Prevalence of Diabetes and Diabetic Neuropathy in Qena Governorate: Population-Based Survey

2016 ◽  
Vol 46 (3) ◽  
pp. 173-181 ◽  
Author(s):  
Eman M. Khedr ◽  
Gharib Fawi ◽  
Mohammed Abd Allah Abbas ◽  
Noha Abo El-Fetoh ◽  
Ghada Al Attar ◽  
...  
Keyword(s):  
Diabetic Neuropathy ◽  
Prevalence Rate ◽  
Diabetic Polyneuropathy ◽  
Population Based ◽  
University Hospital ◽  
Diabetic Patients ◽  
Urban Residents ◽  
Type I ◽  
Rural Residents ◽  
Laboratory Investigations

Background: No previous study was done to estimate the prevalence of diabetic neuropathy (DN) in Arabic countries. The aim of this study was to estimate the prevalence of DN and its characteristics in Qena governorate. Material and Methods: This is a random sampling of 10 study areas, involving 9,303 inhabitants; 51.1% men and 48.9% women were recruited. There were 57.3% urban residents and 42.7% rural residents. Patients were diagnosed using a screening questionnaire for diabetes mellitus (DM) as well as for DN in addition to measuring blood sugar in suspected cases. All positive cases were referred to Qena University Hospital and were subjected to full clinical, electrophysiological and laboratory investigations. Results: Out of 9,303 people screened, 837 were diabetic giving prevalence 8.99% of the population. Eight hundred eleven had type II DM and 26 cases had type I giving prevalence of 8.7 and 0.3%, respectively. One hundred fifty-five out of 837 (18.5%) diabetic patients had evidence of DN with prevalence rate being 1.7% of the total population. Diabetic polyneuropathy was the commonest type with prevalence 1.5%. The prevalence of DN was higher in women than in men. Rural residents had significantly higher prevalence of DN compared to urban residents (1.9 vs. 1.4) and illiterate population more than educated (5.8 vs. 1.2). Conclusion: The overall crude prevalence rate of DM and DN is nearly the same as in European countries and lower than that in other Arabic countries.

Glycemic Control and Clinico-Electrophysiological Severity of Diabetic Polyneuropathy

2019 ◽  
Vol 5 (2) ◽  
pp. 177-184
Author(s):  
KM Nazmul Islam Joy ◽  
ATM Hasibul Hasan ◽  
Md Rafiqul Islam ◽  
Farhana Kalam ◽  
M Lutful Kabir ◽  
...  
Keyword(s):  
Glycemic Control ◽  
Diabetic Neuropathy ◽  
Nerve Conduction ◽  
Scoring System ◽  
Diabetic Polyneuropathy ◽  
Nerve Conduction Studies ◽  
Clinical Severity ◽  
Diabetic Patients ◽  
Motor Neuropathy ◽  
Clinical Scoring

