Materiały źródłowe

• #1 Autonomic neuropathy | UM Health-Sparrow

  https://www.uofmhealthsparrow.org/departments-conditions/conditions/autonomic-neuropathy

  Certain inherited diseases that put you at risk of developing autonomic neuropathy can’t be prevented. But you can slow the onset or progression of symptoms by taking care of your health in general and managing your medical conditions. […] To control diseases and conditions, follow your health care provider’s advice on healthy living. That advice might include these recommendations: […] Control your blood sugar if you have diabetes. […] Avoid alcohol and smoking. […] Get appropriate treatment if you have an autoimmune disease. […] Take steps to prevent or control high blood pressure. […] Achieve and maintain a healthy weight. […] Exercise regularly.

• #2 Autonomic neuropathy – Augusta HealthSearchClose SearchSearch IconSearch IconClose Search IconMobile Menu IconMobile Menu Close IconInstagramFacebookTwitterYoutube

  https://www.augustahealth.com/disease/autonomic-neuropathy/

  While certain inherited diseases that put you at risk of developing autonomic neuropathy can’t be prevented, you can slow the onset or progression of symptoms by taking care of your health in general and managing your medical conditions. […] Follow your doctor’s advice on healthy living to control diseases and conditions, which might include these recommendations: […] Control your blood sugar if you have diabetes. […] Avoid alcohol and smoking. […] Get appropriate treatment if you have an autoimmune disease. […] Take steps to prevent or control high blood pressure. […] Achieve and maintain a healthy weight. […] Exercise regularly.

• #3 Autonomic Neuropathy: Causes, Diagnosis, & Prevention

  https://www.healthline.com/health/autonomic-neuropathy

  Addressing conditions that may cause neuropathy can help prevent its development. Some suggestions include: […] Keep your blood sugar stable if you have diabetes. Eating a low-sugar and high-fiber diet might help regulate diabetes. […] Stop smoking cigarettes. Talk to your doctor about treatments that can help you quit. […] Stop drinking alcohol. Seeking the services of a counselor may be helpful. […] Exercise daily to help manage certain health conditions and lose weight if necessary. […] Prevent high blood pressure by drinking plenty of fluids, exercising regularly, and eliminating stressors.

• #4 What is Autonomic Neuropathy? – Amputation Prevention Center

  https://apcofamerica.com/autonomic-neuropathy/

  Slowing the progression of autonomic neuropathy is possible, and it can greatly minimize your symptoms. To limit the impact of the condition as much as you can, follow these tips: […] Control your blood sugar. Keep it between 80-130 mg/dL before eating and under 180 mg/dL after. […] Avoid alcohol and smoking. […] Get appropriate treatment for any autoimmune disease. […] Control your blood pressure, keeping it below 130/80. […] Maintain a healthy weight. […] Exercise regularly, shooting for at least 30 minutes of exercise five times weekly. Biking, running, walking, or swimming are good options. […] Making a few lifestyle changes can also lead to improvements: […] Stand up slowly to decrease dizziness. Tense your leg muscles when standing to increase your blood pressure. […] If you have low blood pressure, raise the head of your bed by approximately 4 inches. […] Eat smaller, more frequent meals. Increase fluids. Choose low-fat, high-fiber options, and restrict lactose and gluten.

• #5 Peripheral neuropathy – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/peripheral-neuropathy/symptoms-causes/syc-20352061

  The best way to prevent peripheral neuropathy is to manage medical conditions that put you at risk. […] These habits support your nerve health: […] Eat a diet rich in fruits, vegetables, whole grains and lean protein to keep nerves healthy. Protect against low levels of vitamin B-12 by eating meats, fish, eggs, low-fat dairy foods and fortified cereals. If you’re vegetarian or vegan, fortified cereals are a good source of vitamin B-12, but talk to your health care professional about B-12 supplements. […] Exercise regularly. With a health care professional’s OK, try to get at least 30 minutes to one hour of exercise at least three times a week. […] Avoid factors that may cause nerve damage. These factors can include repetitive motions, exposure to toxic chemicals, smoking and drinking too much alcohol.

