scholarly journals Differential diagnosis of polyneuropathies in diabetes mellitus

2021 ◽  
pp. 256-265
Author(s):  
V. N. Khramilin
Keyword(s):  
Diabetes Mellitus ◽  
Differential Diagnosis ◽  
Clinical Manifestations ◽  
Diabetic Polyneuropathy ◽  
Nerve Fibers ◽  
Rapid Progression ◽  
Associated Lesions ◽  
Patients With Diabetes ◽  
History Of ◽  
Inflammatory Neuropathies

Diabetic polyneuropathy (DPN) is heterogeneous in its clinical course and clinical manifestations. Depending on the primary lesion of large or small nerve fibers, different onset, course and clinical manifestations of polyneuropathy are possible. In patients with diabetes, the incidence of associated lesions of the peripheral nervous system is high. When verifying the diagnosis of DPN, it is necessary to carry out a differential diagnosis with a number of diseases: paraneoplastic neuropathies, metabolic neuropathies, neuropathies in vasculitis, toxic neuropathies, autoimmune neuropathies, inflammatory neuropathies and hereditary neuropathies. Diabetes is not the only cause of polyneuropathy. Up to 50% of all cases of polyneuropathies in diabetes have additional causes. Diagnosis of diabetic polyneuropathy - diagnosis of exclusion. The development of polyneuropathy in patients with a duration of type 1 diabetes less than 5 years, the absence of nephropathy and / or retinopathy, asymmetry in symptoms and signs, the predominance of motor symptoms, beginning with upper limb lesions, rapid progression should justify the doctor for differential diagnostic search. You should also take into account the characteristics of the patient (old age, vegetarianism and alcohol use), medical and toxic effects (taking metformin> 3 years and> 2 g / day; cytostatics, chemotherapy, heavy metals), family history of neuropathy. Therapeutic tactics should be individualized and take into account the polyneuropathy polyetiology. The purpose of this review is to discuss the most common reasons peripheral neuropathy in diabetes mellitus. The differential diagnosis of the diabetic polyneuropathy is the focus of this article. 

scholarly journals The relationship between characteristics of calcinosis of the arteries of the lower extremities and the severity of distal neuropathy in the patients with diabetes mellitus

2013 ◽  
Vol 59 (2) ◽  
pp. 7-11
Author(s):  
N A Molitvoslovova ◽  
O V Manchenko ◽  
M V Iaroslavtseva ◽  
G R Galstian
Keyword(s):  
Diabetes Mellitus ◽  
Lower Extremities ◽  
Diabetic Polyneuropathy ◽  
Nerve Fibers ◽  
Tibial Artery ◽  
Leading Role ◽  
Patients With Diabetes ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Aim. To estimate the degree of arterial calcinosis in the distal segments of the lower extremities in the patients presenting with diabetes mellitus (DM) and varying severity of distal diabetic polyneuropathy (DPN). Materials and methods. The study involved 61 patients with DM ( 21 men and 40 women, mean age 51.4 +- 11.68 years) of whom 27 suffered DM1 and 34 DM2. Group 1 was comprised of 37 patients with diabetic osteoarthropathy (DOAP), group 2 included 13 patients with severe DPN, and group 3 11 patients having moderate DPN. All the patients underwent comprehensive laboratory and instrumental examination including measurement of peripheral sensitivity and electromyography. The degree of arterial calcinosis in the distal segments of the lower extremities was determined using multispiral computed tomography (MSCT) with the calculation of the Agatston tibial artery calcification scores. Results. The groups were matched for the patients' age, duration of disease, total cholesterol and creatinin levels, and glomerular filtration rate. Moreover, the patients of groups 1 and 2 were matched for the functional state of nerve fibers in the lower extremities and were significantly different in respect to this characteristic from the patients of group 3. Median of the Agatston tibial artery calcification scores in group 1 was 365.4 (min - 0, max - 1600) and in group 2 2.7 (min - 0, max - 74.6). Groups 1 and 2 were comparable in terms of the degree of calcinosis and were significantly different from group 3 (p < 0.05 1 vs 3; p < 0.005 2 vs 3). The Agatston tibial artery calcification scores negatively correlated with the motor response (r = -0.3; p < 0.05) and vibrational sensitivity (r = -0.4, p < 0.01). Conclusion. Results of the study suggest the leading role of DPN in the development and progression of arterial calcinosis in the distal segments of the lower extremities in the patients with diabetes mellitus.

