Diyabetik Nöropatinin Yönetiminde Güncel Tedavi Yaklaşımları ve Hemşirelik Bakımı

Year 2022, Volume: 12 Issue: 3, 560 - 565, 20.09.2022

Ümit Görgülü Selin Çiftçi Ülkü Polat

https://doi.org/10.33631/sabd.1174408

Cited By: 1

Abstract

Diyabetik nöropati bireylerin yaşam kalitesini etkileyen ve morbidite riski yüksek olan diyabetin en sık görülen nörolojik komplikasyonlarından biridir. Diyabetli birçok kişi, diyabetik nöropati ile ilişkili semptomları veya sorunları bildirmez. Diyabeti olan bireyler, nöropatiye özgü öykü, tarama testi ve fizik muayene yapılarak yıllık olarak taranmalıdır. Bu bireyler kötü yaşam kalitesi, nöropatik ağrı, düşmeler, ayak ülseri gelişimi ve enfeksiyonlar, ampütasyon açısından yüksek risk altındadır. Komplikasyonları en aza indirmek ve yaşam kalitesini iyileştirmek için diyabetik nöropatili bireylerin erken aşamada tanılanması, geçerli ve güvenilir tarama araçları ile değerlendirilmesi ve diyabetik nöropatinin yönetimi önemlidir. Diyabetik nöropatinin yönetimi multidisipliner ekip yaklaşımını gerektirir. Bu ekibin önemli bir üyesi olan hemşirelerin sorumluluklarından bazıları diyabetik nöropatili ve nöropati gelişme riski olan bireylerde farkındalığı artırmak, yüksek riskli gruplar için müdahaleler planlamak, doğru bilgi ve davranış kazanmalarını sağlamaktır. Hemşirenin diyabetik nöropatili bireylerin taranması, teşhisi, tedavisi ve bakım uygulamaları konusunda farkında ve bilgili olması olumsuz sonuçların gelişmesini önlemede veya azaltmada yarar sağlar.

Keywords

Diyabetik nöropati, tarama, tedavi, bakım, hemşirelik

Current Treatment Approaches and Nursing Care in the Management of Diabetic Neuropathy

Abstract

Diabetic neuropathy is one of the most common neurological complications of diabetes with a high risk of morbidity that affects the quality of life of individuals. Many people with diabetes do not report symptoms or problems associated with diabetic neuropathy. All patients with diabetes should be screened annually for neuropathy with a neuropathy-specific history, screening test, and physical examination. These individuals are at high risk for poor quality of life, neuropathic pain, falls, development of foot ulcers and infections, and amputation. In order to minimize complications and improve quality of life, early diagnosis of individuals with diabetic neuropathy, evaluation with valid and reliable screening tools, and management of diabetic neuropathy are important. Management of diabetic neuropathy requires a multidisciplinary team approach. Nurses, who are an important member of this team, are among the responsibilities of nurses to raise awareness of individuals with diabetic neuropathy and those at risk of developing neuropathy, to plan interventions for high-risk groups, and to ensure that they gain correct knowledge and behavior. The nurse's awareness and knowledge about the screening, diagnosis, treatment and care practices of individuals with diabetic neuropathy will be beneficial in preventing or reducing the development of negative outcomes.
Keywords: Diabetic neuropathy; scanning; treatment; care; nursing.

