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Peripheral Neuropathy and Nursing Care in Individuals with Diabetes Mellitus

Yıl 2023, Cilt: 2 Sayı: 3, 113 - 118, 11.01.2024

Semanur Bilgiç Burcu Bayrak Kahraman

https://doi.org/10.59398/ahd.1371075

Öz

Diabetes Mellitus is a metabolic disease characterized by hyperglycemia that is caused by insufficiency, deficiency, or absence of insulin hormone. As a result of secondary metabolic and microvascular changes that develop during this chronic hyperglycemia process, the trunk, axon, and myelin sheath of nerve fibers are damaged, which leads to diabetic peripheral neuropathy, one of the most common complications in individuals with diabetes mellitus. Diabetic peripheral neuropathy, which presents with numbness, tingling, paresthesia, sensory loss, muscle weakness, hyperalgesia, and allodynia, affects all peripheral nerves, including pain fibers and motor neurons. It may cause sensory and reflex losses, falls, infections, ulcerations, diabetic foot wounds, and amputation and increase mortality and morbidity rates. For this reason, in the diagnosis and treatment of diabetic peripheral neuropathy, it is necessary to take patients' medical history, examine their current condition in detail, and perform regular screenings. The nurse has an important role in the multidisciplinary team needed in the diagnosis, treatment, and prevention of diabetic peripheral neuropathy.

