The edition · Diabetes & Endocrinology
Spinal cord stimulation improved sensation, not just pain, in diabetic neuropathy
A randomised trial of 10-kHz spinal cord stimulation for painful diabetic neuropathy reported blinded gains in sensory score and nerve fibre density alongside pain relief. Plus glycaemic variability and peripheral artery disease, a consensus on bone fragility in diabetes, diabetes-specific tube feeds, and a Class II recall of compounded semaglutide.
The edition in brief
Today's edition leads on bone fragility in diabetes and closes on a randomised trial suggesting 10-kHz spinal cord stimulation improves sensory function in painful diabetic neuropathy, not only pain.
A consensus that fracture risk in diabetes is not readable from bone density
In long-standing diabetes, assess fracture risk on the clinical picture — neuropathy, falls, duration — rather than reading safety off the bone density result.
Swings in glucose tracked with peripheral artery disease across eleven cohorts
Variability in glucose, not only the mean, tracks with peripheral artery disease — worth noting in a patient whose HbA1c looks acceptable but whose readings swing.
Class II recall of compounded semaglutide vials for particulate matter
If a patient is injecting semaglutide from a multi-dose vial rather than a licensed pen, ask where it came from.
Diabetes-specific tube feeds improved glycaemia, with modest effect sizes
A diabetes-specific formula is a reasonable default for the hyperglycaemic tube-fed patient, on glycaemic grounds — expect a modest improvement, not a change in outcome.
How the sitting is broken up appears to matter, not only how much
Ask how often a sedentary patient stands up, not just how much they exercise each week.
10-kHz spinal cord stimulation improved sensation and nerve fibre density, blind-assessed
For painful diabetic neuropathy that has failed medical management, 10-kHz stimulation now has blinded evidence of sensory and structural improvement — worth raising with a pain service rather than escalating drugs indefinitely.
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