Depression Symptoms in Patients with Diabetic Peripheral Neuropathy

2020 ◽  
Vol 16 (1) ◽  
pp. 35-40
Author(s):  
Rahab Marhoon Alghafri ◽  
Alfred Gatt ◽  
Cynthia Formosa
Keyword(s):  
Depressive Symptoms ◽  
Peripheral Neuropathy ◽  
Diabetic Peripheral Neuropathy ◽  
Neurological Complications ◽  
Depression Symptoms ◽  
Low Mood ◽  
Patients With Diabetes ◽  
Patient Health ◽  
The Mean

AIM: The study aimed to investigate the possible relationship between diabetic peripheral neuropathy (DPN) and the development of depressive symptoms in patients with type 2 diabetes mellitus (T2D). METHODS: A comparative nonexperimental study was conducted. Ninety-five T2D individuals aged 65 years and more were recruited. The sample was divided into two groups: 50 participants with T2D and without DPN and 45 participants with T2D and DPN. The Patient Health Questionnaire 9 (PHQ-9) was used to collect information about low mood and depression symptoms in the subjects recruited. RESULTS: Participants with DPN recorded higher scores on PHQ-9 than those with T2D only. The mean PHQ-9 score for the DPN group (6.09) was significantly higher than that for the T2D only group (2.24) (p < 0.001). Participants with DPN were more likely to have mild to moderate or moderately severe low mood and depression symptoms than T2D only participants who exhibited minimal to no low mood and depressive symptoms. CONCLUSIONS: The association between DPN and depression is confirmed by this study, with significant depressive symptoms found in patients with neuropathy when compared to diabetes patients with no neurological complications. It is therefore important that discomfort and emotional problems caused by DPN should be taken seriously and addressed closely in the management of DPN in order to prevent depression. Also, a change in screening practices to identify patients with diabetes and depressive symptoms is required.

The Improvement of Neuropathy and Balance after Combination of Indonesian Diabetic and Indonesian Diabetic Foot Exercise on Diabetic Peripheral Neuropathy

2017 ◽  
Vol 6 (02) ◽  
pp. 2
Author(s):  
Putri Dyah Utami Ryadi ◽  
Tertianto Prabowo ◽  
Irma Ruslina Defi
Keyword(s):  
Peripheral Neuropathy ◽  
Diabetic Neuropathy ◽  
Diabetic Foot ◽  
Diabetic Peripheral Neuropathy ◽  
Diabetes Mellitus Type 2 ◽  
Berg Balance Scale ◽  
Type 2 Dm ◽  
Quasi Experimental ◽  
The Mean

Background: Half of people with Type 2 Diabetes Mellitus (Type 2 DM) developed diabetic neuropathyat 25 years after being diagnosed and around 75% of the neuropathy were diabetic peripheral neuropathy(DPN), that associated with balance disturbance. This study aimed to know the effect of combining Indonesiandiabetic exercise (Senam Diabetes Indonesia/SDI) and Indonesian diabetic foot exercise (Senam Kaki DiabetesIndonesia/SKDI) on improvement of diabetic neuropathy and balance score in people with Type 2 diabeticperipheral neuropathy.Methods: Design study was a quasi-experimental study with pre-posttest design. The participants were Type 2DM patients aged 40-65 years old, with DPN confirmed based on Indonesian version of Diabetic NeuropathySymptom (DNS-INA) >1 or Indones ian version of Diabetic Neuropathy Exmination (DNE-INA) >3, who didnot do exercise regularly. All participants had Berg Balance Scale (BBS) score within 41-55, and the randomperipheral blood glucose within 100-250mg/dL. The BBS, DNE-INA, and DNS-INA score were evaluatedbefore and after 12 weeks of excercise.Results: There were 6 women aged 52-65 years. The mean of BBS, DNS-INA, and DNE-INA scores beforeand after intervention were 54.33±1.032 and 55.16±1.329 (p=0.025), 2.50±1.048 and 1.50±0.836 (p=0.063),3.66±1.505 and 1.33±0.816 (p=0.041), respectively.Conclusion: There were improvement of Berg Balance Score and Diabetic Neuropathy Score after thecombination of Diabetic exercises.Keywords: Berg Balance Score, diabetic neuropathy score, Indonesian Diabetic Exercise, Indonesian FootDiabetic Exercise

scholarly journals Comparison of Efficiencies of Michigan Neuropathy Screening Instrument, Neurothesiometer, and Electromyography for Diagnosis of Diabetic Neuropathy