Background: Diabetic polyneuropathy (DPN) has a significant positive correlation with poor glycemic control (HbA1c ≥7%). The clinical, biochemical and electrophysiological parameters of DPN in Bangladeshi citizens have not yet been explored elaborately Objective: The purpose of the study was to detect and categorize status of glycemic control of Bangladeshi people and to analyze its impact on clinical severity of DPN using Toronto Clinical Scoring System (TCSS) and electrophysiological severity by modified Michigan diabetic neuropathy score (MDNS). Methodology: This observational study was carried out on diabetic patients having probable DPN by purposive sampling, attending Neurology OPD of Dhaka Medical College Hospital, Dhaka, Bangladesh and Bangladesh Institute of Research & Rehabilitation in Diabetes, Endocrine & Metabolic Disorder (BIRDEM) Hospital, Dhaka, Bangladesh from July 2014 to June 2016. Clinical parameters were recorded and DPN was graded as “no neuropathy”, “mild”, “moderate” and “severe” neuropathy by the Toronto Clinical Scoring System (TCSS). A standard nerve conduction study was performed on each patient and electrophysiological grading according to modified Michigan diabetic neuropathy score (MDNS) was done. Diabetic status of patients was classified into “controlled” (HbA1c <7.0%) and “uncontrolled” (HbA1c ≥7.0%) groups and HbA1c level and the clinical & electrophysiological severity scores were compared and were analyzed. Results: Mean age of the patients was 57.2±9.37 years. 51.0% cases were males and 49% cases were females. The mean HbA1c in the study population was 7.6±0.94% and 56.0% patients had HbA1c≥ 7% .Motor nerve conduction studies revealed that both CMAP amplitudes and MNCV in the ulnar, peroneal and tibial nerves were reduced significantly in patients of uncontrolled (HbA1c≥7%) DM (p<0.001). Sensory nerve conduction studies revealed significant reduction in SNAP amplitudes of median and ulnar sensory and sural nerves in the uncontrolled group (p<0.001). Electrophysiologically, 65.43% patients had mixed sensory-motor neuropathy (p<0.00001). Clinically severe DPN patients were higher (45.2%) within the uncontrolled (HbA1C ≥7%) group (p<0.00001). Similarly, severity in electrophysiological grading was more in patients with uncontrolled DM (48.8%) (p<0.00001). Conclusions: Neuropathic severity, either clinically or electrophysiologically, was associated with higher values of HbA1c. Journal of National Institute of Neurosciences Bangladesh, 2019;5(2): 177-184

Intraperitoneal Insulin Reduces Plasma Leptin Concentration in Diabetic Patients on CAPD

2000 ◽  
Vol 20 (1) ◽  
pp. 27-32 ◽  
Author(s):  
Pasi I. Nevalainen ◽  
Jorma T. Lahtela ◽  
Jukka Mustonen ◽  
Amos Pasternack
Keyword(s):  
Insulin Therapy ◽  
Tertiary Care ◽  
University Hospital ◽  
Glucose Disposal ◽  
Diabetic Patients ◽  
Type I ◽  
Intraperitoneal Insulin ◽  
End Stage ◽  
Plasma Leptin ◽  
Glucose Disposal Rate

Objective To determine the effects of subcutaneous (SC) and intraperitoneal (IP) insulin on serum leptin concentration in type I diabetic patients with end-stage renal failure treated with continuous ambulatory peritoneal dialysis (CAPD). Design Prospective, open, before–after study. Setting Tertiary-care university hospital. Participants Twelve type I diabetic patients with stabilized CAPD, age 43.9 ± 2.8 years, and duration of diabetes 30.4 ± 3.5 years. Intervention After stabilized CAPD therapy, all patients were treated first with SC insulin for a median of 3 months, and thereafter with IP insulin for another 3 months. Main Outcome Measures Plasma leptin, insulin sensitivity with euglycemic clamp, and glycemic and uremic status after both treatment periods. Results During SC insulin therapy, plasma leptin concentration was significantly higher than during IP insulin (19.8 ± 5.9 ng/mL and 12.8 ± 6.2 ng/mL, respectively; p < 0.001). Leptin concentration was higher in CAPD patients and was related to body mass index in both genders. No correlation was detected between plasma leptin and fasting insulin, glycemic control, glucose disposal rate, or serum lipids. Conclusion Plasma leptin concentration is lower during IP insulin therapy compared to SC insulin. Insulin has probably a direct effect on both peritoneal leptin clearance and adipose tissue leptin production. The significance of leptin in regulating appetite and anorexia in uremia remains unclear.

scholarly journals Analysis of the prevalence of myasthenia gravis in Ukraine depending on the place of residency and type of settlement

2019 ◽  
Author(s):  
Oleksandr Kalbus
Keyword(s):  
Myasthenia Gravis ◽  
Rural Areas ◽  
Prevalence Rate ◽  
Epidemiological Methods ◽  
Urban Residents ◽  
Place Of Residence ◽  
Key Words Myasthenia Gravis ◽  
Rural Residents ◽  
Annual Prevalence ◽  
The City