Keywords

Diabetic neuropathy, scanning, treatment, care, nursing

References

• Patel K, Horak H, Tiryaki E. Diabetic neuropathies. Muscle&Nerve. 2021; 63: 22-30.
• Calcutt NA. Diabetic neuropathy and neuropathic pain:a(con)fusion of pathogenic mechanisms? Pain. 2020; 161: 65-86.
• Kioskli K, Scott W, Winkley K, Kylakos S, McCracken LM. Psychosocial factors in painful diabetic neuropathy: A systematic review of treatment trials and survey studies. Pain Medicine. 2019; 20(9): 1756-73.
• Li Z, Lei X, Xu B, Wang S , Gao T , Lv H. Analysis of risk factors of diabetes peripheral neuropathy in type 2 diabetes mellitus and nursing intervention. Exp Ther Med. 2020; 20(6): 127.
• Feldman EL, Callaghan BC, Pop-Busui R, Zochodne DW, Wright DE, Bennett DL, et al. Diabetic neuropathy. Nat Rev Dis Primers. 2019; 5(1): 41.
• Pang L, Lian X, Liu H, Zhang Y, Li Q, Cai Y, et al. Understanding diabetic neuropathy: focus on oxidative stres. Oxid Med Cell Longev. 2020; 9524635.
• Oh J. Clinical spectrum and diagnosis of diabetic neuropathies. Korean J Intern Med. 2020; 35(5): 1059-69.
• Callaghan BC, Fiyat RS, Feldman EL. Distal symmetric polyneuropathy: a review. JAMA. 2015; 314(20): 2172-81.
• Sopacua M, Hoeijmakers JGJ , Merkies ISJ , Lauria G , Waxman SG , Faber CG. Small-fiber neuropathy: expanding the clinical pain universe. J Peripher Nerv Syst. 2019; 24(1): 19-33.
• Wooton AK, Melchior L. Diabetes-associated cardiac autonomic neuropathy. Nurse Pract. 2020; 45(2): 24-31.
• Bharucha AE, Kudva YC, Prichard DO. Diabetic gastroparesis. Endocr Rev. 2019; 40(5): 1318-52.
• Lajmi H, Hmaied W, Ben Jalel W, Chelly Z, Ben Yakhlef A, Ben Zineb F, et al. Oculomotor palsy in diabetics. J Fr Ophtalmol. 2018; 41(1): 45-9.
• Chakraborty PP, Singha A, Bhattacharjee R, Chowdhury S. Abdominal pseudohernia: a manifestation of diabetic truncal radiculoneuropathy. BMJ Case Rep. 2016; 1-2.
• Glenn MD, Jabari D. Diabetic lumbosacral radiculoplexus neuropathy (diabetic amyotrophy). Neurol Clin. 2020; 38(3): 553-64.
• Kaymaz S, Alkan H, Karasu U, Çobankara V. Turkish version of the michigan neuropathy screening ınstrument in the assessment of diabetic peripheral neuropathy: a validity and reliability study. Diabetol Int. 2020; 11(3): 283-92.
• Tavakoli M, Begum P, McLaughlin J, Malik RA. Corneal confocal microscopy for the diagnosis of diabetic autonomic neuropathy. Muscle Nerve. 2015; 52(3): 363-70.
• Bennett, M. The lanss pain scale: the leeds assessment of neuropathic symptoms and signs. Pain. 2001; 92(1-2):147-57.
• Alkan H, Ardic F, Erdogan C, Sahin F, Sarsan A, Findikoglu G. Turkish version of the painDETECT questionnaire in the assessment of neuropathic pain: a validity and reliability study. Pain Med. 2013; 14(12): 1933-43.
• Rosenberger DC, Blechschmidt V, Timmerman H,Wolff A, Treede RD. Challenges of neuropathic pain: focus on diabetic neuropathy. J Neural Transm (Vienna). 2020; 127(4): 589-624.
• Kluding PM, Pasnoor M, Singh R, Jernigan S, Farmer K, Rucker J, et al. The effect of exercise on neuropathic symptoms, nerve function, and cutaneous innervation in people with diabetic peripheral neuropathy. J Diabetes Complications. 2012; 26: 424–9.
• Callaghan BC, Little AA, Feldman EL, Hughes RA. Enhanced glucose control for preventing and treating diabetic neuropathy. Cochrane Database Syst Rev. 2012; 6(6): CD007543.
• Zheng Y, Ley SH, Hu FB. Global aetiology and epidemiology of type 2 diabetes mellitus and its complications. Nat Rev Endocrinol. 2018; 14(2): 88-98.
