes mellitus. J
Diabetes Complications 1997;11:307–313.[Medline]
20. Neumann C., Branchtein L., Schmid H. Severe Autonomic Neuropathy: How Many Symptoms?
Diabetes Care 1995;18:133-134.
21. Neumann C., Schmid H. Relationship Between The Degree Of Cardiovascular Autonomic
Dysfunction And Symptoms Of Neuropathy And Other Complications Of Diabetes Mellitus. Braz J
Med Biol Res 1995;28:751-757.
22. Martin CL, Albers JW, Pop-Busui R; DCCT/EDIC Research Group. Neuropathy and related
findings in the diabetes control and complications trial/epidemiology of diabetes interventions and
complications study. Diabetes Care 2014;37(1):31-8.
23. Pop-Busui, R, Kirkwood, I, Schmid, H, Marinescu, V, Schroeder, J, Larkin, D, Yamada, E Raffel,
DM and Stevens, MJ. Augmented cardiac sympathetic tone and responsiveness and impaired
myocardial perfusion may contribute to myocardial injury in diabetes. J Am Coll Cardiol
2004;44:2368–74
24. Schmid H. Neuropatia Diabética in Diabetes mellitus. Editado por Ruy Lyra e Ney Cavalcanti;
Edição: 1ª; Capítulo 56, Rio de Janeiro, Diagraphic 2006;537-556.
25. Casellini CM, Parson HK, Richardson MS, Nevoret ML, Vinik AI. Sudoscan, a noninvasive tool for
detecting diabetic small fiber neuropathy and autonomic dysfunction. Diabetes Technol Ther
2013;15:948-53.
26. Pop-Busui R, Stevens MJ, Raffel DM, White EA, Mehta M, Plunkett CD, Brown MB, Feldman EL.
Effects of triple antioxidant therapy on measures of cardiovascular autonomic neuropathy and on
myocardial blood flow in type 1 diabetes: a randomised controlled trial. Diabetologia
2013;56:1835-44.
Tweetar Be the first of your friends to like
this.
Like
https://twitter.com/intent/tweet?original_referer=https%3A%2F%2Febook.diabetes.org.br%2Fcomponent%2Fk2%2Fitem%2F40-neuropatia-diabetica-autonomica%3Ftmpl%3Dcomponent%26print%3D1&ref_src=twsrc%5Etfw&text=Cap%C3%ADtulo%2003%20-%20Neuropatia%20diab%C3%A9tica%20auton%C3%B4mica&tw_p=tweetbutton&url=https%3A%2F%2Febook.diabetes.org.br%2Fcomponent%2Fk2%2Fitem%2F40-neuropatia-diabetica-autonomica%3Ftmpl%3Dcomponent%26print%3D1