Features of diabetic polyneuropathy in patients with diabetes mellitus according to the results of electroneuromyography

The aim of the study was to evaluate foot bone mineral density (BMD) in diabetes mellitus (DM) complicated with distal neuropathy (DN). Materials and methods. 61 patients with DM (DM1-27, DM2-34) were included. 37patients had Charcot osteoarthropathy (the 1st group), the 2nd group (13 patients) with severe DN, the 3rd group (11 patients) with mild DN, and control group consisted of 15 healthy people. All patients underwent dual energy X-ray absorptiometry (DXA) Lunar Prodigy scan. BMD was measured in lumbar spine, hip and radius. Foot BMD was measured using the «Total Body» region’s analysis. Results. There was a significant difference in foot BMD between controls and the 1st (р=0,031) and the 3rd (р=0,027) groups with no significant difference between the groups of patients. Foot BMD significantly correlated with spine, hip and radiusBMD (г=0,5-0,63, р<0,00001), BMI (r=0,4, р=0,000). Negative correlation was found between foot BMD and diabetes duration (r=-0,3, p<0,005) and HbA1c (r=-0,2, р=0,045). No correlation was found between DN and foot BMD. Conclusion. No association between severity of DN and foot BMD was found.

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The sensitivity of electromyoneurography in the diagnosis of diabetic polyneuropathy

Medicinski pregled ◽

10.2298/mpns1102011c ◽

2011 ◽

Vol 64 (1-2) ◽

pp. 11-14

Author(s):

Milan Cvijanovic ◽

Miroslav Ilin ◽

Petar Slankamenac ◽

Sofija Banic-Horvat ◽

Zita Jovin

Keyword(s):

Diabetes Mellitus ◽

Nervous System ◽

Early Diagnosis ◽

Diabetic Polyneuropathy ◽

Peripheral Neurons ◽

Peripheral Nerve Damage ◽

Clinical Syndromes ◽

Patients With Diabetes ◽

Tendon Reflexes

Diabetic polyneuropathy is a complex set of clinical syndromes, which deplete various regions of the nervous system. The process leading to diabetic neuropathy is multi-factorial. Its symptoms are paresthesia, dysesthesia and pain. The signs of damage to the peripheral neurons are hypoesthesia, hypoalgesia, hyperesthesia and hyperalgesia, decreased tendon reflexes, and, possibly, weakness and muscle atrophy. There is no universal classification. Electromyoneurography is indispensable in the diagnosis of diabetic polyneuropathy. However, there is no agreement on the most sensitive parameter for an early diagnosis. One hundred patients with diabetes mellitus were examined in order to investigate the sensitivity of different electromyographic parameters. Electromyographic techniques proved to be entirely sensitive for the early diagnosis of diabetic polyneuropathy. Some of the parameters are more suitable for an early detection of peripheral nerve damage, and others, which are not so sensitive but easy to use and stable, are suitable to follow up the course of diabetic polyneuropathy.

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OUR EXPERIENCE OF USING AUTOLOGICAL BLOOD SERUM IN COMPLEX TREATMENT OF BACTERIAL CORNEAL ULCERS IN PATIENTS WITH DIABETES MELLITUS DEPENDING ON THESEVERETY OF DIABETIC POLYNEUROPATHY

Kharkiv Surgical School ◽

10.37699/2308-7005.3.2020.18 ◽

2020 ◽

pp. 92-98

Author(s):

O. V. Zavoloka ◽

P. A. Bezditko ◽

M. A. Karliychuk ◽

N. M. Bezega

Keyword(s):

