Publications by authors named "Troels Jensen"
Diabetic peripheral neuropathy (DPN) is length-dependent peripheral nerve damage arising as a complication of type 1 or type 2 diabetes in up to 50% of patients. DPN poses a substantial burden on patients, who can experience impaired gait and loss of balance, predisposing them to falls and fractures, and neuropathic pain, which is frequently difficult to treat and reduces quality of life. Advanced DPN can lead to diabetic foot ulcers and non-healing wounds that often necessitate lower-limb amputation.
View Article and Find Full Text PDFArticle Synopsis
- The study explored genetic links to neuropathic pain by comparing individuals with the condition to those who had injuries but did not experience neuropathic pain.
- Key findings included significant associations with the KCNT2 gene and pain intensity, as well as other genes like LHX8 and TCF7L2 connected to neuropathic pain.
- The research also highlighted the influence of polygenic risk scores related to depression and inflammation on neuropathic pain, while discovering novel genetic variants tied to specific sensory profiles.
Background: Neuropathic pain is pain due to a disease or lesion of the somatosensory system, and can be either spontaneous, evoked or both. Hyperpathia is a type of evoked pain defined by IASP as 'a painful syndrome characterized by an abnormally painful reaction to a stimulus, especially a repetitive stimulus, as well as an increased threshold'. The literature is sparse, and definitions are unclear and inconsistent.
View Article and Find Full Text PDFBackground And Objectives: There is a need for knowledge regarding the natural course of diabetic polyneuropathy (DPN), a complication in type 2 diabetes (T2D). The aim of this study was to examine the development of DPN over time.
Methods: Patients with newly diagnosed T2D, recruited from a national cohort, and controls without diabetes of similar age and sex, underwent sensory phenotyping in 2016-2018.
Article Synopsis
- The study investigates the reasons behind why some patients experience painful polyneuropathy while others do not, utilizing data from 1181 patients in the DOLORISK database.
- Researchers used multivariate logistic regression and machine learning to identify key factors related to painful neuropathy, including severity of neuropathy, family history of chronic pain, fatigue, depression scores, and pain-related worrying.
- The findings suggest that emotional and clinical factors play a significant role in the development of painful neuropathy, with predictive models achieving over 76% accuracy, which could help in identifying patients at risk in the future.
Importance: The past several decades have witnessed substantial changes in treatments that are particularly relevant for older patients.
Objectives: To assess changes in national-level incidence rates of fracture- and musculoskeletal-related (ie, arthritis-related) hip replacement procedures for individuals aged 40 to 104 years over a 23-year period in Denmark.
Design, Setting, And Participants: This cohort study used national Danish health registers to include the Danish population aged 40 to 104 years from January 1, 1996, to December 31, 2018.
Correction: Effect of an entry-to-care intervention on diabetes distress in individuals with newly diagnosed type 2 diabetes: a study protocol for a cluster-randomized trial.
Trials
April 2024
Background: Diabetes distress (DD) affects at least 36% of T2DM patients and is often associated with insufficient support and care. This study examines an intervention that targets DD through enhanced cross-sectoral collaboration and treatment during the first 3 months following diagnosis. The intervention aims to improve care and self-management and to reduce DD.
View Article and Find Full Text PDFObjective: To investigate the longitudinal development of neurofilament light chain (NfL) levels in type 2 diabetes with and without diabetic polyneuropathy (+/-DPN) and to explore the predictive potential of NfL as a biomarker for DPN.
Research Design And Methods: We performed retrospective longitudinal case-control analysis of data from 178 participants of the Anglo-Danish-Dutch Study of Intensive Treatment in People with Screen-Detected Diabetes in Primary Care-Denmark (ADDITION-Denmark) cohort of people with screen-detected type 2 diabetes. Biobank samples acquired at the ADDITION-Denmark 5- and 10-year follow-ups were analyzed for serum NfL (s-NfL) using single-molecule array, and the results were compared with established reference material to obtain NfL z-scores.