scholarly journals Dry Eye Syndrome in Patients with Diabetes Mellitus: Prevalence, Etiology, and Clinical Characteristics

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Xinyuan Zhang ◽  
Lin Zhao ◽  
Shijing Deng ◽  
Xuguang Sun ◽  
Ningli Wang
Keyword(s):  
Diabetes Mellitus ◽  
Dry Eye ◽  
Keratoconjunctivitis Sicca ◽  
Clinical Manifestations ◽  
Treatment Strategies ◽  
Dry Eye Syndrome ◽  
Surface System ◽  
Patients With Diabetes ◽  
Function Unit ◽  
Substantial Progress

There has been substantial progress in our understanding of the ocular surface system/lacrimal function unit in the past 15 years. Keratoconjunctivitis sicca, more commonly referred to as dry eye syndrome (DES), is the most frequently encountered condition and diabetes mellitus (DM) has been identified as one of the leading causes of DES. Poor glycemic control affects both the anterior and the posterior segments of the eye and increasing prevalence of diabetes-associated DES (DMDES) has been reported in recent years. The pathogenesis and specific features of DMDES remain uncertain and interventions are limited to those used in DES. This review outlines the pathogenesis, clinical manifestations, and the current preventive and treatment strategies for diabetes-related DES.

Nasal mucociliary clearance in patients with diabetes mellitus

1989 ◽  
Vol 103 (9) ◽  
pp. 853-855 ◽  
Author(s):  
W. L. Yue
Keyword(s):  
Diabetes Mellitus ◽  
Mucociliary Clearance ◽  
Mean Value ◽  
Nasal Disease ◽  
Patients With Diabetes ◽  
History Of ◽  
Insulin Dependent ◽  
Mucociliary Function ◽  
The Mean ◽  
Nasal Mucociliary Clearance

AbstractFifty insulin-dependent diabetics and 50 non-diabetics without a history of nasal disease have been studied for nasal problems including mucociliary function complicated by diabetes mellitus. For the diabetics, the mean value of nasal mucociliary clearance was considerably decreased and this was more often associated with dry noses but increased pH-values, both of which were higher than those for non-diabetics (p<0.05). As suggested in earlier literature, more aggressive nasal moistening therapy must be recommended for those patients presenting with these conditions in the light of systemic diabetic abnormalities.

scholarly journals Depression and Anxiety among Patients with Type II Diabetes Mellitus in Chitwan Medical College Teaching Hospital, Nepal

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Kalpana Sharma ◽  
Govinda Dhungana ◽  
Shailendra Adhikari ◽  
Archana Bista Pandey ◽  
Muna Sharma
Keyword(s):  
Diabetes Mellitus ◽  
College Teaching ◽  
Educational Status ◽  
Current Treatment ◽  
Depression And Anxiety ◽  
Medical College ◽  
Prevalence Of Depression ◽  
Patients With Diabetes ◽  
History Of ◽  
Diabetes Patients

