Solomon Tesfaye

Solomon Tesfaye
Sheffield Teaching Hospitals NHS Foundation Trust | STH · Diabetes Centre (Royal Hallamshire Hospital)

Mb ChB, MD

About

286
Publications
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Publications

Publications (286)
Article
Painful diabetic neuropathy (DN) is a common and distressing complication. New approaches are required to identify novel targets that will serve as a catalyst for future drug discovery programmes. We have demonstrated that responders to neuropathic pain treatment have greater functional connectivity between the insula cortex and the corticolimbic s...
Article
Objective: We have previously demonstrated increased thalamic blood volume and preserved HMRS neuronal metabolite ratios in painful diabetic peripheral neuropathy (P-DPN) . We hypothesised that perfusion measures and neuronal function measured by metabolite ratios may be related. However, as brain metabolite ratios may also be affected by mood diso...
Article
Aims: Altered functional connectivity has been identified in key brain regions involved in somatosensory perception in patients with painful diabetic peripheral neuropathy (painful-DPN) , using resting state functional-magnetic resonance imaging (fMRI) . This study aimed to examine the impact of neuropathic pain treatments on these regions. Methods...
Article
Aim: Our study predicted treatment responses in patients with painful DPN (diabetic peripheral neuropathy) by developing a deep learning model using resting state functional magnetic resonance imaging (fMRI) neuroimaging datasets. Methods: Forty-three consecutive patients who received intravenous lidocaine treatment for painful DPN were assessed. A...
Article
Diabetic peripheral neuropathy (DPN) is associated with loss of motor units (MUs), which can cause changes in the activation pattern of muscle fibres. This study investigated the pattern of muscle activation using high-density surface electromyography (HD-sEMG) signals from subjects with type 2 diabetes mellitus (T2DM) and DPN. Thirty-five adults p...
Article
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Painful diabetic peripheral neuropathy can be intractable with a major impact, yet the underlying pain mechanisms remain uncertain. A range of neuronal and vascular biomarkers was investigated in painful diabetic peripheral neuropathy (painful-DPN) and painless-DPN and used to differentiate painful-DPN from painless-DPN. Skin biopsies were collecte...
Article
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Diabetic sensorimotor polyneuropathy (DSPN) affects around one third of people with diabetes and accounts for considerable morbidity, increased risk of mortality, reduced quality of life, and increased health care costs resulting particularly from neuropathic pain and foot ulcers. Painful DSPN is encountered in 13-26% of diabetes patients, while up...
Article
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One in five diabetic patients suffers from chronic pain with neuropathic characteristics, but the pathophysiological mechanisms underlying the development of neuropathic pain in diabetic distal symmetrical polyneuropathy (DSP) patients are poorly understood. Systemic low-grade inflammation has been implicated, but there is still a considerable know...
Article
Painful diabetic peripheral neuropathy (painful-DPN) is a highly prevalent and disabling condition, affecting up to one-third of patients with diabetes. This condition can have a profound impact, resulting in a low quality of life, disruption of employment, impaired sleep, and poor mental health with an excess of depression and anxiety. The managem...
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Aims/hypothesis The aim of this work was to investigate whether different clinical pain phenotypes of diabetic polyneuropathy (DPN) are distinguished by functional connectivity at rest. Methods This was an observational, cohort study of 43 individuals with painful DPN, divided into irritable (IR, n = 10) and non-irritable (NIR, n = 33) nociceptor...
Article
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Background: People with diabetic cardiovascular autonomic neuropathy (CAN) have increased cardiovascular mortality. However, the association between distal symmetric polyneuropathy (DSPN) or CAN with all-cause mortality is much less investigated. Thus, we set out to examine the effect of CAN and DSPN on all-cause mortality in a well-phenotyped coh...
Article
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Diabetic sensorimotor peripheral neuropathy (DSPN) is a serious complication of diabetes mellitus and is associated with increased mortality, lower-limb amputations and distressing painful neuropathic symptoms (painful DSPN). Our understanding of the pathophysiology of the disease has largely been derived from animal models, which have identified k...
Article
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Aims/hypothesis Distal diabetic sensorimotor polyneuropathy (DSP) is a common complication of diabetes with many patients showing a reduction of intraepidermal nerve fibre density (IENFD) from skin biopsy, a validated and sensitive diagnostic tool for the assessment of DSP. Axonal swelling ratio is a morphological quantification altered in DSP. It...
Article
Objective Thalamus is essential in processing of sensory information. This study explored the associations between thalamic volume and intra-thalamic metabolites and associations to clinical and experimental characteristics of sensory function in adults with diabetic polyneuropathy. Methods 48 adults with type 1 diabetes and confirmed distal symmet...
Article
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Aim: To investigate the effect of normalizing vitamin B12 (B12) levels with oral B12 (methylcobalamin) 1000 μg/day for one year in patients with diabetic neuropathy (DN). Patients and methods: In this prospective, double-blind, placebo-controlled trial, 90 patients with type 2 diabetes on metformin for at least four years and both peripheral and...
Article
