Blog Entries from May 2014

What is Wearable Medical Technology?

Wednesday, May 28th, 2014

Popular media references to the term “wearable technology” have increased dramatically over the past five years.   What is wearable technology, and more specifically what is wearable medical technology?

There is no technical definition of wearable technology, however most participants in the field probably agree that a wearable product must meet the following criteria:

  • The product must be worn on the user's body for an extended period of time.
  • The product should significantly enhance the user's quality of life, health or experience as a result of the product being worn.
  • The product must contain advanced circuitry, independent processing capability, and wireless or other connectivity.
Wearable medical technology is a wearable product that is designed to improve the user’s health.  This may be accomplished through monitoring of physiological and biological data (e.g., ECG, blood pressure), storage of critical medical information (e.g., medical record), or in the case of SENSUS, delivery of a specific therapeutic benefit such as pain control. Read More

Posted by NeuroMetrix in Wearable Technology

Associations Between Restless Leg Syndrome (RLS) and Diabetic Peripheral Neuropathy (DPN)

Tuesday, May 20th, 2014

Several published studies have described strong associations between restless leg syndrome (RLS) and diabetic peripheral neuropathy (DPN); for example Lopes et al. Diabetes Care. (pubmed.gov/200516249531).   In a recent study published in 2013 by Sadosky and colleagues (pubmed.gov/23403729), half of people with severe painful diabetic neuropathy reported having RLS.   The biological reason for the RLS and DPN association is unknown.  However, a study just published in the journal Neurology (pubmed.gov/24789861) may shed some light on this important question.   Salminen and colleagues demonstrated peripheral hypoxia in patients with RLS.  This finding promotes the hypothesis that peripheral microvascular abnormalities may contribute to the development of RLS.  DPN is a microvascular complication of diabetes, and therefore the results reported in the Saliminen study raise the possibility that diabetic microvascular disease may cause both DPN and RLS.   This interesting hypothesis may suggest novel therapeutic approaches to both conditions. Read More

Posted by NeuroMetrix in Restless Leg Syndrome

The Underdiagnosis and Undertreatment of Painful Diabetic Neuropathy

Tuesday, May 13th, 2014

A study recently published in the Journal of the American Pharmacists Association (http://www.ncbi.nlm.nih.gov/pubmed/24257634) assessed the prevalence of painful diabetic peripheral (PDN) and its impact on quality of life and patient satisfaction with their treatment.  The cross section study evaluated 71 subjects with Type 1 or type 2 diabetes (age 45 – 85 years).  Although 22% of the subjects reported a diagnosis of PDN from their physician, 54% reported symptoms of burning, aching, or tenderness in their hands, arms, legs, or feet.  Only 14% of these patients were receiving treatment for their symptoms.  Among subjects reporting symptoms of PDN, over half reported some level of interference with their sleep and a similar percentage stated dissatisfaction with their current treatment. The authors conclude that PDN may be substantially underdiagnosed and undertreated; which represents a potential opportunity for pharmacists to help patients with diabetes achieve a better quality of life. Read More

Posted by NeuroMetrix in Painful Diabetic Neuropathy

Links Between Obstructive Sleep Apnea and Diabetic Peripheral Neuropathy

Thursday, May 8th, 2014

Obstructive sleep apnea (OSA) is a common disorder that is prevalent in people with Type 2 diabetes.  It is characterized by upper airway instability during sleep, resulting in markedly reduced or absent airflow.  People with untreated sleep apnea frequently stop breathing during their sleep, which results in fragmented, low quality sleep. Diabetic peripheral neuropathy (DPN) affects over 50% of people with diabetes. If left untreated, diabetic neuropathies trigger foot ulcers that may require amputation and cause disabling pain in the form of painful diabetic neuropathy. An interesting study by Tahrani and colleagues published in the American Journal of Respiratory and Critical Care Medicine (http://www.ncbi.nlm.nih.gov/pubmed/22723291) in 2012, evaluated the link between OSA and DPN from both clinical and pathophysiological perspectives.  The prevalence of DPN was 60% in subjects with OSA and only 27% in those without OSA.  The study identified increased nitrosative/oxidative stress and impaired microvascular regulation in OSA subjects.  These are pathophysiological processes that may damage peripheral nerves and thereby cause DPN.  The authors concluded by hypothesizing that OSA treatment, such as CPAP, may have therapeutic benefits in patients with DPN. Read More

Posted by NeuroMetrix in Sleep Disorders

Predictors of Long-term Use of Transcutaneous Electrical Nerve Stimulation

Monday, May 5th, 2014

A recently published prospective study by Koke and colleagues in Pain Practice (http://www.ncbi.nlm.nih.gov/pubmed/24433244) evaluated predictors of long-term (> 6 months) use of transcutaneous electrical nerve stimulation (TENS) in patients with chronic pain.  In a multivariate analysis, independent predictors of long-term use were neuropathic pain, non-severe pain (<80 millimeters on 100 millimeter VAS) and positive expectations of pain relief success. The results of the Koke et al. study re-enforce the positive clinical results patients with neuropathic pain, such as painful diabetic neuropathy, have reported with SENSUS. Read More

Posted by NeuroMetrix in Chronic Pain