scholarly journals Clinico-expert diagnostics of gastrointestinal form of diabetic neuropathy

2011 ◽  
Vol 14 (2) ◽  
pp. 94-97
Author(s):  
Irina Alekseevna Kurnikova ◽  
Tatiana Evgen'evna Chernyshova ◽  
Irina Vladimirovna Gur'eva ◽  
Guzyal' Ilgisovna Kliment'eva
Keyword(s):  
Gastrointestinal Tract ◽  
Diabetic Neuropathy ◽  
Diabetic Patients ◽  
Parasympathetic Innervation ◽  
Gastric Tone ◽  
Functional Changes ◽  
Gastrointestinal Pathology ◽  
Upper Gastrointestinal

Aim. To estimate dynamics of secretory and motor-evacuational functions of the stomach in patients with type 1 diabetes mellitus and gastrointestinalform of diabetic neuropathy. Materials and methods. 32 patients with DM1 without gastrointestinal pathology allocated to different groups depending on DM duration (gr. 1 lessthan 10 yr, gr. 2 over 10 yr). Vegetative equilibrium was estimated from the Kerdo index, rehabilitative potential from its basic constituent (morphophysiologicalindex). The motor-evacuational function of the stomach was studied with the use of a scintillation gamma-chamber, the gastric secretoryfunction by pH measurements. Results. Half of the patients in gr 2 presented with hypersympathicotony. The frequency of hypertonic form of gastric tone increased with durationof DM while the acid-producing and evacuational functions of the stomach decreased (as estimated by pH-measurement and gastroscintiographyrespectively). The propulsive function most significantly decreased in the pyloric part. The efficacy of rehabilitation of diabetic patients with gastrointestinalform of diabetic neuropathy was much lower than in those with preserved vegetative function of the stomach. Conclusion. Impairment of evacuational function of the stomach and duodenum with DM1 duration may be a cause of unstable blood glucose level.Hypomotor dyskinesia of the upper gastrointestinal tract due to DM1 and deficit of parasympathetic innervation occurs more frequently in patientswith low rehabilitative potential. Functional changes in the gastrointestinal tract of DM1 patients do not depend on the quality of compensation ofmetabolic disorders but correlate (r=-0.39) with DM duration. It is concluded that the gastrointestinal form of diabetic neuropathy impairs rehabilitativepotential of fhe patients.

scholarly journals Risk factors associated with peripheral neuropathy among diabetic individuals: a case control study

2021 ◽  
Vol 8 (2) ◽  
pp. 768
Author(s):  
Christa Kingston ◽  
Aravindan J. ◽  
Srikumar Walsalam
Keyword(s):  
Quality Of Life ◽  
Risk Factors ◽  
Diabetic Neuropathy ◽  
Case Control Study ◽  
Case Control ◽  
Diabetic Patients ◽  
Factors Associated ◽  
History Of ◽  
Control Study

Background: Diabetic neuropathy is one among the most common complication in diabetes mellitus. Diabetic peripheral neuropathy hinders the quality of life causing morbidity and mortality. The purpose of this study was to find the risk factors associated with diabetic neuropathy.Methods: This case control study involved 100 diabetic patients attending the Dohnavur fellowship hospital, Dohnavur from October 2019 to March 2020. Sociodemographic profile and diabetic characteristics of the study group were obtained and analysed. Diagnosis of Diabetic Neuropathy was done by using the diagnostic method proposed by American Diabetic Association.Results: Of the total study population with mean age 59.43 years, 63% had family history of diabetes. Almost 70% had poor diabetic control. Statistically significant relationships were found between neuropathy and duration of diabetes, glycaemic control, history of hypertension, monofilament test and pinprick sensation.Conclusions: In this study, glycemic control, dyslipidemia and hypertension were modifiable risk factors for diabetic neuropathy. Early interventional programs to sensitize diabetics on these factors could improve the quality of life of Diabetic patients. 