Anahtar Kelimeler

diabetes mellitus diabetic peripheral neuropathy nursing care

Kaynakça

  • Petersmann A, Müller-Wieland D, Müller U A, Landgraf R, Nauck M, Freckmann G, et al. Definition, Classification and Diagnosis of Diabetes Mellitus. Experimental and clinical endocrinology & diabetes: official journal, German Society of Endocrinology (and) German Diabetes Association. 2019;127:1–7.
  • Demir S, Nawroth P P, Herzig S, & Ekim Üstünel B. Emerging Targets in Type 2 Diabetes and Diabetic Complications. Advanced science (Weinheim, Baden-Wurttemberg, Germany). 2021;8(18).
  • International Diabetes Federation (IDF) Diabetes Atlas 10th Edition. (2021). IDF_Atlas_10th_Edition_2021.pdf (diabetesatlas.org) (Erişim Tarihi: 19.07.2023).
  • Castelli G, Desai K M, & Cantone R E. Peripheral Neuropathy: Evaluation and Differential Diagnosis. American family physician. 2020;102(12):732–739.
  • Liu X, Xu Y, An M, & Zeng Q. The risk factors for diabetic peripheral neuropathy: A meta-analysis. PloS one. 2019;14(2).
  • International Diabetes Federation (IDF) Diabetes Atlas 9th Edition. (2019). https://www.diabetesatlas.org/upload/resources/material/20200302_133351_IDFATLAS9e-final-web.pdf (Erişim Tarihi: 19.07.2023)
  • Bağrıaçık E, & Aydın, N. Diyabete Bağlı Periferal Nöropatide Geleneksel Uygulamalar. İzmir Demokrasi Üniversitesi Sağlık Bilimleri Dergisi. 2020;3(3):170-176.
  • Ertur E, Vural Keskinler M, Çakır İ B, Erbakan A, & Oğuz A. Tip 2 Diyabetli Hastalarda Diyabetik Periferik Nöropati Sıklığı, İlişkili Faktörler ve Farkındalık Durumunun Değerlendirilmesi. Kocaeli Üniversitesi Sağlık Bilimleri Dergisi. 2020;6(3):180-185.
  • Ziegler D, Papanas N, Vinik A I, & Shaw J E. Epidemiology of polyneuropathy in diabetes and prediabetes. Handbook of clinical neurology. 2014;126:3–22.
  • Sharma S, & Rayman G. Frontiers in diagnostic and therapeutic approaches in diabetic sensorimotor neuropathy (DSPN). Frontiers in endocrinology. 2023;14.
  • Sloan G, Selvarajah D. & Tesfaye S. Pathogenesis, diagnosis and clinical management of diabetic sensorimotor peripheral neuropathy. Nature reviews. Endocrinology. 2021;17(7):400–420.
  • Yang K, Wang Y, Li Y W, Chen Y G, Xing N, Lin H B, et al. Progress in the treatment of diabetic peripheral neuropathy. Biomedicine & pharmacotherapy = Biomedecine & pharmacotherapie. 2022;148.
  • Carmichael J, Fadavi H, Ishibashi F, Shore A C, & Tavakoli M. Advances in Screening, Early Diagnosis and Accurate Staging of Diabetic Neuropathy. Frontiers in endocrinology. 2021;12.
  • Elafros M A, Andersen H, Bennett D L, Savelieff M G, Viswanatha, V, Callaghan B C, et al. Towards prevention of diabetic peripheral neuropathy: clinical presentation, pathogenesis, and new treatments. The Lancet. Neurology. 2022;21(10):922–936.
  • Jensen T S, Karlsson P, Gylfadottir S S, Andersen S T, Bennett D L, Tankisi H, et al. Painful and non-painful diabetic neuropathy, diagnostic challenges and implications for future management. Brain: a journal of neurology. 2021;144(6):1632–1645.
  • Selvarajah D, Kar D, Khunti K, Davies M J, Scott A R, Walker J, et al. Diabetic peripheral neuropathy: advances in diagnosis and strategies for screening and early intervention. The lancet. Diabetes & endocrinology. 2019;7(12):938–948.
  • Chang M C, & Yang S. Diabetic peripheral neuropathy essentials: a narrative review. Annals of palliative medicine. 2023;12(2):390–398.
  • Tanırlar M. Deni̇zli İli̇nde Bi̇ri̇nci̇ Basamak Sağlık Kuruluşlarında Çalışan Heki̇mleri̇n Di̇yabeti̇k Nöropati̇ Konusundaki̇ Bi̇lgi̇ Düzeyi̇ ve Yaklaşımlarının Değerlendi̇ri̇lmesi. (2016). (Uzmanlık Tezi, Pamukkale Üniversitesi Tıp Fakültesi)
  • Wu B, Niu Z, & Hu F. Study on Risk Factors of Peripheral Neuropathy in Type 2 Diabetes Mellitus and Establishment of Prediction Model. Diabetes & Metabolism Journal. 2021;45(4):526–538.