Aim: to study the prevalence of myasthenia gravis among adults in certain regions of Ukraine, taking into account the type of settlement and place of residence. The biostatistical, medical-statistical and epidemiological methods was used in the study. A study of the prevalence of myasthenia gravis in Ukraine was conducted on a sample of ten regions of Ukraine. 757 cases of myasthenia gravis were studied in selected territories, of which 465 (61.43 %) were among urban residents, 292 (38.57 %) were among rural residents. The average annual prevalence of myasthenia gravis was 5.16 (95 % CI —4.79—5.53) per 100,000 population. An analysis of the prevalence of myasthenia gravis in each region showed that this indicator among rural residents was statistically signifi cantly higher than the prevalence of myasthenia gravis among urban residents in Vinnytsia, Zaporizhzhia and Kirovohrad regions (p < 0.05), and in Volyn, Ivano-Frankivsk, Mykolaiv and Chernivtsi regions — without statistically significant differences (p > 0.05). The highest prevalence of myasthenia gravis in rural residents compared with urban residents was in the Vinnytsia region with an excess of 5.63 times (p < 0.001). The city prevalences of myasthenia in the Dnipropetrovsk (+39.14 %; p = 0.001) and Poltava regions (+35.87 %; p = 0.048) signifi cantly exceeded the average city prevalence of myasthenia gravis in Ukraine. They were signifi cantly lower in Vinnytsia (–75.07 %; p < 0.001), Volyn (–51.49 %; p < 0.001), Ivano-Frankivsk (–42.58 %; p = 0.004) and Chernivtsi (–37.35 %; p = 0.046) regions. The chances of rural residents to have myasthenia gravis were signifi cantly higher compared to urban residents. In general, according to the data of mya sthenia gravis prevalence rate in the context of the place of residence, it was proved that living in rural areas is associated with the presence of myasthe nia gravis. Key words: myasthenia gravis, epidemiology, prevalence, incidence, urban residents, rural residents,

scholarly journals ASSOCIATION OF SERUM HOMOCYSTEINE IN DIABETIC NEUROPATHY

2018 ◽  
Vol 11 ◽  
Author(s):  
Rujaswini T ◽  
Ranadheer Chowdary P ◽  
Vijey Aanandhi M ◽  
Shanmugasundaram P
Keyword(s):  
Diabetic Neuropathy ◽  
Blood Sugar ◽  
Elevated Serum ◽  
Serum Levels ◽  
Blood Parameters ◽  
P Value ◽  
Diabetic Patients ◽  
Type I ◽  
Type Ii ◽  
Serum Homocysteine

Aims and Objectives: The main aim of the study was to find out the association of serum homocysteine (HCY) in diabetic neuropathy patients. Methods: All the patients who were diagnosed with Type II diabetes mellitus will be included. Their serum levels of fasting blood sugar, postprandial blood sugar, glycated hemoglobin, and associated blood parameters will be assessed. Diabetic neuropathy will be confirmed using nerve conduction testing, electromyography, and quantitative sensory testing with clinically correlated. The serum HCY levels will be measured and correlated with other blood parameters. Results: Of 1000 patients, 46 were Type I diabetic and 954 were Type II. The prevalence of neuropathy in diabetic patients was 156. Mean serum HCY without diabetic neuropathy was 6.8+2.9 and serum HCY with diabetic neuropathy was 21.6+0.29 and p value was found to be 0.0017. The correlation between serum HCY and diabetic neuropathy was found to be 14.5 with p=0.001. Conclusion: There has been a significant increase of HCY in diabetic patients. It can be clearly seen that elevated serum HCY level has led to some of the complications of diabetic neuropathy.