• #6 Diabetic autonomic neuropathy

  https://elsevier.health/en-US/preview/diabetic-autonomic-neuropathy-co

  Low-fat diet (less than 30% daily calorie intake from fat, less than 10% of daily calorie intake from fatty acids) c200 […] Light to moderate exercise (30 minutes 3-5 times per week) c201c202 […] ACE inhibitor or angiotensin receptor blocker (regardless of blood pressure) c203c204 […] Daily low-dose aspirin c205 […] Treatment of dyslipidemia c206 […] Smoking cessation if applicable c207

• #7 Evaluation and Prevention of Diabetic Neuropathy | AAFP

  https://www.aafp.org/pubs/afp/issues/2005/0601/p2123.html

  Diabetic neuropathy is a debilitating disorder that occurs in nearly 50 percent of patients with diabetes. […] Strict glycemic control and good daily foot care are key to preventing complications of diabetic neuropathy. […] Early detection and control of diabetes and coexisting risk factors for neuropathy (e.g., smoking, alcohol abuse, hypertension) can prevent, delay, or slow the progression of diabetic neuropathy. […] The Diabetes Control Complications Trial (DCCT) demonstrated that tight glycemic control may result in a 60 percent reduction in the risk of developing clinical neuropathy. […] Daily foot care is essential for preventing complications of diabetic neuropathy. […] Once a patient has diabetic neuropathy, foot care becomes essential for preventing ulceration, infection, and amputation.

• #8 Diabetic Neuropathy: An Overview Of Risk Factors & Prevention – The Foot Doc™

  https://thefootdocaz.com/diabetic-neuropathy-an-overview-of-risk-factors-prevention/

  Up to 50 percent of patients with diabetes may suffer from diabetic neuropathy. However, measures such as maintaining a healthy lifestyle and keeping tight control of blood glucose levels may prevent or slow the progression of diabetic neuropathy. […] Diabetic neuropathy and its complications may be prevented or delayed with careful attention to the following: […] By tightly controlling their blood glucose levels, patients can minimize the amount of harm to the nerves and, therefore, reduce their chances of developing diabetic neuropathy. […] The downstream consequences of diabetic neuropathy of the feet, such as diabetic foot ulcers and amputations, may be largely prevented through routine monitoring. […] Patients may reduce their chances of developing peripheral neuropathy by reducing or eliminating smoking.

• #9 Cardiac autonomic neuropathy: Risk factors, diagnosis and treatment

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5763036/

  Prevention of diabetic neuropathies focuses on lifestyle modifications and tight glucose control. Early optimization of glucose control in patients with T1DM (class A) and a multifactorial approach targeting glycaemia among other cardiovascular risk factors in patients with T2DM (class C) were considered for prevention or delay of CAN development. […] Implementation of tight glucose control as early as possible to prevent or delay the development of CAN in the course of T1DM (class A); consider a multifactorial approach in the course of T2DM (class C). […] The basic CAN prevention and treatment tools are intensive glycemic control, lifestyle modification and management of CVD risk, but the unified algorithm and known disease modifying treatment is lacking.

• #10 Diabetic autonomic neuropathy

  https://elsevier.health/en-US/preview/diabetic-autonomic-neuropathy-co

  Prevention of diabetic autonomic neuropathy is primarily through optimizing glycemic control; people with type 2 diabetes benefit from additional behavioral and pharmacologic interventions aimed at other cardiovascular risk factors r1 […] American Diabetes Association recommends optimizing glycemic control as early as possible for patients with type 1 diabetes and adopting a multifactorial approach that includes aggressive management of cardiovascular risks as well as good glycemic control for patients with type 2 diabetes r1 […] Intensive glucose control resulted in a 45% reduction in the development of cardiac autonomic neuropathy in patients with type 1 diabetes in the Diabetes Control and Complications Trial r38 […] Intensive glycemic control alone is less effective in preventing neuropathy in type 2 diabetes; the Steno-2 Study showed a near 60% reduction in risk for cardiac autonomic neuropathy through a multipronged program of good glycemic control and specific measures aimed at reducing other cardiac risk factors over a period of almost 8 years. These measures include the following: r40c199

• #11 Cardiac autonomic neuropathy and risk of cardiovascular disease and mortality in type 1 and type 2 diabetes: a meta-analysis | BMJ Open Diabetes Research & Care

  https://drc.bmj.com/content/9/2/e002480

  We found a significant association between early and definite CAN and CVE in patients with diabetes. […] CAN therefore remains a target for prevention of both development and subsequent progression. […] The ACCORD Trial also adopted a successful approach for CAN prevention, where a negative CVD history identified patients who benefitted from an intensive glycemic control. […] Early detection of CAN is key to the success of therapeutic response, as it has been suggested that cardiovascular denervation may be reversible if multifactorial and lifestyle interventions are implemented soon after onset. […] The American Diabetes Association position statement for diabetic neuropathy advocates the prevention of CAN. […] Indeed, in the Intensified Multifactorial Intervention in Patients With Type 2 Diabetes and Microalbuminuria (STENO-2) Trial, multifactorial intervention was beneficial for autonomic neuropathy (OR: 0.32, 95%CI 0.12 to 0.78 for intensive therapy vs standard therapy) and persisted beyond two decades.

