SynthesisBMJ open diabetes research & care2020
Altered pain processing in patients with type 1 and 2 diabetes: systematic review and meta-analysis of pain detection thresholds and pain modulation mechanisms.
Synthesis in BMJ open diabetes research & care, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers.
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Who cites it
23 citing papers in PubMed.
- Physiological and autonomic responses to intermittent low-lung-volume apnoea and pain sensitivity: A randomized controlled pilot trial.Experimental physiology · 2026Trial
- Postprandial glycaemic response and pain sensitivity in breast cancer survivors suffering from chronic pain: a double-blind, randomised controlled cross-over pilot experiment.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2025Trial
- Hypoalgesic effects, safety, and feasibility of a 6-minute high-lung-volume static apnea intervention.The Korean journal of pain · 2026Article
- Opioid Dependency After Craniomaxillofacial Trauma Surgery.Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery · 2026Article
- Pain Modulation and Central Sensitization in Painful Diabetic Peripheral Neuropathy: Updated Narrative Review and Future Directions.Journal of diabetes · 2026Review
- Beyond Neuropathy: The Mechanisms and Phenotypes of Diabetes-Related Musculoskeletal Pain.Journal of clinical medicine · 2026Review
- Random forest-based prediction of early postoperative pain after pelvic organ prolapse surgery under standardized remimazolam anesthesia.BMC anesthesiology · 2026Observational
- Quantitative sensory testing and skin biopsy for neuropathy assessment in Portuguese patients with type 1 diabetes: an exploratory study.Endocrine · 2025Article
- Impact of visceral pain on migraine symptoms in comorbid patients: a retrospective observational study.The journal of headache and pain · 2025Observational
- Changes of intestinal microbiome and its relationship with painful diabetic neuropathy in rats.BMC microbiology · 2025Article
- Small Fibre Pathology in Fibromyalgia: A review.Pain and therapy · 2025Review
- Article
- Neuropathic Pain With and Without Diabetic Peripheral Neuropathy in Type 1 Diabetes.Diabetes care · 2024Article
- Interaction between local blood flow and tolerance to prolonged pain in the elderly.European journal of applied physiology · 2024Article
- Peripheral Neuropathy in Diabetes Mellitus: Pathogenetic Mechanisms and Diagnostic Options.International journal of molecular sciences · 2023Review
- UltramicronizedBiomolecules · 2023Article
- Spinal disinhibition: evidence for a hyperpathia phenotype in painful diabetic neuropathy.Brain communications · 2023Article
- Clinical Characteristics of Lower-Limb Ischemia in Japanese Patients with Type 2 Diabetes and Usefulness of the Great Toe Blood Flow as a Predictive Indicator of Leg Arterial Obstruction.Healthcare (Basel, Switzerland) · 2022Article
- Hospital opioid use predicts the need for discharge opioid prescriptions following laparoscopic bariatric surgery.Surgical endoscopy · 2022Article
- Detecting Peripheral Neuropathy in Patients with Diabetes, Prediabetes and other High-Risk Conditions: An Advanced Practice Nurse's Perspective.Journal of medical & clinical nursing · 2022Article
Corrections and comments
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The first signs of diabetic neuropathy typically result from small-diameter nerve fiber dysfunction. This review synthesized the evidence for small-diameter nerve fiber neuropathy measured via quantitative sensory testing (QST) in patients with diabetes with and without painful and non-painful neuropathies. Electronic databases were searched to identify studies in patients with diabetes with at least one QST measure reflecting small-diameter nerve fiber function (thermal or electrical pain detection threshold, contact heat-evoked potentials, temporal summation or conditioned pain modulation). Four groups were compared: patients with diabetes (1) without neuropathy, (2) with non-painful diabetic neuropathy, (3) with painful diabetic neuropathy and (4) healthy individuals. Recommended methods were used for article identification, selection, risk of bias assessment, data extraction and analysis. For the meta-analyses, data were pooled using random-effect models. Twenty-seven studies with 2422 participants met selection criteria; 18 studies were included in the meta-analysis. Patients with diabetes without symptoms of neuropathy already showed loss of nerve function for heat (standardized mean difference (SMD): 0.52, p<0.001), cold (SMD: -0.71, p=0.01) and electrical pain thresholds (SMD: 1.26, p=0.01). Patients with non-painful neuropathy had greater loss of function in heat pain threshold (SMD: 0.75, p=0.01) and electrical stimuli (SMD: 0.55, p=0.03) compared with patients with diabetes without neuropathy. Patients with painful diabetic neuropathy exhibited a greater loss of function in heat pain threshold (SMD: 0.55, p=0.005) compared with patients with non-painful diabetic neuropathy. Small-diameter nerve fiber function deteriorates progressively in patients with diabetes. Because the dysfunction is already present before symptoms occur, early detection is possible, which may assist in prevention and effective management of diabetic neuropathy.
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