Coaching of lifestyle recommendations improves sensory neurophysiological parameters in neuropathies related to glycemic disorder or metabolic syndrome. A pilot study - 05/01/19

Doi : 10.1016/j.neucli.2018.12.004

Sophie Ng Wing Tin ^a,^b,^c, Hela G. Zouari ^a,^d, Samar S. Ayache ^a,^e, Anne-Isabelle Tropeano ^f, Christiane Ajzenberg ^g, Jora Xhaxho ^h, Abir Wahab ^a,^h, Jean-Pascal Lefaucheur ^a,^e, Alain Créange ^a,^h,^⁎
^a EA 4391, Faculté de médecine de Créteil, Université Paris Est Créteil, 94010 Créteil, France
^b EA 2363, UFR SMBH, Université Paris 13, 93000 Bobigny, France
^c Service de physiologie, Explorations fonctionnelles et médecine du sport, hôpital Avicenne, Assistance publique–Hôpitaux de Paris, 93000 Bobigny, France
^d Service d’explorations fonctionnelles, CHU Habib Bourguiba, Sfax, Tunisia
^e Service de physiologie, Explorations fonctionnelles, hôpital Henri-Mondor, Assistance publique–Hôpitaux de Paris, 94010 Créteil, France
^f Service d’explorations fonctionnelles cardiovasculaire non invasives et hôpital de jour cardio-métabolique, Groupe hospitalier Henri-Mondor, Assistance publique–Hôpitaux de Paris, 94010 Créteil, France
^g Service d’endocrinologie diabetologie, Groupe hospitalier Henri-Mondor, Assistance Publique–Hôpitaux de Paris, 94010 Créteil, France
^h Service de neurologie, Groupe hospitalier Henri-Mondor, Centre hospitalier universitaire Henri-Mondor, Assistance publique–Hôpitaux de Paris, 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil, France

^⁎Corresponding author. Service de neurologie, Groupe hospitalier Henri-Mondor, Centre hospitalier universitaire Henri-Mondor, Assistance publique–Hôpitaux de Paris, 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil, France.Service de neurologie, Groupe hospitalier Henri-Mondor, Centre hospitalier universitaire Henri-Mondor, Assistance publique–Hôpitaux de Paris51, avenue du Maréchal-de-Lattre-de-TassignyCréteil94010France

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Summary

Objectives

Metabolic abnormalities, such as, glycemic disorders and metabolic syndrome (GDMS) are one of the main causes of peripheral neuropathies. The objective of this study was to evaluate the impact of adding specific coaching care (CC) to standard care (SC) of therapeutic education based on lifestyle recommendations for neuropathies associated with GDMS.

Methods

This prospective randomized study included two groups of four patients (SC vs. CC) with examiners blinded to group allocation. The SC group had one day of therapeutic education on lifestyle measures (physical activity and diet recommendations) followed by only one phone call of reinforcement. The CC group received an additional weekly phone call of reinforcement for 3 months. Clinical, biological and neurophysiological variables were compared between the two groups at baseline and for the percentage of change at 3 months.

Results

All patients (4 men and 4 women) had diabetes or pre-diabetes, which was associated with metabolic syndrome in 5 cases. There was no difference on any variable at baseline, but at 3 months, Mann-Whitney test showed a difference (P=0.0008) between the two groups regarding the sensory neurophysiological variable, which deteriorated in the SC group (median: −6.0%) and improved in the CC group (median: +12.4%). No significant difference was observed between the two groups for the other variables at 3 months.

Conclusion

The weekly coaching of recommendations for lifestyle measures over a period of three months allows an improvement of GDMS neuropathies, at least in terms of sensory aspects, as evidenced by neurophysiological assessments.

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Keywords : Diabetes mellitus, Metabolic syndrome, Nerve conduction study, Peripheral neuropathy, Quantitative sensory testing, Therapeutic education