Diagnosis and Prevalence of Onychomycosis in Diabetic Neuropathic Patients

2009 ◽  
Vol 99 (2) ◽  
pp. 135-139 ◽  
Author(s):  
Isabelle J. Dumont
Keyword(s):  
Diabetic Neuropathy ◽  
Potassium Hydroxide ◽  
Diagnostic Methods ◽  
Diabetic Patients ◽  
Full Cohort ◽  
Perception Threshold ◽  
Predictive Values ◽  
Entire Cohort ◽  
The Mean

Background: An observational study was conducted to assess the prevalence of onychomycosis in clinically suspected diabetic neuropathic patients and to assess the reliability of the diagnosis. Methods: One hundred successive type 1 and 2 diabetic patients with diabetic neuropathy were followed. Diabetic neuropathy was defined by a vibration perception threshold greater than 25 V and onychomycosis by clinical diagnosis. Samples of the most affected nail were taken. Potassium hydroxide testing and culture were performed. Photographs of the nails were used by two dermatologists for diagnosis. Results: The mean ± SE age was 62.3 ± 11.4 years for the 20 onychomycotic patients and 60.3 ± 10.4 years for the entire cohort; 14 onychomycotic patients (70%) were male versus 56 in the full cohort (56%) (P < .05). The prevalence of onychomycosis was 20% (culture and potassium hydroxide test positive) and 24% (culture positive). Twenty or 30 patients were positive by the potassium hydroxide test, depending on the investigator. The most frequent pathogen found was Trichophyton rubrum (11 of 20 patients; 55%). The positive predictive values of the dermatologist’s diagnoses were 57.8% and 35.6%, and the negative predictive values were 85.0% and 90.5%. The two expert’s results were significantly different (P < .05). Conclusions: The diagnosis of onychomycosis is difficult to make. The diagnostic methods commonly used are not satisfactory. If onychomycosis is dangerous for the diabetic foot, a better diagnostic method is needed. (J Am Podiatr Med Assoc 99(2): 135–139, 2009)

Polymorphism in exon 7 of the endothelial nitric oxide synthase gene is associated with low incidence of microvascular damage in type 1 diabetic neuropathy

2009 ◽  
Vol 4 (4) ◽  
pp. 521-527 ◽  
Author(s):  
Constantina Heltianu ◽  
Simona-Adriana Manea ◽  
Cristian Guja ◽  
Alexandra Robciuc ◽  
Constantin Ionescu-Tirgoviste
Keyword(s):  
Nitric Oxide ◽  
Nitric Oxide Synthase ◽  
Diabetic Neuropathy ◽  
Endothelial Nitric Oxide Synthase ◽  
Microvascular Complications ◽  
Diabetic Patients ◽  
Enos Gene ◽  
Oxide Synthase ◽  
Endothelial Nitric Oxide

AbstractMicrovascular complications associated with type 1 diabetes mellitus (T1DM) are caused in part by endothelial dysfunction. We aimed to determine the association between polymorphisms in endothelial nitric oxide synthase (eNOS) gene (894G>T, 4ab) and T1DM-associated microvascular disorders, and the roles of nitrite/nitrate products (NOx) and low molecular weight-AGEs (LMW-AGEs) levels in this relationship. We carried out a case-control study (328 subjects) and determined genotypes by PCR. The rare-type TT of eNOS 894G>T was significantly overrepresented in patients without microvascular disorders as compared with control (OR=3.64; 95% C.I.=1.02–12.73; P=0.039). The prevalence of neuropathy was high among 894GG homozygotes (OR=0.5; 95% C.I.=0.29–0.86; P=0.012) who had high levels of triglycerides, elevated systolic BP, increased NOx, and LMW-AGEs. Decreased NOx levels were associated with 894TT genotype (beta=−0.65; P=0.043) in diabetic patients prone to microvascular complications. Multiple regression analysis indicated a negative correlation between eNOS 894G>T and diabetic neuropathy (P=0.025). The distribution of eNOS 4aa genotype was high (P=0.042) in patients with T1DM; however, it does not represent a risk factor for neuropathy. The overrepresentation of eNOS 894TT genotype in diabetic patients is associated with low risk for neuropathy. Decreased NOx and LMW-AGEs levels and lower lipid profile are the main features of patients carrying the eNOS 894T allele. These data suggest that the eNOS 894TT genotype may play a protective role by preventing microvascular disorders.

scholarly journals Beyond Genetic Borders: Sardinian Exposure And Type 1 Diabetes