  • Görgülü Ü, Çiftçi S, & Polat Ü. Diyabetik Nöropatinin Yönetiminde Güncel Tedavi Yaklaşımları ve Hemşirelik Bakımı. Sağlık Bilimlerinde Değer. 2022;12(3):560-565.
  • Reyhanioğlu Aktar D, Adıyaman S C, Bektaş M, Bulut O, Saydam Özgen B, Bayraktar F, ve ark. (2020). Validity and reliability of the Turkish version of the Michigan Neuropathy Screening Instrument, Turkish Journal of Medical Sciences: Vol. 50: No. 4, Article 19.
  • Kaymaz S, Aykan S A, Uyar Köylü S, & İkiz Kaymaz T. The Validity and Reliability of the Turkish Version of the Toronto Clinical Scoring System, J PMR Sci. 2019;22(2):41-47.
  • Feldman E L, Stevens M J, Thomas P K, Brown M B, Canal N, & Greene D A. A practical two-step quantitative clinical and electrophysiological assessment for the diagnosis and staging of diabetic neuropathy. Diabetes care. 1994;17(11):1281–1289.
  • Bril V, & Perkins B A. Validation of the Toronto Clinical Scoring System for diabetic polyneuropathy. Diabetes care. 2002;25(11):2048–2052.
  • Fateh HR, Madani S P, & Heshmat R. Correlation of Michigan neuropathy screening instrument, United Kingdom screening test and electrodiagnosis for early detection of diabetic peripheral neuropathy. J Diabetes Metab Disord. 2016;15.
  • Matalqah L M, Yehya A, & Radaideh K M. Pharmacist-lead screening for diabetic peripheral neuropathy using Michigan Neuropathy Screening Instrument (MNSI). The International journal of neuroscience. 2022:1–7.
  • Karatas G, & Ertınmaz Ozkan A. Diyabetik Polinöropatiyi Predikte Eden Bağımsız Klinik ve Demografik Faktörler. Türkiye Diyabet ve Obezite Dergisi. 2020;4(1):11-15.
  • Cevik A B, & Olgun N. The Predictors of Painful Diabetic Neuropathy and Its Effect on Quality of Life. Pain management nursing: official journal of the American Society of Pain Management Nurses. 2022;23(3):345–352.
  • Javed S, Hayat T, Menon L, Alam U, & Malik R A. Diabetic peripheral neuropathy in people with type 2 diabetes: too little too late. Diabetic medicine: a journal of the British Diabetic Association. 2020;37(4):573–579.
  • Ernandes R C, Brech G C, Luna N M S, Bega A, GuimarÃes D S, Bocalini D S, et al. Impact of Dıabetıc Neuropathy on Qualıty of Lıfe And Postural Balance in Brazılıan Older Adults. Acta ortopedica brasileira. 2020;28(6):275–279.
  • Preston F G, Riley D R, Azmi S, & Alam U. Painful Diabetic Peripheral Neuropathy: Practical Guidance and Challenges for Clinical Management. Diabetes, metabolic syndrome and obesity: targets and therapy. 2023;16:1595–1612.
  • Bayram E, & Elçioğlu K. Diyabetik Nöropatiye Güncel Tedavi Yaklaşımları. Marmara Pharmaceutical Journal. 2016;20(3):252-262.
  • Feldman E L, Callaghan B C, Pop-Busui R, Zochodne D W, Wright D E, Bennett D L, et al. Diabetic neuropathy. Nature reviews. Disease primers. 2019;5(1):42.
  • İmamoğlu Ş, & Özyardımcı Ersoy, C. (Eds.). Diabetes Mellitus Tanı, Tedavi ve İzlemi. Bursa: Bursa Uludağ Üniversitesi Tıp Fakültesi Yayınları. 2022. https://acikerisim.uludag.edu.tr/bitstream/11452/30068/4/Diabetes_mellitusun_tan%C4%B1_tedavi_ve_izlemi.pdf#page=212 (Erişim Tarihi: 09.08.2023)
  • Malik R A, Andag-Silva A, Dejthevaporn C, Hakim M, Koh J S, Pinzon R, et al. Diagnosing peripheral neuropathy in South-East Asia: A focus on diabetic neuropathy. Journal of diabetes investigation. 2020;11(5):1097–1103.
  • Pop-Busui R, Boulton A J, Feldman E L, Bril V, Freeman R, Malik R A, et al. Diabetic Neuropathy: A Position Statement by the American Diabetes Association. Diabetes care. 2017;40(1):136–154.
  • Mustapa A, Justine M, Mohd Mustafah N, Jamil N, & Manaf H. Postural Control and Gait Performance in the Diabetic Peripheral Neuropathy: A Systematic Review. BioMed research international. 2016;9305025.
  • Anastasi J K, & Klug C. Diabetic peripheral neuropathy: Person-centered care. Nursing. 2021;51(4):34–40.