2013 ◽  
Vol 2013 ◽  
pp. 1-7 ◽  
Author(s):  
Turkan Mete ◽  
Yusuf Aydin ◽  
Mustafa Saka ◽  
Halise Cinar Yavuz ◽  
Sule Bilen ◽  
...  
Keyword(s):  
Peripheral Neuropathy ◽  
Physical Examination ◽  
Diabetic Peripheral Neuropathy ◽  
Diabetes Type 2 ◽  
Screening Instrument ◽  
Diabetes Type ◽  
Diabetic Patients ◽  
Patients With Diabetes ◽  
Michigan Neuropathy Screening Instrument

Aim. This study compares the effectiveness of Michigan Neuropathy Screening Instrument (MNSI), neurothesiometer, and electromyography (EMG) in detecting diabetic peripheral neuropathy in patients with diabetes type 2.Materials and Methods. 106 patients with diabetes type 2 treated at the outpatient clinic of Ankara Numune Education and Research Hospital Department of Endocrinology between September 2008 and May 2009 were included in this study. Patients were evaluated by glycemic regulation tests, MNSI (questionnaire and physical examination), EMG (for detecting sensorial and motor defects in right median, ulnar, posterior tibial, and bilateral sural nerves), and neurothesiometer (for detecting alterations in cold and warm sensations as well as vibratory sensations).Results. According to the MNSI score, there was diabetic peripheral neuropathy in 34 (32.1%) patients (score ≥2.5). However, when the patients were evaluated by EMG and neurothesiometer, neurological impairments were detected in 49 (46.2%) and 79 (74.5%) patients, respectively.Conclusion. According to our findings, questionnaires and physical examination often present lower diabetic peripheral neuropathy prevalence. Hence, we recommend that in the evaluation of diabetic patients neurological tests should be used for more accurate results and thus early treatment options to prevent neuropathic complications.

Self-Reported Depressive Symptoms Might be Associated with Sudomotor Dysfunction in Chinese T2DM Patients

2019 ◽  
Author(s):  
Lijin Ji ◽  
Yuanpin Zhang ◽  
Qi Zhang ◽  
Hangping Zheng ◽  
Wanwan Sun ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Hba1c Level ◽  
Point Of Care ◽  
Community Health Center ◽  
Laboratory Data ◽  
Patient Health ◽  
Michigan Neuropathy Screening Instrument ◽  
The Mean ◽  
Hands And Feet

Abstract Aims To determine the relationships of sudomotor functions, nerve conductions and self-reported depressive symptoms in Chinese type 2 diabetes (T2DM) patients. Methods T2DM patients in a single community health center were included in this study. Demographic, medical and laboratory data were collected. Michigan Neuropathy Screening Instrument (MNSI) examination was conducted in all patients. SUDOSCAN test and Point-of-care Nerve Conduction Device (DPN-check) were conducted and all the patients finished the Patient Health Questionnaire-9 (PHQ-9). Results A total of 162 T2DM patients (74 males and 88 females) were included. The mean age was 69.0±7.2 years and the mean course of diabetes was 10.5±8.0 years with a mean HbA1c level of 7.3±1.4%. Thirty of them (18.5%) had self-reported depressive symptoms (PHQ-9 scores≥5). Diabetic peripheral neuropathy (DPN) was diagnosed according to the MSNI examination in 74 patients. Electrochemical skin conductance (ESC) values of both hands and feet were significantly lower in patients with depressive symptoms (Hands ESC: 60.63±18.92 vs. 67.64±16.02 μS, p<0.05; Feet ESC: 59.60 ± 15.19 vs. 66.19±14.99 μS, p<0.05). The proportion of patients with moderate to severe depressive symptoms were significantly higher in those with ESC values<60 μS (13.33% vs. 3.846%, p<0.05). Hands ESC values were negatively related to PHQ-9 scores (r =− 0.168, p<0.05). After adjusting for variables, hands and feet ESC values remained negatively related with depressive symptoms (β =− 0.036 and−0.038, p<0.05). Female were positively related to depressive symptoms with odds ratio 3.4 (95%CI 1.1–10.5, p<0.05). Conclusion Self-reported depressive symptoms might be associated with sudomotor dysfunction in Chinese T2DM patients.