• #12 Neuropathy, Autonomic | 5-Minute Clinical Consult

  https://www.unboundmedicine.com/5minute/view/5-Minute-Clinical-Consult/816059/all/Neuropathy_Autonomic?q=Pheochromocytoma

  Autonomic effects of diabetes are most common with long-standing and poorly controlled diabetes. […] Exercise improves cardiac autonomic function in diabetic autonomic neuropathy and improves overall autonomic function in prediabetic patients.

• #13

  https://link.springer.com/article/10.1007/s13300-019-00693-0

  Cardiac autonomic neuropathy (CAN) is a major complication of type 1 and type 2 diabetes mellitus (T1DM and T2DM). […] The link between obesity and CAN highlights the therapeutic potential of lifestyle interventions including diet and physical activity to reverse MetS and prevent CAN. […] Screening for CAN in pre-DM using risk scores with analysis of heart rate variability (HRV) or Sudoscan is important to allow earlier treatment at a reversible stage. […] Lifestyle interventions including dietary and exercise interventions to achieve weight loss could help to reverse the development of early CAN, by reducing insulin resistance and hyperinsulinaemia, leading to a reduction in SNS activation. […] An early diagnosis of CAN should be established wherever possible because multifactorial and lifestyle interventions can then be implemented to prevent or reverse CAN.

• #14 Cardiac Autonomic Neuropathy in Diabetes Mellitus | Methodist DeBakey Cardiovascular J

  https://journal.houstonmethodist.org/articles/10.14797/mdcj-14-4-251

  In general, there are two therapeutic approaches targeting CAN: one aimed at preventing the development or progression of CAN and one targeting symptomatic control of CAN in DM. […] In the DCCT/EDIC study, intensive glycemic control in T1DM reduced the incidence of CAN by more than 50 initially, and although CAN prevalence increased, the benefit was maintained 13 to 14 years out. […] It is less extensively proven that tighter glucose control may be able to reduce the progression of CAN in T2DM; however, weight loss and exercise are known to have a favorable effect. […] Therapies to reverse CAN are limited; however, early detection and lifestyle modification are important in limiting the deleterious effects from severe DM-associated CAN.

• #15 Focus on Diabetic Cardiac Autonomic Neuropathy

  https://www.hcplive.com/view/focus-diabetic-cardiac-autonomic-neuropathy

  DCAN highlights the early systemic effects of diabetes. Given its progressive course and few treatment options, DCAN underscores the importance of prevention. […] Experts advise multivariable lifestyle modification including smoking cessation, exercise, and early therapy targeting strict glycemic control and cardiovascular risk factors. […] Prevention remains the best medicine. […] Given the long, asymptomatic course of DCAN, some advise early evaluation for DCAN, ambulatory blood pressure monitoring, echocardiography, and early treatment in all patients with T2DM, especially those who already have microalbuminuria. […] Overly intensive glycemic control can increase the risk of hypoglycemia and has been linked to increased all-cause and cardiovascular death in T2DM.

• #16 Diabetes Distilled: Cardiovascular autonomic neuropathy – prevention, identification and management – DiabetesontheNet

  https://diabetesonthenet.com/diabetes-primary-care/distilled-cardiovascular-autonomic-neuropathy/

  Cardiovascular autonomic neuropathy (CAN), a common microvascular complication of type 1, type 2 and prediabetes, is underdiagnosed yet has a 5-year mortality rate greater than most cancers, according to this review in Diabetologia. […] Early glycaemic control, ACE inhibitor or ARB use, and multifactorial cardiovascular risk factor management can reduce the risk of CAN developing and slow its progression. […] Optimising glycaemic control and cardiovascular risk factors early may both prevent CAN and, once established, slow its progression. […] This review highlights the important role of early intensive glycaemic and multifactorial risk factor management in people with diabetes, as seen in the Steno-2 study, in potentially reducing the risk of CAN development and progression. […] We could all use ACE inhibitors and ARBs more consistently, which is likely not only to benefit CAN but also to provide renal protection.

• #17 Diabetes Distilled: Cardiovascular autonomic neuropathy – prevention, identification and management – DiabetesontheNet

  https://diabetesonthenet.com/diabetes-primary-care/distilled-cardiovascular-autonomic-neuropathy/

  In the meantime, optimising glycaemia and lipids and encouraging lifestyle changes to achieve weight loss in those with prediabetes and type 2 diabetes, as well as optimising our use of ACE inhibitors and ARBs early, may reduce the number of people who develop this high-risk microvascular complication.

