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Diabetes Melllitus Case Study

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Diabetes mellitus (DM) is a chronic health issue faced by 347 million people around the world as stated by the World Health Organization (WHO) (2013). It is predicted by the year 2030 over 366 million people will be diagnosed with diabetes (Stein, Eible, Sbruzzi, Lago, & Plentz, 2013). According to Stein et al (2013), 50% of DM cases will experience some type of neuropathy in their lifetime. "Chronic hyperglycemia is a major factor that induces nerve fiber injury" (Bulut, Ozcan, Cakan, Bektas, & Culha, 2010, p. 914). The pain caused by the damage is described as "burning, tingling, lancinating, formicating, aching, or tearing" (Wunderlich, Peters, Bosma, & Armstrong, 1998, p. 895).
In diabetes, pain that is located in the upper and lower extremities is referred to as Painful Diabetic Neuropathy (PDN) (Stein et al., 2013). Other names, such as Painful Diabetic Peripheral Neuropathy (PDPN) and Diabetic Peripheral Neuropathy (DPN) are also used to describe this symptom (Zelman, Brandenburg, & Gore, 2006). For continuity of this paper, the term PDN will be used. PDN is considered a chronic pain, and a common complaint is increased peripheral pain at night that disrupts sleep (Zelman et al., 2006). This exacerbated nighttime pain and disruption in sleep can affect the overall health and quality of life for the diabetic person (Zelman et al., 2006).
The aim of this study is to explore the effectiveness of continued nighttime use of a TENS device as a supplement to pharmaceutical therapies to improve sleep quality in patients who experience sleep disruption due to nocturnal PDN. This study would provide an extension to current research in the use of a TENS device to manage diabetic neuropathic pain, with the focus on impro...

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...ic field use in patients with diabetic neuropathy: Systematic review and meta-analysis. Brazilian Journal of Physical Therapy, 2, 93-104. Retrieved from http://dx.doi.org/10.1590/S1413-35552012005000083
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World Health Organization: Diabetes. (2013). http://www.who.int/mediacentre/factsheets/fs312/en/
Wunderlich, R. P., Peters, E. J., Bosma, J., & Armstrong, D. G. (1998). Pathophysiology and treatment of painful diabetic neuropathy of the lower extremity. Southern Medical Journal, 91, 894-898.
Zelman, D. C., Brandenburg, N. A., & Gore, M. (2006). Sleep impairment in patients with painful diabetic peripheral neuropathy. Clinical Journal of Pain, 22, 681-685. http://dx.doi.org/10.1097/01.ajp.0000210910.49923.09
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