Vitamin D Status in a Bulgarian Population With Type 2 Diabetes and Diabetic Foot Ulcers

2020 ◽  
pp. 153473462096582
Author(s):  
Ani S. Todorova ◽  
Edward B. Jude ◽  
Rumyana B. Dimova ◽  
Nevena Y. Chakarova ◽  
Mina S. Serdarova ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Vitamin D ◽  
Peripheral Neuropathy ◽  
Diabetic Foot ◽  
Diabetic Peripheral Neuropathy ◽  
Foot Ulcers ◽  
Diabetic Foot Ulcers ◽  
Vitamin D Status ◽  
Active Infection

The aim of this study was to assess vitamin D status in patients with type 2 diabetes and diabetic foot ulcers (DFU). A total of 242 participants with type 2 diabetes, mean age 59.1 ± 10 years, mean body mass index 31.4 ± 6.3 kg/m2, and estimated glomerular filtration rate ≥45 mL/min/1.73m2, were divided into 2 groups: 73 with DFU (35 with and 38 without active infection) and 169 without DFU (106 with diabetic peripheral neuropathy, 63 without complications). Neuropathy was assessed by 10 g monofilament, Rydel-Seiffer 128 Hz tuning fork, and temperature discrimination. Serum 25(OH)D (25-hydroxy vitamin D) was assessed by ECLIA (electro-chemiluminescence immunoassay) method. Median 25(OH)D level was 12.6 ng/mL (IQR [interquartile range] 9.3-17.6 ng/mL) in the studied cohort. The DFU group presented with lower 25(OH)D level as compared with diabetic patients without foot ulcers (non-DFU group): 11.6 ng/mL (IQR 8.5-15.8 ng/mL) versus 13.5 ng/mL (IQR 9.6-18.6 ng/mL), P = .001; the diabetic peripheral neuropathy subgroup demonstrated lower 25(OH)D level in comparison with participants without complications: 12.5 ng/mL (IQR 9-17.2 ng/mL) versus 15.9 ng/mL (IQR 10.4-20.8 ng/mL), P = .031. This remained significantly different even after correction for age and duration of diabetes. There was no difference in 25(OH)D level between the subgroups according to the presence of active infection. In conclusion, vitamin D deficiency may play a role in the development of diabetes complications.

scholarly journals The reliability and validity of the Patient Health Questionnaire-9 (PHQ-9) and PHQ-2 in patients with infertility

2019 ◽  
Vol 16 (1) ◽  
Author(s):  
Saman Maroufizadeh ◽  
Reza Omani-Samani ◽  
Amir Almasi-Hashiani ◽  
Payam Amini ◽  
Mahdi Sepidarkish
Keyword(s):  
Depressive Symptoms ◽  
Internal Consistency ◽  
Convergent Validity ◽  
Univariate Analysis ◽  
Reliability And Validity ◽  
Well Being ◽  
Patient Health Questionnaire ◽  
Depression Symptoms ◽  
Health Questionnaire ◽  
Patient Health

Abstract Background Depression in patients with infertility often goes undiagnosed and untreated. The Patient Health Questionnaire-9 (PHQ-9) and its ultra-brief version (i.e. PHQ-2) are widely used measures of depressive symptoms. These scales have not been validated in patients with infertility. The aim of the present study was to examine the reliability and validity of the PHQ-9 and PHQ-2 in patients with infertility. Methods In this cross-sectional study, a total of 539 patients with infertility from a referral infertility clinic in Tehran, Iran completed the PHQ-9, along with other relevant scales: the WHO-five Well-being Index (WHO-5), the Hospital Anxiety and Depression Scale (HADS), and the Generalized Anxiety Disorder-7 (GAD-7). Factor structure and internal consistency of PHQ-9 were examined via confirmatory factor analysis (CFA) and Cronbach’s alpha, respectively. Convergent validity was evaluated by relationship with WHO-5, HADS and GAD-7. Results The mean total PHQ-9 and PHQ-2 scores were 8.47 ± 6.17 and 2.42 ± 1.86, respectively, and using a cut-off value of 10 (for PHQ-9) and 3 (for PHQ-2), the prevalence of depressive symptoms was 38.6 and 43.6%, respectively. The Cronbach’s alphas for PHQ-9 and PHQ-2 were, respectively, 0.851 and 0.767, indicating good internal consistency. The CFA results confirmed the one-factor model of the PHQ-9 (χ2/df = 4.29; CFI = 0.98; RMSEA = 0.078 and SRMR = 0.044). Both PHQ-9 and PHQ-2 showed moderate to strong correlation with the measures of WHO-5, HADS-depression, HADS-anxiety, and the GAD-7, confirming convergent validity. In univariate analysis, female sex, long infertility duration, and unsuccessful treatment were significantly associated with depression symptoms. Conclusion Both PHQ-9 and PHQ-2 are brief and easy to use measures of depressive symptoms with good psychometric properties that appear suitable for routine use in patients with infertility.

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