2018 ◽  
Vol 3 (2) ◽  
Keyword(s):  
Type 1 Diabetes ◽  
Environmental Factors ◽  
Diabetic Patients ◽  
Β Cells ◽  
Autoimmune Destruction ◽  
The People ◽  
Technological Advances ◽  
Chronic Childhood

Type 1 diabetes mellitus (T1D), one of the most chronic childhood disease, results from an autoimmune destruction of pancreatic β cells producing insulin, with insulin deficiency. Recently significant technological advances have been achieved in treatment and quality of life in diabetic patients but the causes are still uncertain, so it is still very difficult to foresee the possible prevention of this disease. The genetic factors alone do not explain the high risk of T1D, sharply increased over the last 40 years in Sardinia, with the second highest risk in the world after Finland, even as many of the people genetically predisposed to T1D do not develop the disease [1]. It is still unknown why some people develop T1D although it is agreed that genetic, non-genetic and probably epigenetic environmental factors all together contribute to the disease. The environmental factors are probably very important for both the development and the increase of T1D. The epigenetic factor possible interrelationships are to be cleared at most.

scholarly journals Reversal of the Symptoms of Diabetic Neuropathy through Correction of Vitamin D Deficiency in a Type 1 Diabetic Patient

2012 ◽  
Vol 2012 ◽  
pp. 1-3 ◽  
Author(s):  
David S. H. Bell
Keyword(s):  
Vitamin D ◽  
Diabetic Neuropathy ◽  
Diabetic Patient ◽  
Vitamin D Deficiency ◽  
Diabetic Patients ◽  
Lower Pain ◽  
Microvascular And Macrovascular Complications ◽  
Lower Pain Threshold

Vitamin D deficiency has been associated with both type 1 and type 2 diabetes as well as both the microvascular and macrovascular complications of diabetes. Vitamin D deficiency has been shown to be more common in diabetic patients who have symptoms of distal symmetrical polyneuropathy. In addition, vitamin D deficiency has been associated with a lower pain threshold which increases when vitamin D deficiency is corrected. Herein, I describe a type 1 diabetic patient with neuropathic symptoms so severe that he could not work and for which he needed narcotics for pain management and whose symptoms improved dramatically with correction of the vitamin D deficiency. To my knowledge, this is the first report of an improvement in severe symptoms of diabetic neuropathy with correction of vitamin D deficiency in a single patient.

Differences in Microvascular Fluid Permeability between Long-Duration Type 1 (Insulin-Dependent) Diabetic Patients with and without Significant Microangiopathy

1996 ◽  
Vol 90 (2) ◽  
pp. 113-117 ◽  
Author(s):  
Alan J. Jaap ◽  
Angela C. Shore ◽  
John E. Tooke
Keyword(s):  
Disease Duration ◽  
Diabetic Microangiopathy ◽  
Diabetic Patients ◽  
Functional Changes ◽  
Control Subjects ◽  
Fluid Permeability ◽  
Significant Difference ◽  
Incipient Nephropathy ◽  
Insulin Dependent Diabetic

1. To further investigate the role of microvascular functional changes in the pathogenesis of diabetic microangiopathy in type 1 diabetes, microvascular fluid permeability was measured in nine patients with a long disease duration and no or minimal (background retinopathy alone) microangiopathy, nine age-, sex- and duration-matched patients with microalbuminuria and nine control subjects. Microvascular fluid permeability was assessed by determination of the forearm capillary filtration coefficient using a sensitive strain-gauge plethysmographic technique. 2. Microvascular fluid permeability was significantly higher in the patients with microalbuminuria [8.5 (6.8–15.2) × 10−3 ml min−1 100 g−1 of tissue mmHg−1; median (range)] than in the patients with no or minimal complications [5.2 (3.6–7.0) × 10−3 ml min−1 100 g−1 of tissue mmHg−1, P < 0.001]. There was, however, no significant difference in microvascular fluid permeability between the patients with no or minimal complications and control subjects [4.5 (3.2–5.7) × 10−3 ml min−1 100 g−1 of tissue mmHg−1, P = 0.31]. Blood pressure and glycaemic control were similar in the two groups of diabetic patients. 3. These results provide further evidence that changes in microvascular permeability are found in other vascular beds in patients with incipient nephropathy, whereas no such changes are found in patients with a long disease duration and little evidence of microangiopathy.

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