Early diagnosis of diabetic polyneuropathy and the use of alpha-lipoic acid to prevent its progression
A.V. Bregovskaya, A. Yu. Babenko, E.V. Grineva

National Medical Research Center named after V.A. Almazov, St. Petersburg

The literature review is devoted to the issues of early diagnosis of diabetic neuropathy (DN), as well as the possibilities of preventing its progression. DN is one of the most common complications of diabetes mellitus (DM), and it is a pathogenetic factor in the development of the diabetic foot syndrome, which determines the need not only for its diagnosis at preclinical stages, but also for measures to reduce the progression rate. Due to the lack of objective non-invasive methods for assessing the damage of small nerve fibers in the early stages, it is necessary to look for new diagnostic methods, such as corneal confocal microscopy (CMR), which not only makes it possible to assess the degree of damage to the corneal nerves, but also to provide new information about the possibilities of pathogenetic therapy of DN at pre-clinical stages. Currently, the DN therapy is based on the compensation of DM with the minimization of the variability of glycemia during the day, the correction of other complications of diabetes and concomitant diseases, anticonvulsants, antideprimants and opioid analgesics therapy when developing painful forms of DN, as well as pathogenetic therapy aimed at reducing the of the lesion nerve fibers progression. Numerous sources indicate the prescribing of alpha-lipoic acid (ALA) preparations as an effective and safe pathogenetic therapy within the framework of complex DN treatment. The increase in the efficiency of ALA against the background of strict glycemic control is shown, as well as optimal control of cardiovascular complication risks.

Key words: diabetes mellitus, diabetic neuropathy, early diagnosis, small nerve fibres, corneal confocal microscopy, alpha lipoic acid.
For citation: Bregovskaya A.V., Babenko A.Yu., Grineva E.V. Early diagnosis of diabetic polyneuropathy and the use of alpha-lipoic acid to prevent its progression // RMJ. 2018. № 1 (I). P. 41–46.