Background And Objectives: In Parkinson's disease (PD) patients, verbal suggestions have been shown to modulate motor and clinical outcomes in treatment with subthalamic deep brain stimulation (DBS). Furthermore, DBS may alleviate pain in PD. However, it is unknown if verbal suggestions influence DBS' effects on pain.
View Article and Find Full Text PDFObjectives: To assess the agreement between clinical cardiovascular adrenergic function and cardiac adrenergic innervation in type 2 diabetes patients (T2D).
Methods: Thirty-three patients with T2D were investigated bimodally through (1) a standardized clinical cardiovascular adrenergic assessment, evaluating adequacy of blood pressure responses to the Valsalva maneuver and (2) I-meta-iodobenzylguanidine (MIBG) scintigraphy assessing myocardial adrenergic innervation measured as early and delayed heart heart/mediastinum (H/M) ratio, and washout rate (WR).
Results: T2D patients had significantly lower early and delayed H/M-ratios, and lower WR, compared to laboratory specific reference values.
Article Synopsis
- * Data from 178 participants with type 2 diabetes and 32 healthy controls were analyzed, revealing that NfL levels were significantly higher in those with DPN compared to those without.
- * While NfL may not be a dependable indicator for the presence of DPN, it is associated with the severity of nerve damage related to the condition.
Purpose: We assessed long-term outcomes in acutely admitted adult patients with delirium treated in intensive care unit (ICU) with haloperidol versus placebo.
Methods: We conducted pre-planned analyses of 1-year outcomes in the Agents Intervening against Delirium in the ICU (AID-ICU) trial, including mortality and health-related quality of life (HRQoL) assessed by Euroqol (EQ) 5-dimension 5-level questionnaire (EQ-5D-5L) index values and EQ visual analogue scale (EQ VAS) (deceased patients were assigned the numeric value zero). Outcomes were analysed using logistic and linear regressions with bootstrapping and G-computation, all with adjustment for the stratification variables (site and delirium motor subtype) and multiple imputations for missing HRQoL values.
Article Synopsis
- The article discusses the progress made in pain research over the past 50 years since the founding of the International Association for the Study of Pain.
- It focuses on three main areas: basic science preclinical research, clinical research, and psychological research.
- Key findings and trends in each of these areas are highlighted, showing how the understanding and treatment of pain have evolved.
Article Synopsis
- The study aimed to examine structural changes in skin Schwann cells and nerves in individuals with diabetic polyneuropathy, particularly in those with type 1 diabetes, and how these changes relate to neuropathic symptoms.
- Skin biopsies were analyzed from four groups: individuals with type 1 diabetes without neuropathy, with painless neuropathy, with painful neuropathy, and healthy controls, using immunostaining to visualize Schwann cells and nerve fibers.
- Results showed significant differences in Schwann cell and nerve fiber density among the groups, particularly between those with diabetic neuropathy and healthy controls, while correlations indicated a link between these structural changes and neuropathic symptoms.
Article Synopsis
- This study investigates the impact of placebo analgesia (pain relief) and nocebo hyperalgesia (pain increase) in patients with mild-to-moderate Alzheimer's disease (AD), which is not well understood.
- Twenty-one AD patients and 26 healthy participants were exposed to thermal pain under different conditions involving lidocaine and capsaicin, with verbal suggestions to influence pain perception.
- Results showed that healthy participants experienced placebo effects, while AD patients did not show significant placebo or nocebo effects, suggesting that AD might limit these phenomena, which is important for clinical trial design and treatment approaches.
Article Synopsis
- * A study of 1,090 patients showed that 30% with neuropathic pain experienced PHS, while only 2% of healthy participants did, and its occurrence was not related to overall pain intensity.
- * PHS may indicate diminished function of small thermosensory fibers that detect temperature; recognizing it can assist in identifying small fiber loss in patients, making it easy for them to self-report.