• #18 Update on the Impact, Diagnosis and Management of Cardiovascular Autonomic Neuropathy in Diabetes: What Is Defined, What Is New, and What Is Unmet

  https://e-dmj.org/journal/view.php?doi=10.4093/dmj.2018.0259

  Lifestyle intervention improves autonomic function mostly in pre-diabetes. […] Glycaemic control prevents CAN in T1DM, whereas multifactorial intervention might be effective in T2DM. […] The Toronto Consensus concluded that lifestyle intervention may improve HRV in pre-diabetes and diabetes and recommended that it should be offered as a basic preventive measure. […] The ADA recommends considering lifestyle modifications to improve CAN in patients with pre-diabetes. […] An effective preventive strategy for CAN should include weight control, physical activity, smoking cessation, healthy dietary changes, glycaemic control, control of cardiovascular risk factors like BP and dyslipidemia, and a behavioural approach aimed at stress control, and last but not least, education.

• #19 Autonomic Neuropathy Treatment & Management: Medical Care, Treatments for Specific Conditions, Surgical Care

  https://emedicine.medscape.com/article/1173756-treatment

  Maneuvers to avoid complications of orthostatic hypotension, particularly falls in elderly patients, as described above, are important to avoid further associated morbidity. […] Bladder and gastrointestinal difficulties must be monitored to prevent anuria and bowel obstruction. […] Patients with hypohidrosis/anhidrosis must be cautious in warm climates to avoid excessive heat, preventing heat stroke. […] Foot care is essential in patients with small-fiber neuropathy and diabetic neuropathy. Patients should be instructed to test temperatures with a sensitive limb and to avoid trauma that could have ulcerative complications. […] Patients with dry mouth should be instructed to seek regular dental checkups and be instructed about proper methods of oral hygiene. […] Patients with dry eyes should be given advice regarding proper hydration of the eyes to avoid conjunctival difficulties.

• #20 High dose cholecalciferol supplementation causing morning blood pressure reduction in patients with type 1 diabetes mellitus and cardiovascular autonomic neuropathy | Scientific Reports

  https://www.nature.com/articles/s41598-024-56934-1

  We evaluated the association of cardiovascular autonomic neuropathy (CAN), blood pressure (BP) and Vitamin D (VD) levels before and after high-dose cholecalciferol supplementation (4000/10,000) UI/day) for 12 weeks in patients (N=67) with type 1 diabetes mellitus (T1DM). […] High-dose VD was associated with improved CAN parameters and reduced awake SBP and morning SBP surge. These findings suggest that VD may benefit patients with cardiovascular autonomic neuropathy. […] Therefore, this study aims to evaluate the association between cardiovascular autonomic neuropathy, blood pressure levels and vitamin D levels in T1DM patients before and after supplementation with high doses of cholecalciferol. […] Our study found reductions in total, morning, awake and morning surge SBP, in addition to an improvement in CAN parameters in patients with TDM1 and CAN after high doses of cholecalciferol supplementation. […] Our findings suggest that VD in higher doses could be a potential approach in the treatment of type 1 diabetes mellitus patients with CAN.

• #21 Treatment of autonomic neuropathy in the prevention of diabetic foot ulcers – Acta Vulnologica 2010 June;8(2):73-9 – Minerva Medica – Journals

  https://www.minervamedica.it/en/journals/acta-vulnologica/article.php?cod=R45Y2010N02A0073

  Treatment of autonomic neuropathy in the prevention of diabetic foot ulcers. […] The authors take into consideration Difoprev system, an electrostatic sock positively charged with nanostructured lipid carriers, for the prevention and treatment of autonomic neuropathy in diabetic foot. […] Results obtained demonstrate efficacy and safety of this system with a good skin moisturizing and a reduction of anidrosis and iperkeratosis compared with control group.

• #22

  https://link.springer.com/article/10.1007/s13300-019-00693-0

  Structured lifestyle intervention is recommended already for individuals with IFGIGT combined as they are at high risk for developing T2DM, and this approach is likely to reduce CAN. […] Lifestyle modifications to achieve weight loss including a calorie-controlled diet with regular exercise are an essential component of preventing CAN in obese individuals. […] The Diabetes Prevention Program (DPP) measured indexes of HRV in patients deemed at risk of diabetes including those with obesity and pre-DM. […] The use of bariatric surgery to achieve weight loss in severely obese individuals with NGT and T2DM improves indices of HRV. […] The use of the insulin sensitizer metformin to decrease the rise in postprandial insulin concentrations could lead to a beneficial reduction in insulin-mediated SNS activation, helping to improve cardiac autonomic function.