Diabetes Mellitusu Olan Bireylerde Periferal Nöropati ve Hemşirelik Bakımı

Yıl 2023, Cilt: 2 Sayı: 3, 113 - 118, 11.01.2024

Semanur Bilgiç Burcu Bayrak Kahraman

https://doi.org/10.59398/ahd.1371075

Öz

Diabetes Mellitus; insülin hormonunun yetersizliği, eksikliği veya yokluğu sonucu gelişen hiperglisemi ile karakterize metabolik bir hastalıktır. Bu kronik hiperglisemi sürecinde gelişen sekonder metabolik ve mikrovasküler değişiklikler sonucu sinir liflerinin gövde, akson ve miyelin kılıfı hasar görmekte; diabetes mellitusu olan bireylerde en sık karşılaşılan komplikasyonlardan biri olan diyabetik periferal nöropati oluşmaktadır. Diyabetik periferal nöropati ağrı lifleri, motor nöronlar dahil tüm periferik sinirleri etkilemekte; uyuşma hissi, karıncalanma, parestezi, duyu kaybı, kas güçsüzlüğü, hiperaljezi ve allodini ile belirti vermektedir. Diyabetik periferal nöropati duyu ve refleks kayıplarına, düşmelere, enfeksiyonlara, ülserasyonlara, diyabetik ayak yarasına ve ampütasyonlara kadar ilerleyebilmekte; mortalite ve morbidite oranlarını arttırmaktadır. Bu yüzden diyabetik periferal nöropati tanılama, teşhis ve tedavisinde hastanın tıbbi öyküsünün ve mevcut durumunun detaylı olarak incelenmesi, düzenli aralıklarla taramalar yapılması gerekmektedir. Diyabetik periferal nöropati tanı, tedavi ve önlenmesinde ihtiyaç duyulan multidisipliner ekip içerisinde hemşire önemli bir role sahiptir.