The prevalence of depression and anxiety disorders is common among people with diabetes mellitus. Coexistence of diabetes and depression/anxiety increases the risk of diabetes complications and reduces the overall quality of life. Hence, this study aimed to assess the depression and anxiety among patients with type 2 diabetes mellitus in Chitwan. Descriptive survey was carried out among 296 purposively selected clinically diagnosed type 2 diabetes patients admitted in the Chitwan Medical College Teaching Hospital from 15th June 2018 to 17th September 2019. Patients were interviewed using the Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorders-7 (GAD-7). Data were analyzed using descriptive and inferential statistics. Of 296 diabetic patients, 48.6% were 60 years and above, 59.5% female and 61.5% literate; their common occupation was agriculture (38.2%) followed by household work (26.4%). Nearly two-thirds (62.8%) of diabetes patients had other chronic comorbid conditions. Depression and anxiety were observed among 57.8% and 49.7% of diabetes patients, respectively. While observing the severity, 27.4%, 19.6%, 8.4%, and 2.4% of patients had mild, moderate, moderately severe, and severe depression, respectively. Likewise, 24.7%, 20.3%, and 4.7% of patients had mild, moderate, and severe anxiety, respectively. Current living status, educational status, medicine adherence, satisfaction toward current treatment, and history of mental illness in the family were found to be significant factors associated with the anxiety of patients with diabetes. Further, educational status, smoking habit, satisfaction towards current treatment, and history of diabetes in family were the factors associated with depression. Prevalence of depression and anxiety is high among admitted patients with diabetes mellitus, and many factors are associated with it. Hence, regular screening services are essential along with diabetes management plan for timely identification and treatment of the vulnerable groups in the healthcare centers.

scholarly journals A Study to Evaluate the Quality of Life of Patients with Diabetes Mellitus

2021 ◽  
pp. 575-585
Author(s):  
P. Amulya Reddy ◽  
K. Saravanan ◽  
A. Madhukar
Keyword(s):  
Diabetes Mellitus ◽  
Diabetes Management ◽  
Study Data ◽  
Categorical Variables ◽  
P Value ◽  
Diabetic Patients ◽  
Physical Endurance ◽  
Glucose Levels ◽  
Patients With Diabetes ◽  
History Of

Aim: The aim of the study was to evaluate the QOL of patients with Diabetes Mellitus. Study Design: This was a prospective, observational study. Duration of Study: The study was conducted from August 2019 to January 2021 in Yashoda Hospital, Hyderabad. Methodology: Patients of either sex with ≥1year history of diabetes willing to give the consent were included in the study. Patients of either sex with <1year history of DM, Pregnant/lactating women and patients not willing to give the consent were excluded from the study. Data on Blood glucose levels (FBS, PPBS) and HbA1C was also obtained and assessed. QOLID questionnaire was administered to the patients and assessed which consisted of a set of 34 items representing 8 domains such as Role limitation due to the physical health, Physical endurance, General health, Treatment satisfaction, Symptom botherness, Financial worries, Mental health, and Diet satisfaction). Results: A total of 200 patients were analysed in the study,108(54%) were males and 92(46%) were females. The average age of the patients was 58.5 years with majority being 51-70years (73.5%) of age. Patients with higher age and females had poor QOL compared to others. The correlation between various categorical variables with that of scores of QOL in various domains was assessed, Age of the patients influenced QOL score in various domains like RLPH (p value-0.038), PE (p value-0.0183), and SB (p value-0.0002), Gender has influenced QOL score in domains like RLPH (p value-0.0008), PE (p value-0.0106), TS (p value-0.0005) and Educational Qualification has influenced QOL score in RLPH (p value-0.0008), GH (p value-<0.0001), TS (p value-<0.0001), E/MH (p value-<0.0001). Conclusion: The results concluded that overall QOL was noticeably low in Diabetic patients especially in Women and elderly thus indicating that Diabetes management is not restricted to treatment but also requires attention on QOL of patients.

scholarly journals THE USE OF A VITAMIN-MINERAL COMPLEX IN THE COMBINED THERAPY OF PATIENTS WITH OBESITY AND TYPE 2 DIABETES MELLITUS: A CLINICAL TRIAL

2021 ◽  
Vol 22 (1) ◽  
pp. 60-71
Author(s):  
I.A. Lapik ◽  
◽  
K.M. Gapparova ◽  
A.V. Galchenko ◽  
◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Combined Therapy ◽  
Clinical Manifestations ◽  
Micronutrient Deficiency ◽  
The Body ◽  
Control Group ◽  
Mineral Complex ◽  
Patients With Diabetes