Skin Microcirculation in Patients with Type I Diabetes with and without Neuropathy after Neurovascular Stimulation

1998 ◽  
Vol 94 (3) ◽  
pp. 255-261 ◽  
Author(s):  
Thomas Forst ◽  
Andreas Pfützner ◽  
Thomas Kunt ◽  
Thomas Pohlmann ◽  
Ulrike Schenk ◽  
...  
Keyword(s):  
Blood Flow ◽  
Diabetic Neuropathy ◽  
Type I Diabetes ◽  
Capillary Blood ◽  
Capillary Blood Flow ◽  
Diabetic Patients ◽  
Type I ◽  
Skin Microcirculation ◽  
Skin Perfusion ◽  
Diabetes Patients

1. Neurovascular inflammation is impaired in patients suffering from diabetic neuropathy. The aim of our study was to evaluate the distribution of nutritive and total skin blood flow in diabetic patients with and without neuropathy after neurovascular stimulation with acetylcholine. 2. Twenty patients with Type I diabetes, 10 with and 10 without neuropathy, and 10 age-matched non-diabetic control subjects, underwent microvascular investigations before and after neurovascular stimulation by intracutaneous application of acetylcholine. The capillary blood cell velocity in the nailfold of the hallux was measured by videophotometric capillaroscopy, and the total skin microcirculation in the same area by laser Doppler flowmetry. 3. The increase in total skin blood flow was significantly impaired in the group of neuropathic diabetic patients compared with the non-neuropathic diabetic patients (17.5 ± 83 versus 51.0 ± 16.2; P < 0.05) and the non-diabetic subjects (17.5 ± 8.3 versus 67.8 ± 19.7; P < 0.01). The increase in capillary blood flow was not significantly impaired in Type 1 diabetes patients with neuropathy. 4. The ratio between capillary blood flow and total skin perfusion decreased significantly in the control group (from 0.82 ± 0.15 to 0.47 ± 0.11; P < 0.005) and in the Type I diabetes patients without neuropathy (from 0.79 ± 0.12 to 0.43 ± 0.12; P < 0.05), whereas the decrease in the neuropathic group was statistically insignificant (from 1.05 ± 0.19 to 0.72 ±0.16). 5. Diminished total skin perfusion in the foot after intracutaneous stimulation with acetylcholine in Type I diabetes patients is associated with diabetic neuropathy, indicating a disturbance in the neurovascular reflex arc. This impaired neurovascular response is caused by a diminished total and sub-papillary blood flow and not by a diminished nutritive capillary flow. There is no evidence of a diminished nutritive capillary blood flow during neurogenic inflammation in Type I diabetes patients suffering from diabetic neuropathy.

scholarly journals Reliability of diabetic neuropathy symptom and diabetic neuropathy examination scoring system for the diagnosis of diabetic peripheral neuropathy in type 2 diabetes mellitus patients

2019 ◽  
Vol 8 (1) ◽  
pp. 327
Author(s):  
Labani M. Ghosh ◽  
Jyoti G. Mannari
Keyword(s):  
Peripheral Neuropathy ◽  
Diabetic Neuropathy ◽  
Screening Method ◽  
Diabetic Polyneuropathy ◽  
Cost Effective ◽  
Limb Amputation ◽  
Diabetic Patients ◽  
Type 2 Diabetic Patients ◽  
Perception Threshold

Background: This study aims to evaluate the reliability of the Diabetic Neuropathy Examination Score (DNE), 10-g Semmes-Weinstein Monofilament Examination and Quantitative Sensory Testing by Vibration Perception Threshold (VPT) in the diagnosis of diabetic polyneuropathy and seek a cost effective and reliable screening method in diabetic OPD and IPD against the gold standard of NCV.Methods: This study was carried out in 50 confirmed type 2 diabetic patients matched for age, sex, duration and ABI >0.9 irrespective of the presenting complaints. Patients with either limb amputation, other reasons for peripheral neuropathy, ABI <0.9, critical and comatose were excluded. A complete neurological assessment using a symptom questionnaire, Semmes Weinstein monofilament, vibration and thermal threshold perception analyzer was done and recorded. A score was given out of 20. The patients were retrograde subjected to NCV by a blinded technician and the readings were then compared to the scores.Results: The level of significance between the total neuropathy score and the presence of neuropathy (by NCV) was very significant (p<0.0001) with an association of 0.932. In patients with a mean total neuropathy score of 3.28,10.80 and 15.37, there was no, mild and severe levels of neuropathy in NCV respectively.Conclusions: There is correlation between the total neurological scores and NCV. Therefore, it can be used to screen all diabetic patients for earliest signs of diabetic neuropathy with sustainable results.