Anahtar Kelimeler

hemşire diyabetik periferal nöropati hemşirelik bakımı

Kaynakça

  • Petersmann A, Müller-Wieland D, Müller U A, Landgraf R, Nauck M, Freckmann G, et al. Definition, Classification and Diagnosis of Diabetes Mellitus. Experimental and clinical endocrinology & diabetes: official journal, German Society of Endocrinology (and) German Diabetes Association. 2019;127:1–7.
  • Demir S, Nawroth P P, Herzig S, & Ekim Üstünel B. Emerging Targets in Type 2 Diabetes and Diabetic Complications. Advanced science (Weinheim, Baden-Wurttemberg, Germany). 2021;8(18).
  • International Diabetes Federation (IDF) Diabetes Atlas 10th Edition. (2021). IDF_Atlas_10th_Edition_2021.pdf (diabetesatlas.org) (Erişim Tarihi: 19.07.2023).
  • Castelli G, Desai K M, & Cantone R E. Peripheral Neuropathy: Evaluation and Differential Diagnosis. American family physician. 2020;102(12):732–739.
  • Liu X, Xu Y, An M, & Zeng Q. The risk factors for diabetic peripheral neuropathy: A meta-analysis. PloS one. 2019;14(2).
  • International Diabetes Federation (IDF) Diabetes Atlas 9th Edition. (2019). https://www.diabetesatlas.org/upload/resources/material/20200302_133351_IDFATLAS9e-final-web.pdf (Erişim Tarihi: 19.07.2023)
  • Bağrıaçık E, & Aydın, N. Diyabete Bağlı Periferal Nöropatide Geleneksel Uygulamalar. İzmir Demokrasi Üniversitesi Sağlık Bilimleri Dergisi. 2020;3(3):170-176.
  • Ertur E, Vural Keskinler M, Çakır İ B, Erbakan A, & Oğuz A. Tip 2 Diyabetli Hastalarda Diyabetik Periferik Nöropati Sıklığı, İlişkili Faktörler ve Farkındalık Durumunun Değerlendirilmesi. Kocaeli Üniversitesi Sağlık Bilimleri Dergisi. 2020;6(3):180-185.
  • Ziegler D, Papanas N, Vinik A I, & Shaw J E. Epidemiology of polyneuropathy in diabetes and prediabetes. Handbook of clinical neurology. 2014;126:3–22.
  • Sharma S, & Rayman G. Frontiers in diagnostic and therapeutic approaches in diabetic sensorimotor neuropathy (DSPN). Frontiers in endocrinology. 2023;14.
  • Sloan G, Selvarajah D. & Tesfaye S. Pathogenesis, diagnosis and clinical management of diabetic sensorimotor peripheral neuropathy. Nature reviews. Endocrinology. 2021;17(7):400–420.
  • Yang K, Wang Y, Li Y W, Chen Y G, Xing N, Lin H B, et al. Progress in the treatment of diabetic peripheral neuropathy. Biomedicine & pharmacotherapy = Biomedecine & pharmacotherapie. 2022;148.
  • Carmichael J, Fadavi H, Ishibashi F, Shore A C, & Tavakoli M. Advances in Screening, Early Diagnosis and Accurate Staging of Diabetic Neuropathy. Frontiers in endocrinology. 2021;12.
  • Elafros M A, Andersen H, Bennett D L, Savelieff M G, Viswanatha, V, Callaghan B C, et al. Towards prevention of diabetic peripheral neuropathy: clinical presentation, pathogenesis, and new treatments. The Lancet. Neurology. 2022;21(10):922–936.
  • Jensen T S, Karlsson P, Gylfadottir S S, Andersen S T, Bennett D L, Tankisi H, et al. Painful and non-painful diabetic neuropathy, diagnostic challenges and implications for future management. Brain: a journal of neurology. 2021;144(6):1632–1645.
  • Selvarajah D, Kar D, Khunti K, Davies M J, Scott A R, Walker J, et al. Diabetic peripheral neuropathy: advances in diagnosis and strategies for screening and early intervention. The lancet. Diabetes & endocrinology. 2019;7(12):938–948.
  • Chang M C, & Yang S. Diabetic peripheral neuropathy essentials: a narrative review. Annals of palliative medicine. 2023;12(2):390–398.
  • Tanırlar M. Deni̇zli İli̇nde Bi̇ri̇nci̇ Basamak Sağlık Kuruluşlarında Çalışan Heki̇mleri̇n Di̇yabeti̇k Nöropati̇ Konusundaki̇ Bi̇lgi̇ Düzeyi̇ ve Yaklaşımlarının Değerlendi̇ri̇lmesi. (2016). (Uzmanlık Tezi, Pamukkale Üniversitesi Tıp Fakültesi)
  • Wu B, Niu Z, & Hu F. Study on Risk Factors of Peripheral Neuropathy in Type 2 Diabetes Mellitus and Establishment of Prediction Model. Diabetes & Metabolism Journal. 2021;45(4):526–538.
  • Görgülü Ü, Çiftçi S, & Polat Ü. Diyabetik Nöropatinin Yönetiminde Güncel Tedavi Yaklaşımları ve Hemşirelik Bakımı. Sağlık Bilimlerinde Değer. 2022;12(3):560-565.