Background Although T2DM patients with COVID‐19 develop a more severe condition compared to those without diabetes, the mechanisms for this are unknown. Moreover, the impact of treatment with anti‐hyperglycemic drugs and glucocorticoids is unclear. Methods From 1584 COVID‐19 patients, 364 severe/critical COVID‐19 patients with clinical outcome wer...
Chapter
Diabetic neuropathy is a heterogeneous group of conditions and clinical classification of the various syndromes has proved challenging. Acute Painful Neuropathies are transient neuropathic syndromes characterized by an acute onset of pain in the lower limbs. There are two distinct syndromes, the first of which occurs within the context of poor glyc...
Article
Painful diabetic polyneuropathy (DPN) is difficult to manage as treatment response is often varied. The primary aim of this study was to examine differences in pain phenotypes between responders and non-responders to intravenous lidocaine treatment using quantitative sensory testing. The secondary aim was to explore differences in brain structure a...
Article
Full-text available
Over half of people with diabetes mellitus develop diabetic polyneuropathy (DPN), which is a major cause of reduced quality of life due to disabling neuropathic pain, sensory loss, gait instability, fall-related injury, and foot ulceration and amputation. The latter represents a major health and economic burden, with lower limb amputation rates rel...
Article
There is a high prevalence of painful diabetic polyneuropathy (pDPN) with around one-third of all patients with diabetes suffering from pDPN. pDPN has debilitating consequences, with a major impact on morbidity and quality of life. Unfortunately, there is no globally licenced pharmacotherapy that modulates the underlying disease mechanisms to preve...
Article
Full-text available
Diabetic peripheral neuropathy (DPN) is a common chronic complication of diabetes mellitus. It leads to distressing and expensive clinical sequelae such as foot ulceration, leg amputation, and neuropathic pain (painful-DPN). Unfortunately, DPN is often diagnosed late when irreversible nerve injury has occurred and its first presentation may be with...
Article
Diabetic peripheral neuropathy (DPN) is a common complication of both type 1 and 2 diabetes. It is a leading cause of lower-limb amputation and disabling neuropathic pain. Amputations in patients with diabetes have a devastating effect on quality of life and are associated with an alarmingly low life expectancy (on average only 2 years from the amp...
Article
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Purpose of Review The prevalence of diabetes mellitus and its chronic complications are increasing to epidemic proportions. This will unfortunately result in massive increases in diabetic distal symmetrical polyneuropathy (DPN) and its troublesome sequelae, including disabling neuropathic pain (painful-DPN), which affects around 25% of patients wit...
Article
Diabetic distal symmetrical peripheral polyneuropathy (DSP) results in decreased somatosensory cortical gray matter volume, indicating that the disease process may produce morphological changes in the brains of those affected. However, no study has examined whether changes in brain volume alter the functional organization of the somatosensory corte...
Article
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Background : Despite being a very common complication, the aetiology and potential risk factors of diabetic neuropathy (DN) have not been clearly determined in a prospective study. Aims: The aim of Sheffield Prospective Diabetes Study was to identify the abnormalities of physiological, biochemical, haemorrhelogical and cellular function for complic...
Article
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Background The number of people with diabetes is growing rapidly. Diabetes can cause nerve damage leading to severe pain in the feet, legs and hands, which is known as diabetic peripheral neuropathic pain (DPNP). In the UK, the National Institute for Health and Care Excellence (NICE) recommends amitriptyline, duloxetine, pregabalin or gabapentin as...
Chapter
Diabetic neuropathy is a common complication of diabetes and a cause of considerable morbidity and increased mortality. Diabetic neuropathy encompasses several neuropathic syndromes, the commonest of which is diabetic peripheral neuropathy (DPN), the main initiating factor for foot ulceration. Some patients with peripheral neuropathy may experience...
Article
The prevalence of diabetes mellitus and its chronic complications continue to increase alarmingly. Consequently, the massive expenditure on diabetic distal symmetrical polyneuropathy (DSPN) and its sequelae, will also likely rise. Up to 50% of patients with diabetes develop DSPN, and about 20% develop neuropathic pain (painful-DSPN). Painful-DSPN c...
Article
This cross-sectional multicentre study aimed at investigating frequency and features of painful diabetic polyneuropathyWe consecutively enrolled 816 patients attending hospital diabetic outpatient clinics. We first definitely diagnosed diabetic polyneuropathy and pure small-fibre polyneuropathy using clinical examination, nerve conduction study, an...
Conference Paper
Full-text available
QUASAR ASL is an arterial transit time insensitive perfusion imaging technique which can be used to unravel hemodynamic patterns. This study evaluates cerebral perfusion hemodynamics using QUASAR in patients with type-2 diabetes mellitus (T2DM) and normoglycemic controls. In addition to standard perfusion parameters, multiple metrics were extracted...
Article
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Background: Epidemiological studies in patients with neuropathic pain demonstrate a strong association with psychiatric conditions such as anxiety; however, the precipitating pathology between these symptoms remains unclear. To investigate this, we studied the effects of lifelong stress on levels of neuropathic pain-like behavior and conversely, t...
Article