scholarly journals Demographic Characteristics of Diabetic Neuropathy Patients Attended at a Tertiary Care Hospital in Dhaka City

2019 ◽  
Vol 31 (1) ◽  
pp. 27-30
Author(s):  
Mohammad Mashudur Rahman ◽  
Abu Nasir Rizvi ◽  
Mohammad Nazim Uddin ◽  
Rashida Akter Khanam ◽  
Muhammad Abdul Momen Khan ◽  
...  
Keyword(s):  
Neuropathic Pain ◽  
Diabetic Neuropathy ◽  
Demographic Characteristics ◽  
Outpatient Department ◽  
Diabetic Patients ◽  
Type I ◽  
Care Hospital ◽  
Type Ii ◽  
Study Population ◽  
The Mean

Introduction: Diabetic neuropathy is one of the early complications of diabetes mellitus patients which is very difficult to face in the daily living activities. The purpose of the present study was to see the demographic characteristics of diabetic neuropathy patients. Metarials & Methods: This descriptive type of cross-sectional study was conducted in the Department of Neurology including Neuropathy Clinic and in collaboration with department of Endocrinology at Banghabandhu Sheikh Mujib Medical University, Dhaka from January 2012 to December 2013 for a period of two (2) years. Adult diabetic patients presented with neuropathic pain with symmetrical involvement of distal limbs from indoor and outpatient department of Neurology including Neuropathy clinic as well as indoor and outpatient department of Endocrinology, BSMMU were enrolled in the study population. Data was collected by face to face interview. Information was collected by taking medical history and clinical examinations and subsequent laboratory investigations. Results: A total number of 102 cases were recruited for this study who were clinically diagnosed as painful diabetic polyneuropathy. Female was predominant than male 55(53.9%) cases and 47(46.1%) cases respectively. The male and female ratio was 1:1.2. Majority were in the age group of more than 55 years which was 55(53.9%) cases. The mean age with SD of the study population was 52.79±9.42 years. Among 102 patients type II DM was predominate than type I patients which were 95(92.2%) cases and 8(7.8%) cases respectively. The mean duration of DM with SD was 6.51±3.6 years. However the mean duration of neuropathic pain was 1.68±1.155 years. Conclusion: In conclusion majority of the diabetic neuropathy patients are female suffering from type II DM in the middle age. Medicine Today 2019 Vol.31(1): 27-30

scholarly journals VIRAL HEPATITIS E IN PLEVEN REGION – CLINICAL, LABORATORY AND EPIDEMIOLOGICAL CHARACTERISTICS

2021 ◽  
Vol 27 (2) ◽  
pp. 3804-3811
Author(s):  
Galya Gancheva ◽  
Keyword(s):  
Viral Hepatitis ◽  
Serum Bilirubin ◽  
Clinical Laboratory ◽  
Epidemiological Data ◽  
Hepatitis E ◽  
University Hospital ◽  
Diagnostic Process ◽  
Urban Residents ◽  
Laboratory Investigations ◽  
Epidemiological Characteristics

