Spinal cord stimulation eased painful diabetic neuropathy and improved sensation over six months

The edition in brief

The PDN-Sensory randomised trial compared high-frequency (10-kHz) spinal cord stimulation plus usual care with usual care alone in 91 people with painful diabetic neuropathy. Among those who went through a temporary trial, 27 of 34 reached at least 50% pain relief versus 2 of 50 on usual care. Sensory scores improved in 55% versus 25%, and skin biopsy nerve-fibre density rose slightly with stimulation, both assessed blind. Findings run to six months only, and the disease-modifying suggestion needs longer follow-up. A diabetes analysis of the ILUMIEN IV trial found that people with diabetes had higher two-year target vessel failure after PCI (9.9% vs 6.3%, adjusted HR 1.48) and that OCT guidance did not close the gap. A 21-patient open-label pilot found empagliflozin raised sodium excretion and was associated with less paracentesis in people with diabetes and refractory cirrhotic ascites. A meta-analysis of 13 Chinese hypoglycaemia prediction models reported high discrimination but weak validation. An expert forum argued that insulin resistance is many phenotypes rather than one defect.