Diabetes Mellitus ◽

Type 1 Diabetes ◽

Corneal Ulcer ◽

Diabetic Polyneuropathy ◽

Autologous Serum ◽

Eye Drops ◽

Corneal Sensitivity ◽

Corneal Ulcers ◽

Patients With Diabetes

Summary. Diabetic keratopathy, which develops against the background of diabetic corneal neuropathyshould be taken into account when choosing tactics for the treatment of bacterial corneal ulcers in patients with diabetes mellitus. The aim of the study was to determine the effectiveness of treatment of bacterial corneal ulcers with the help of additional local use of autological serum eye drops in patients with type 1 diabetes depending on the severity of diabetic polyneuropathy (DPN). Materials and methods. The results of observation of 10 patients (10 eyes) with bacterial corneal ulcer and type 1 diabetes mellitus, in which delayed healing of corneal ulcer defect were noted and the absence of microorganisms ware confirmed by repeated bacteriological examinations of corneal smears and scrapings,were analyzed. In addition to standard therapy, all patients 2 weeks after the start of treatment were additionally prescribed eye drops with autologous serum. Patients were divided into 2 groups according to the stage of severity of DPN: the first group consisted of 5 patients with symptomatic stage, the second - 5 patients with a stage of severe complications. In addition to standard, ophthalmic examination methods included bacteriological examination, fluorescein test, OCT of the anterior segment of the eye on the device TOPCON 3D OCT-2000, non-contact examination of corneal sensitivity. Results and discussion. It was found that the threshold of corneal sensitivity in patients with bacterial corneal ulcer at the stage of severe complications of DPN was higher than that in symptomatic DPN by an average of 16.6 % during the observation. The degree of pericorneal injection and infiltration of the cornea, as well as the size and depth of the ulcerative defect of the cornea at the stage of severe complications exceeded the corresponding indicators of patients with symptomatic DPN during the observation. Normalization of conjunctival color and reepithelialization of the cornea in all patients with severe complications occurred 3 days later than in patients with symptomatic DPN. Conclusions. The course of bacterial keratitis in patients with diabetes mellitus depends on the severity of DPN: a pronounced violation of corneal innervation at the stage of severe complications of DPN, manifested by a decrease in its sensitivity, leads to prolongation of treatment, even with additional use of eye drops with autologous serum.

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Differential diagnosis of polyneuropathies in diabetes mellitus

Medical Council ◽

10.21518/2079-701x-2021-12-256-265 ◽

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.

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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

Problems of Endocrinology ◽

10.14341/probl20135927-11 ◽

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.

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LABORATORY INDICATORS OF DIABETIC POLYNEUROPATHY

Medical academic journal ◽

10.17816/maj191s1112-114 ◽

2019 ◽

Vol 19 (1S) ◽

pp. 112-114

Author(s):

T V Stepanova ◽

E B Popyhova ◽

A N Ivanov

Keyword(s):

Diabetes Mellitus ◽

Tissue Damage ◽

Neural Tissue ◽

Diabetic Polyneuropathy ◽

Laboratory Diagnosis ◽

Diagnostic Significance ◽

Complications Of Diabetes ◽

Neurospecific Proteins ◽

Patients With Diabetes ◽

The Common

This study is devoted to diabetic polyneuropathy (DPN) - one of the common complications of diabetes mellitus (DM). The possibilities of laboratory diagnosis of this condition are shown. The purpose of this study was to examine the pathogenetic and diagnostic significance of certain neurospecific proteins and cytokines in DPN. The analysis of the literature data on the possibility of using neurospecific proteins and some cytokines in patients with diabetes as markers of neural tissue damage has been carried out.

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Pathogenesis, evaluation and pathogenetic therapy of diabetic polyneuropathy

Neurology neuropsychiatry Psychosomatics ◽

10.14412/2074-2711-2021-3-99-106 ◽

2021 ◽

Vol 13 (3) ◽

pp. 99-106

Author(s):

I. A. Strokov ◽

V. V. Oganov

Keyword(s):

Diabetes Mellitus ◽

Diabetic Polyneuropathy ◽

Late Complications ◽

Common Type ◽

Randomized Controlled ◽

High Prevalence ◽

Patients With Diabetes ◽

Pathogenetic Therapy ◽

Modifying Effect ◽

Cellular Pathology

The increase in the number and life expectancy of patients with diabetes mellitus (DM) worldwide determines the high prevalence of late complications of diabetes, including diabetic polyneuropathy (DPN), the most common type of polyneuropathy. Oxidative stress is considered the main reason for the cellular pathology development in diabetes mellitus, which determines the use of antioxidants for the DPN treatment. Alpha-lipoic acid (ALA), a natural fat-soluble antioxidant, is the most effective drug for reducing DPN symptoms. Furthermore, the symptom-modifying effect of ALA has been shown in numerous randomized controlled trials. The article discusses the possible disease-modifying effect of ALA.

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