• Yüksel M, Bektaş H. Diyabete bağlı kronik komplikasyonların yönetiminde güncel yaklaşımlar. Turkiye Klinikleri J Nurs Sci. 2020; 12(1): 133-57.
• Armstrong DG, Boulton AJ, Bus SA. Diabetic foot ulcers and their recurrence. N Engl J Med. 2017; 376(24): 2367-75.
• Mishra SC, Chhatbar KC, Kashikar A, Mehndiratta A. Diabetic foot. BMJ. 2017; 359: j5064.
• Schaper NC, Van Netten JJ, Apelqvist J, Lipsky BA, Bakker K, International Working Group on the Diabetic Foot (IWGDF). Prevention and management of foot problems in diabetes: a summary guidance for daily practice 2015, based on the ıwgdf guidance documents. Diabetes Metab Res Rev. 2016; 32(1): 7-15.
• Şen HM, Şen H, Aşık M, Özkan A, Binnetoglu E, Erbağ GK, et al.. The importance of education in diabetic foot care of patients with diabetic neuropathy. Exp Clin Endocrinol Diabetes. 2015; 123(03): 178- 81.
• Bril V, England J, Franklin GM, Backonja M, Cohen J, Del Toro D, et al. Evidence-based guideline : treatment of painful diabetic neuropathy: report of the american academy of neurology, the american association of neuromuscular and electrodiagnostic medicine, and the american academy of physical medicine and rehabilitation. Neurology. 2011;76(20): 1758-65.
• Freeman R, Durso-Decruz E, Emir B. Efficacy, safety, and tolerability of pregabalin treatment for painful diabetic peripheral neuropathy: findings from seven randomized, controlled trials across a range of doses. Diabetes Care. 2008; 31(7): 1448-54.
• Jin D, Xu Y, Geng D, Yan T. Effect of transcutaneous electrical nevre stimulation on symptomatic diabetic peripheral neuropathy: a metaanalysis of randomized controlled trials. Diabetes Res Clin Pract. 2010; 89(1): 10-5.
• Onesti E, Gabriele M, Cambieri C, Ceccanti M, Raccah R, Di Stefano G, et al. H-coil repetitive transcranial magnetic stimulation for pain relief in patients with diabetic neuropathy. Eur J Pain. 2013; 17(9): 1347-56.
• Slangen R, Schaper NC, Faber CG, Joosten EA, Dirksen CD, van Dongen RT, et al. Spinal cord stimulation and pain relief in painful diabetic peripheral neuropathy: a prospective two-center randomized controlled trial. Diabetes Care. 2014; 37(11): 3016-24.
• Ibrahim MM, Rizk SMA, The efficacy of foot reflexology on the reduction of peripheral diabetic neuropathic pain. J Nurs Health Sci. 2018; 7(5): 44-55.
• Gok Metin Z, Arikan Donmez A, Izgu N, Ozdemir L, Arslan IE . Aromatherapy massage for neuropathic pain and quality of life in diabetic patients. J Nurs Scholarsh. 2017; 49(4): 379-88.
• Dixit S, Maiya A, Shastry B. Effect of aerobic exercise on quality of life in population with diabetic peripheral neuropathy in type 2 diabetes: a single blind, randomized controlled trial. Qual Life Res. 2014; 23(5): 1629-40.
• Koçak FA, Kurt EE, Koçak Y, Şaş S, Tuncay F, Erdem HR. Diyabetik nöropatik ağrılı hastalarda kaplıca tedavisinin ağrı, uyku ve yaşam kalitesi üzerine etkisi. Van Tıp Derg. 2019; 26(2): 186-94.
• Agustini N LP I B, Wulansari NT, Yusniawati YNP, Sintia NW. The effect of foot massage on decreasing peripheral neuropathy diabetic complaints in the patients with type 2 diabetes mellitus. Jurnal Ners. 2019; 14(3si): 305-9.
• Kartika AW, Widyatuti W, Rekawati E. The effectiveness of home-based nursing intervention in the elderly with recurrent diabetic foot ulcers: a case report. J Public Health Res. 202114; 10(2): 2162.