Viral hepatitis E (VHE) is endemic in most countries nowadays. Our purpose was to analyze the characteristics of VHE in the Pleven region. Material and Methods: We performed a retrospective analysis of clinical, laboratory, and epidemiological data of 33 consecutive serologically confirmed cases of VHE treated in Clinic of Infectious Diseases at University Hospital – Pleven (2016-2019) (18 male – 56%, mean age 59±15 years). Statistical methods – t-test and χ2 test (for parametric and non-parametric distributions, respectively; P<0.05 was considered to be significant). Results: Totally 283 cases of hepatitis were treated in the Clinic (2016-2019) (cases of VHE- 12%). Fifty-five percent of VHE cases were older than sixty years (79% – urban residents); 39% acquired the disease during March-April. Only in two cases had contacts with pigs. The commonest symptoms were hepatomegaly (100%), fatigue (94%), darkness of urine (92%), jaundice (79%), anorexia (76%), splenomegaly (67%), nausea and vomiting (58%). The jaundice was protracted (median six days). Laboratory investigations- mild leukocytosis (21%), thrombocytopenia (18%), increased serum bilirubin with a prevalence of direct fraction (82%; mean ± sd 94±91 µmol/L; 95% CI 63÷125), increased aminotransferases in 100% (ASAT mean ± sd 812±629 IU/L; 95% CI 598÷1027; ALAT mean ± sd 1327± 790 IU/L; 95% CI 1058÷1597), mild to moderately increased alkaline phosphatase and GGT (90% and 100%, respectively). All of the patients were successfully treated with glucose infusions, hepatoprotective drugs and vitamins (mean 10 days). Conclusions: The clinicians should consider VHE in the diagnostic process. The disease affects mainly older ages, and jaundice is protracted.

scholarly journals HYPOGLYCAEMIA

2016 ◽  
Vol 23 (07) ◽  
pp. 64-869
Author(s):  
Muhammad Umar Khan ◽  
Darshan Kumar ◽  
Adil Faraz ◽  
Muhammad Adnan ◽  
Hala Soomro
Keyword(s):  
Diabetes Mellitus ◽  
Type I Diabetes ◽  
University Hospital ◽  
Hypoglycemic Agents ◽  
Renal Diseases ◽  
Severe Malnutrition ◽  
Diabetic Patients ◽  
Type I ◽  
Type Ii ◽  
Study Results

Objectives: Find out the hypoglycaemia in patients with diabetic nephropathicpatients. Study Design: Cross sectional study. Setting: National Institute of Diabetes &Endocrinology at Dow University Hospital, Ojha Campus, Karachi. Duration of Study: For theperiod of one year, from October 2014 to November 2015. Methodology: Known “diabeticpatients” with nephropathy which were present at National Institute of Diabetes & Endocrinology,Dow University Hospital, Ojha Campus, Karachi Patients presenting with signs and symptomsof hypoglycemia are diagnosed cases of “diabetes mellitus with nephropathy”, age 30 andabove, Type-I and type-Il diabetes mellitus, on oral hypoglycemic agents I insulin were includedin this study. Questions regarding the time period for which patient has been using these drugsand if the patient is suffering from illness which may be acute or chronic, should be askedregarding the relevant disease & its association with hypoglycaemia be mentioned, & patientsurine D/R & Serum Creatinine & Urea are measured by sending to the appropriate laboratory.Patients with severe malnutrition and starvation, chronic liver disease, alcoholics, chronicdisease as tuberculosis, patients with renal diseases without diabetes, any other malignancypatients were excluded from this study. Results: Depending upon the selection of 200 patients,the result concluded in our study consisted of 54% male patients and 46% were females, out ofwhich 11% had type I and diabetes and type II diabetics constituted 89%. Most of the patientsage between 60 to 75 years of age. The average duration of diabetes was 12.20 + 6.14 years.Out of 24 hypoglycaemic patients, 6 (25%) had type-I diabetes in which 4 were male and 2 wasfemale while 18 (75%) had type-II diabetes in which 10 were male and 8 were female patients.Conclusion: Observed that hypoglycaemia was common in diabetic patients, who developedrenal failure due to diabetic nephropathy.

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