• #23 Relationship between autonomic and peripheral neuropathies and cardiovascular outcomes in diabetes

  http://www.e-jcpp.org/journal/view.php?number=98

  This review explores the complex relationship between diabetic neuropathy and cardiovascular disease (CVD). […] The review recommends a multidisciplinary approach to diabetes care, including early screening, accurate risk stratification, and targeted therapeutic strategies to prevent or slow the progression of CVD in patients with autonomic and peripheral neuropathies. […] Autonomic neuropathy, which is closely associated with CVD, occurs more frequently than commonly recognized. […] Moreover, closer monitoring and adjustments to medication are recommended during and after surgical procedures. […] Consequently, it may be necessary to promptly evaluate patients exhibiting signs of neuropathy and to employ screening tests and early management strategies for CVD prevention in these individuals, who might face a comparatively high risk. Further research is required to determine the appropriate level of intervention for preventive treatment.

• #24 Neuropathy | Diabetes Standards of Care and Resources for Clinicians and Educators

  https://www.ihs.gov/diabetes/clinician-resources/soc/neuropathy1/

  Neuropathy is a common complication of diabetes affecting multiple organ systems, and is a significant cause of morbidity and mortality. Poor blood glucose control and smoking can significantly increase the risk of neuropathy and its complications. There is no specific treatment for the nerve damage associated with diabetic neuropathy. Improving glycemic control may slow progression, but does not reverse nerve loss. […] Screen patients with diabetes for distal symmetric polyneuropathy (DPN) and autonomic neuropathy at diabetes diagnosis, and then at least annually. […] Autonomic neuropathy is responsible for various cardiovascular, gastrointestinal, and genitourinary clinical problems that can have significant associated morbidity and increased mortality rates. This form of neuropathy can manifest as: resting tachycardia, exercise intolerance, orthostatic hypotension, constipation, gastroparesis, erectile dysfunction, and sudomotor dysfunction. Screening consists of assessing signs and symptoms of autonomic dysfunction when taking the patient’s history and during physical examination. Treatments are available for symptomatic autonomic neuropathy that may improve quality of life, but these treatments do not alter the disease process.

• #25 The ADA Revises its Guidelines on Diabetic Neuropathy – Advances in Diabetes

  https://www.medpagetoday.com/resource-centers/advances-in-diabetes/ada-revises-its-guidelines-diabetic-neuropathy-/962

  Optimal glucose management is the single-most important approach to prevention and treatment of diabetic neuropathy, she says, adding “it’s crucial these patients are identified early for better prognosis.” […] The position statement’s authors note a lack of treatments that specifically target diabetes-inflicted nerve damage, making prevention especially important. In both type 1 and type 2 diabetes, prevention of diabetic neuropathy focuses on glycemic control. […] Treatment of CAN focuses on prevention with early glucose control and lifestyle modifications. […] “Symptom control does not necessarily prevent progression, so a multifaceted approach is necessary. Optimal lifestyle choices have been shown to be effective to lower glucose levels, reduce risk factors, minimize symptoms, and prevent progression,” Dr. Ruhoy says. […] “Diabetes is a lifestyle disease for the most part,” she adds, “and early nutritional and other lifestyle changes can have a profound and exponential impact on patients’ health and well-being.”

• #26 Autonomic Neuropathy in Diabetes Mellitus

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4249492/

  Intensive glycemic control seems to be the most effective way to prevent/delay the onset and slow the progression of autonomic dysfunction in patients with T1DM. […] The best results on prevention of autonomic dysfunction in patients with T2DM seem to be derived by multifactorial strategy treatment and lifestyle modification. […] Prevention strategies are based on strict glycemic control with intensive insulin treatment, multifactorial intervention, and lifestyle modification including control of hypertension, dyslipidemia, stop smoking, weight loss, and adequate physical exercise.

• #27 Autonomic Neuropathy: Definition, Symptoms, Treatments

  https://resources.healthgrades.com/right-care/symptoms-and-conditions/autonomic-neuropathy

  Managing diabetes through effective treatment is key to preventing autonomic neuropathy. […] However, treatments can help slow the progression of autonomic neuropathy and prevent further damage. […] Talk with your doctor if you experience symptoms of autonomic neuropathy so you can begin treatment and prevent further nerve damage.

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