  • Reyhanioğlu Aktar D, Adıyaman S C, Bektaş M, Bulut O, Saydam Özgen B, Bayraktar F, ve ark. (2020). Validity and reliability of the Turkish version of the Michigan Neuropathy Screening Instrument, Turkish Journal of Medical Sciences: Vol. 50: No. 4, Article 19.
  • Kaymaz S, Aykan S A, Uyar Köylü S, & İkiz Kaymaz T. The Validity and Reliability of the Turkish Version of the Toronto Clinical Scoring System, J PMR Sci. 2019;22(2):41-47.
  • Feldman E L, Stevens M J, Thomas P K, Brown M B, Canal N, & Greene D A. A practical two-step quantitative clinical and electrophysiological assessment for the diagnosis and staging of diabetic neuropathy. Diabetes care. 1994;17(11):1281–1289.
  • Bril V, & Perkins B A. Validation of the Toronto Clinical Scoring System for diabetic polyneuropathy. Diabetes care. 2002;25(11):2048–2052.
  • Fateh HR, Madani S P, & Heshmat R. Correlation of Michigan neuropathy screening instrument, United Kingdom screening test and electrodiagnosis for early detection of diabetic peripheral neuropathy. J Diabetes Metab Disord. 2016;15.
  • Matalqah L M, Yehya A, & Radaideh K M. Pharmacist-lead screening for diabetic peripheral neuropathy using Michigan Neuropathy Screening Instrument (MNSI). The International journal of neuroscience. 2022:1–7.
  • Karatas G, & Ertınmaz Ozkan A. Diyabetik Polinöropatiyi Predikte Eden Bağımsız Klinik ve Demografik Faktörler. Türkiye Diyabet ve Obezite Dergisi. 2020;4(1):11-15.
  • Cevik A B, & Olgun N. The Predictors of Painful Diabetic Neuropathy and Its Effect on Quality of Life. Pain management nursing: official journal of the American Society of Pain Management Nurses. 2022;23(3):345–352.
  • Javed S, Hayat T, Menon L, Alam U, & Malik R A. Diabetic peripheral neuropathy in people with type 2 diabetes: too little too late. Diabetic medicine: a journal of the British Diabetic Association. 2020;37(4):573–579.
  • Ernandes R C, Brech G C, Luna N M S, Bega A, GuimarÃes D S, Bocalini D S, et al. Impact of Dıabetıc Neuropathy on Qualıty of Lıfe And Postural Balance in Brazılıan Older Adults. Acta ortopedica brasileira. 2020;28(6):275–279.
  • Preston F G, Riley D R, Azmi S, & Alam U. Painful Diabetic Peripheral Neuropathy: Practical Guidance and Challenges for Clinical Management. Diabetes, metabolic syndrome and obesity: targets and therapy. 2023;16:1595–1612.
  • Bayram E, & Elçioğlu K. Diyabetik Nöropatiye Güncel Tedavi Yaklaşımları. Marmara Pharmaceutical Journal. 2016;20(3):252-262.
  • Feldman E L, Callaghan B C, Pop-Busui R, Zochodne D W, Wright D E, Bennett D L, et al. Diabetic neuropathy. Nature reviews. Disease primers. 2019;5(1):42.
  • İmamoğlu Ş, & Özyardımcı Ersoy, C. (Eds.). Diabetes Mellitus Tanı, Tedavi ve İzlemi. Bursa: Bursa Uludağ Üniversitesi Tıp Fakültesi Yayınları. 2022. https://acikerisim.uludag.edu.tr/bitstream/11452/30068/4/Diabetes_mellitusun_tan%C4%B1_tedavi_ve_izlemi.pdf#page=212 (Erişim Tarihi: 09.08.2023)
  • Malik R A, Andag-Silva A, Dejthevaporn C, Hakim M, Koh J S, Pinzon R, et al. Diagnosing peripheral neuropathy in South-East Asia: A focus on diabetic neuropathy. Journal of diabetes investigation. 2020;11(5):1097–1103.
  • Pop-Busui R, Boulton A J, Feldman E L, Bril V, Freeman R, Malik R A, et al. Diabetic Neuropathy: A Position Statement by the American Diabetes Association. Diabetes care. 2017;40(1):136–154.
  • Mustapa A, Justine M, Mohd Mustafah N, Jamil N, & Manaf H. Postural Control and Gait Performance in the Diabetic Peripheral Neuropathy: A Systematic Review. BioMed research international. 2016;9305025.
  • Anastasi J K, & Klug C. Diabetic peripheral neuropathy: Person-centered care. Nursing. 2021;51(4):34–40.
Toplam 38 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Dahili Hastalıklar Hemşireliği
Bölüm Derlemeler
Yazarlar

Semanur Bilgiç 0000-0001-9839-0307

Burcu Bayrak Kahraman 0000-0003-2301-1274

Yayımlanma Tarihi 11 Ocak 2024
Gönderilme Tarihi 4 Ekim 2023
Yayımlandığı Sayı Yıl 2023 Cilt: 2 Sayı: 3

Kaynak Göster

Vancouver Bilgiç S, Bayrak Kahraman B. Diabetes Mellitusu Olan Bireylerde Periferal Nöropati ve Hemşirelik Bakımı. Akd Hemsirelik D. 2024;2(3):113-8.
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