{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,11]],"date-time":"2026-02-11T19:51:50Z","timestamp":1770839510329,"version":"3.50.1"},"reference-count":16,"publisher":"American Diabetes Association","issue":"12","content-domain":{"domain":["diabetesjournals.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2006,12,1]]},"abstract":"<jats:p>OBJECTIVE\u2014No specific treatment for oropharyngeal dysphagia related to diabetic neuropathy has been described to date. Chemical myotomy of the cricopharyngeus (CP) muscle by botulinum neurotoxin type A (BoNT\/A) has been effective in reducing or abolishing dysphagia associated with upper esophageal sphincter (UES) hyperactivity of different etiologies. In the present study, we evaluated the efficacy of BoNT\/A injections into the CP muscle in diabetic patients with severe oropharyngeal dysphagia associated with diabetic autonomic and\/or somatic peripheral neuropathy.<\/jats:p>\n               <jats:p>RESEARCH DESIGN AND METHODS\u2014Twelve type 2 diabetic patients with severe dysphagia for both solid and liquid foods associated with autonomic and\/or peripheral somatic neuropathy were investigated. Swallowing function was evaluated by clinical examination, videofluoroscopy, and simultaneous needle electromyography (EMG) of the CP and pharyngeal inferior constrictor (IC) muscles. Clinical evaluation using a four-level dysphagia severity score was performed every other day for the 1st week and thereafter every other week until week 24. Videofluoroscopy and EMG follow-up were carried out at week 1, 4, 12, 16, 18, and 24 after BoNT\/A injection. BoNT\/A was injected percutaneously into the CP muscle under EMG control.<\/jats:p>\n               <jats:p>RESULTS\u2014BoNT\/A induced the complete recovery of dysphagia in 10 patients and had a significant (P = 0.0001, ANOVA) improvement in 2 patients within 4 \u00b1 1.1 days (range 3\u20137). Clinical improvement was confirmed by videofluoroscopy and EMG.<\/jats:p>\n               <jats:p>CONCLUSIONS\u2014Our findings suggest a potential benefit from BoNT\/A treatment in dysphagia associated with diabetic neuropathy. Randomized controlled trials are needed to confirm this observation.<\/jats:p>","DOI":"10.2337\/dc05-2486","type":"journal-article","created":{"date-parts":[[2006,11,27]],"date-time":"2006-11-27T19:22:18Z","timestamp":1164655338000},"page":"2650-2653","update-policy":"https:\/\/doi.org\/10.2337\/ada-journal-policies","source":"Crossref","is-referenced-by-count":30,"title":["Botulinum Toxin Treatment for Oropharyngeal Dysphagia Associated With Diabetic Neuropathy"],"prefix":"10.2337","volume":"29","author":[{"given":"Domenico A.","family":"Restivo","sequence":"first","affiliation":[{"name":"Division of Neurology, Garibaldi Hospital, Catania, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rosario","family":"Marchese-Ragona","sequence":"additional","affiliation":[{"name":"Otalaryngology Department, University of Padua, Padua, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giuseppe","family":"Lauria","sequence":"additional","affiliation":[{"name":"Neuromuscular Diseases Unit, National Neurological Institute \u201cCarlo Besta,\u201c Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sebastiano","family":"Squatrito","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Department of Internal and Specialistic Medicine, University of Catania, Garibaldi Hospital, Catania, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Damiano","family":"Gullo","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Department of Internal and Specialistic Medicine, University of Catania, Garibaldi Hospital, Catania, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Riccardo","family":"Vigneri","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Department of Internal and Specialistic Medicine, University of Catania, Garibaldi Hospital, Catania, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1167","reference":[{"key":"2022031217582774000_R1","doi-asserted-by":"crossref","unstructured":"Borgstrom PS, Olsson R, Sundkvist G, Ekberg O: Pharyngeal and oesophageal function in patients with diabetes mellitus and swallowing complaints. 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