Background: Neuropathic pain is common and difficult to treat. The sodium channel blocker lacosamide is efficacious in animal models of pain, but its effect on neuropathic pain in humans is inconclusive.
Methods: In a multicentre, randomized, double-blinded placebo-controlled phenotype stratified trial, we examined if lacosamide produced better pain relief in patients with the irritable nociceptor phenotype compared to those without.
Background And Objectives: Diabetic polyneuropathy (DPN) is a complication of diabetes characterized by pain or lack of peripheral sensation, but the underlying mechanisms are not yet fully understood. Recent evidence showed increased cutaneous macrophage infiltration in patients with type 2 diabetes and painful DPN, and this study aimed to understand whether the same applies to type 1 diabetes.
Methods: The study included 104 participants: 26 healthy controls and 78 participants with type 1 diabetes (participants without DPN [n = 24], participants with painless DPN [n = 29], and participants with painful DPN [n = 25]).
Article Synopsis
- Cardiovascular autonomic neuropathy (CAN) is more common in type 2 diabetes patients with distal sensorimotor polyneuropathy (DPN), affecting 22% of those with DPN compared to only 7% without DPN and just 3% of healthy controls.
- The study involved 374 subjects, using the Vagus™ device to diagnose CAN and the COMPASS 31 questionnaire to assess autonomic symptoms, revealing that those with both DPN and CAN reported significantly higher symptom scores.
- Findings suggest that CAN is related to factors like age and HbA1c levels, highlighting the need for identifying specific CAN characteristics in patients to prevent severe complications associated with diabetes.
The Prevalence of Polyneuropathy in Type 2 Diabetes Subgroups Based on HOMA2 Indices of β-Cell Function and Insulin Sensitivity.
Diabetes Care
August 2023
Objective: Metabolic syndrome components may cumulatively increase the risk of diabetic polyneuropathy (DPN) in type 2 diabetes mellitus (T2DM) patients, driven by insulin resistance and hyperinsulinemia. We investigated the prevalence of DPN in three T2DM subgroups based on indices of β-cell function and insulin sensitivity.
Research Design And Methods: We estimated β-cell function (HOMA2-B) and insulin sensitivity (HOMA2-S) in 4,388 Danish patients with newly diagnosed T2DM.
Purpose: The AID-ICU trial was a randomised, blinded, placebo-controlled trial investigating effects of haloperidol versus placebo in acutely admitted, adult patients admitted in intensive care unit (ICU) with delirium. This pre-planned Bayesian analysis facilitates probabilistic interpretation of the AID-ICU trial results.
Methods: We used adjusted Bayesian linear and logistic regression models with weakly informative priors to analyse all primary and secondary outcomes reported up to day 90, and with sensitivity analyses using other priors.
Background And Objectives: Damage to small nerve fibers is common in diabetic polyneuropathy (DPN), and the diagnosis of DPN relies on subjective symptoms and signs in a combination with objective confirmatory tests, typically electrophysiology or intraepidermal nerve fiber density (IENFD) from skin biopsy. Corneal confocal microscopy (CCM) has been introduced as a tool to detect DPN. However, it is unclear if CCM can reliably be used to diagnose DPN and how the technique compares with other commonly used measures of small fiber damage, such as IENFD, cold detection threshold (CDT), and warm detection threshold (WDT).
View Article and Find Full Text PDFArticle Synopsis
- Cannabinoids like CBD and THC are commonly prescribed for neuropathic pain, but existing evidence suggests they may not be effective.
- A study tested the effects of CBD, THC, their combination, and a placebo on patients with various types of neuropathic pain over 8 weeks, but none of the treatments significantly reduced pain compared to the placebo.
- The trial included 145 patients, and results showed no meaningful pain relief from any treatment, leading to the conclusion that cannabinoids are not effective for this condition in patients who have already tried other treatments.