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Objectives Lower gastrointestinal symptoms are not well characterized in people with type 1 diabetes, and the effects on quality of life and glycemic control are unknown. This study aimed to determine the prevalence of lower gastrointestinal symptoms and the effects on glycemic control and quality of life, and to investigate for underlying causes....
Chapter
Chronic neuropathic pain is a common, disabling condition that is often challenging to manage effectively. Unfortunately, most current pharmacological treatments are often ineffective and their use is limited by intolerable side effects. There is ample anecdotal and preclinical trial evidence supporting the pain relieving role of cannabinoids. This...
Article
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Diabetic peripheral neuropathy (DPN) is a common disabling complication of diabetes. Almost half of DPN patients develop neuropathic pain for which current analgesic treatments are inadequate. Understanding the role of genetic variability in the development of painful DPN is needed for improved understanding of pain pathogenesis, for better patient...
Article
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In a recent cluster analysis, it has been shown that patients with peripheral neuropathic pain can be grouped into 3 sensory phenotypes based on quantitative sensory testing profiles, which are mainly characterized by either sensory loss, intact sensory function and mild thermal hyperalgesia and/or allodynia, or loss of thermal detection and mild m...
Article
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Background and Aims To assess the risk factors for sensory nerve dysfunction in subjects with isolated impaired glucose tolerance (IGT). Methods and Results Seventy-two people with isolated IGT (WHO 1999 criteria) and 39 gender and age-matched healthy volunteers underwent detailed clinical and neurological assessment including quantitative sensory...
Conference Paper
Full-text available
This study evaluates cerebral perfusion and cerebrovascular reserve (CVR) in impaired glucose tolerance and patients with type-2 diabetes using QUASAR Arterial Spin Labeling. CVR was evaluated as the change in gray matter CBF in response to a pharmacological stimulus. The developed processing pipeline was based on published QUASAR theory, modiied t...
Article
We fully support the views expressed in The Lancet Diabetes & Endocrinology's Editorial about ensuring affordable access to insulin and the proposal to add analogue insulin to the WHO Essential Medicines list. The International Insulin Foundation in its 2011 position statement called for “the universal access for persons with type 1 diabetes to lif...
Article
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Background Smoking is associated with increased macrovascular and microvascular complications in people with diabetes. In addition to other concomitant vascular perturbations, it also seems to influence the cardiometabolic parameters, which may partly explain the accelerated rate of vascular complications in smokers with diabetes. While smoking ces...
Article
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A high percentage of diabetic patients develop peripheral neuropathy with more than 10 % suffering from severe symptoms. Therapeutic alternatives for diabetic sensorimotor polyneuropathy (DSPN) have so far involved pathogenesis oriented or symptomatic treatments. These two therapeutic approaches differ in their effects: the former aims to reverse,...
Article
Objective: The aims of this study were (1) to examine cerebrovascular autoregulation in subjects with impaired glucose tolerance and type 2 diabetes and (2) to clarify whether cardiovascular autonomic nerve function is associated with abnormal cerebrovascular autoregulation. Research design and methods: Totally, 46 subjects were recruited (12 =...
Article
Disabling neuropathic pain (NeuP) is a common sequel of diabetic peripheral neuropathy (DPN). We aimed to characterise the sensory phenotype of patients with and without NeuP, assess screening tools for NeuP, and relate DPN severity to NeuP. The Pain in Neuropathy Study (PiNS) is an observational cross-sectional multicentre study. A total of 191 pa...
Article
Solomon Tesfaye speaks to Nick Ward, Commissioning Editor: Solomon Tesfaye, MB ChB, MD, FRCP, speaks about PL37; the first orally administered dual inhibitor of enkephalinases and its potential role in the treatment of painful diabetic neuropathy. Solomon Tesfaye is a Consultant Physician/Endocrinologist at Sheffield Teaching Hospitals and Honorary...
Article
Diabetic peripheral neuropathy (DPN) affects up to 50% of patients with diabetes and is a major cause of morbidity and increased mortality. Its clinical manifestations include distressing painful neuropathic symptoms and insensitivity to trauma that result in foot ulcerations and amputations. Several recent studies have implicated poor glycemic con...
Article
Full-text available
Clinical methods of detecting diabetic peripheral neuropathy (DPN) are not objective and reproducible. We therefore evaluated if SUDOSCAN, a new method developed to provide a quick, non-invasive and quantitative assessment of sudomotor function can reliably screen for DPN. 70 subjects (45 with type 1 diabetes and 25 healthy volunteers [HV]) underwe...
Article
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To investigate baseline demographics and disease characteristics as predictors of the analgesic effect of duloxetine and pregabalin on diabetic peripheral neuropathic pain (DPNP). Based on data from the COMBO-DN study, a multinational clinical trial in DPNP, the potential impact of baseline characteristics on pain relief after 8-week monotherapy wi...
Article
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Chronic kidney disease (CKD) has seen increasing prevalence, with current levels at around ten percent in adults aged twenty and over in industrialized western countries. CKD frequently affects both the central nervous system (CNS) and peripheral nervous system (PNS); uraemia, advanced glycation end-product (AGE) accumulation and oxidative stress,...