Low caloric diet is used in the complex treatment of patients with diabetes mellitus and obesity. However, the reduced caloric food can inadvertently lead to decreased intake of micronutrients. The main goal of the research was to assess the necessity and effectiveness of the vitamin-mineral complex in the treatment of type 2 diabetes with obesity. Methods: 80 females suffering from type 2 diabetes and obesity, ranging from 40 to 65 years old participated in the study. The total patients were divided into two groups, each containing 40 patients. All patients were given a personalized diet and 1000mg of metformin every day. The experimental group, besides that, received vitamin-mineral complex. The biochemical analysis of the blood, composition of the body, and the complaint on micronutrient deficiency were taken before the experiment and after 14 days of the therapy. Results: Supplementation of the vitamin-mineral complex was associated with higher blood serum levels of vitamins B6, B12, B9, C, D, potassium, calcium, magnesium and zinc, and lower levels of glucose. Clinical manifestations, associated with micronutrient deficiency, were significantly decreased in patients who were given vitamin-mineral complex. All these changes were valid both in relation to the initial level in the study group and to the indicators after treatment in the control group. Conclusion: Micronutrient supplements may be a very important part of the combined therapy of patients with diabetes mellitus and obesity.

scholarly journals Factors associated with undertriage in patients classified by the need to visit a hospital by telephone triage: a retrospective cohort study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ryota Inokuchi ◽  
Xueying Jin ◽  
Masao Iwagami ◽  
Toshikazu Abe ◽  
Masatoshi Ishikawa ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Cerebral Infarction ◽  
Clinic Visit ◽  
Telephone Triage ◽  
Hospital Visit ◽  
Over The Counter ◽  
Factors Associated ◽  
Patients With Diabetes ◽  
History Of ◽  
House Call

Abstract Background Prehospital telephone triage stratifies patients into five categories, “need immediate hospital visit by ambulance,” “need to visit a hospital within 1 hour,” “need to visit a hospital within 6 hours,” “need to visit a hospital within 24 hours,” and “do not need a hospital visit” in Japan. However, studies on whether present and past histories cause undertriage are limited in patients triaged as need an early hospital visit. We investigated factors associated with undertriage by comparing patient assessed to be appropriately triaged with those assessed undertriaged. Methods We included all patients classified by telephone triage as need to visit a hospital within 1 h and 6 h who used a single after-hours house call (AHHC) medical service in Tokyo, Japan, between November 1, 2019, and November 31, 2020. After home consultation, AHHC doctors classified patients as grade 1 (treatable with over-the-counter medications), 2 (requires hospital or clinic visit), or 3 (requires ambulance transportation). Patients classified as grade 2 and 3 were defined as appropriately triaged and undertriaged, respectively. Results We identified 10,742 eligible patients triaged as need to visit a hospital within 1 h and 6 h, including 10,479 (97.6%) appropriately triaged and 263 (2.4%) undertriaged patients. Multivariable logistic regression analyses revealed patients aged 16–64, 65–74, and ≥ 75 years (adjusted odds ratio [OR], 2.40 [95% confidence interval {CI} 1.71–3.36], 8.57 [95% CI 4.83–15.2], and 14.9 [95% CI 9.65–23.0], respectively; reference patients aged < 15 years); those with diabetes mellitus (2.31 [95% CI 1.25–4.26]); those with dementia (2.32 [95% CI 1.05–5.10]); and those with a history of cerebral infarction (1.98 [95% CI 1.01–3.87]) as more likely to be undertriaged. Conclusions We found that older adults and patients with diabetes mellitus, dementia, or a history of cerebral infarction were at risk of undertriage in patients triaged as need to visit a hospital within 1 h and 6 h, but further studies are needed to validate these findings.

scholarly journals Clinical manifestations and risk factors of coronary artery disease in patients with diabetes mellitus in western Siberia

2010 ◽  
Vol 69 (3) ◽  
pp. 278-284
Author(s):  
Vadim A. Kuznetsov ◽  
Elena I. Yaroslavskaya ◽  
Marina I. Bessonova ◽  
Ivan S. Bessonov ◽  
Igor P. Zyrianov ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Western Siberia ◽  
Clinical Manifestations ◽  
Patients With Diabetes ◽  
Artery Disease
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