scholarly journals EARLY IDENTIFICATION OF THE NEUROLOGICAL COMPLICATIONS OF DIABETES MELLITUS

Author(s):  
Huseyn Elcin ◽  

Diabetes mellitus is still a very common disease in the world and affects the daily lives of patients negatively. Diabetes is also known to be associated with neurological diseases such as peripheral nerve diseases, stroke and dementia. Among these, the most common disease is a peripheral nerve disease, and it has been reported that poor diabetic control increases the risk of development and can be prevented by education of the patients. Vascular dementia is more common in patients with diabetes than Alzheimer's disease, and it is thought that cerebrovascular diseases may berelated to cognitive impairment in diabetes. Although the mechanisms by which diabetes affects the brain are not clearly revealed, it is thought that changes in vascular structure, insulin resistance, glucose toxicity, oxidative stress, accumulation of glycation end products, hypoglycemic episodes and amyloid metabolism are effective.The aim of this article is to describe the neurological complications of diabetes and to emphasize the importance of patient education, good diabetes control and early diagnosis in preventing these complications.

2011 ◽  
Vol 48 (1) ◽  
pp. 66-71 ◽  
Author(s):  
Jacqueline Nelisis Zanoni ◽  
Eleandro Aparecido Tronchini ◽  
Sheila Alves Moure ◽  
Ivan Domicio da Silva Souza

CONTEXT: Peripheral neuropathy is one of the chronic complications of diabetes mellitus and is directly related to gastrointestinal consequences of the disease. Myenteric neurons are affected in some pathological conditions such as diabetic neuropathy. The imbalance between cellular antioxidants and free radicals, leading to an increase in oxidative stress, is considered one of the main factors responsible for neuronal damages in diabetes. Drugs that reduce the oxidative stress may play a significant role in the treatment of neurological complications of diabetes mellitus. OBJECTIVE: To evaluate the effect of L-glutamine supplementation on the myenteric neurons from the cecum and duodenum of Wistar rats with streptozotocin-induced diabetes mellitus. METHODS: The animals were divided in four groups (n = 5): non-treated normoglycemics, normoglycemics treated with L-glutamine, non-treated diabetics and diabetics treated with L-glutamine from the 4th day of diabetes induction on. The amino acid L-glutamine was added to their diet at 1%. Giemsa's technique was employed to stain the myenteric neurons. We determined the cell body area of 500 neurons in each group studied. The quantitative analysis was performed by sampling in an area of 16.6 mm² in the cecum and 3.6 mm² in the duodenum of each animal. RESULTS: After the supplementation with L-glutamine in the duodenum, we observed a preservation of neuronal density in groups normoglycemic and diabetic (P<0.05). We also observed a preservation of the cell bodies area in diabetic animals (group treated with L-glutamine) (P<0.05). In the cecum, that preservation was not evident. CONCLUSION: Supplementation with L-glutamine (1%) promoted a neuroprotective effect on the myenteric neurons from the duodenum of rats, both in terms of natural aging and of diabetes mellitus.


Author(s):  
Abdullaev R.N. ◽  

The number of patients with diabetes mellitus in the Andijan region who were registered according to endocrinologists from 2000 to 2015 increased almost fourfold from 26,000 to more than 110,000 in 2016 (14). This also shows that the number of patients with various purulent-necrotic complications of diabetes mellitus also increases proportionally, in addition, there is an increase in patients with severe purulent-septic complications of these processes, with widespread, deep purulent-necrotic fasciitis [3]. Of patients in the department of surgical infection of the ASMI clinic, patients with purulent-necrotic complications of diabetes mellitus account for almost 78%, which indicates a significant increase in the number of these patients. This tendency continues and goes up every year. According to the WHO, by 2030 every 15 people will have diabetes, and by 2050 this figure will be equal to every 6 people.


2021 ◽  
Vol 15 (10) ◽  
pp. 3170-3172
Author(s):  
Ayesha Masood ◽  
Sana Rehman ◽  
Imran Joher ◽  
Mazhar Ali Bhutto

Aim: This descriptive cross-sectional study was conducted to assess individual information about diabetes complications in patients with diabetes from questionnaires, and to find a relationship of this information to educational attainment and other sociodemographic profiles. Place and duration: Medical Department of Sharif Medical College, Lahore from January 2021 to June 2021. Methods: A total of 192 patients were enrolled in the study. People older than 16 years and who understand the query guidelines well were selected. All subjects answered the questionnaires given voluntarily and safely. The complete questionnaire was accessible in English language but was carefully translated to the official Pakistani language (Urdu). The enquiries were intended to evaluate how they knew about the diabetes mellitus complications and what those complications were. We use the SPSS 21.0 for data input and analysis. Chi-square test was applied for variables comparison. Results: We institute in this study that 94 people (48.9%) knew that the major impediment of diabetes is heart disease when blood sugar was not properly controlled, trailed by kidney disease (10.4%), and hypertension (7.8%), Eye Disease (2.6%) and cerebrovascular disease 32(16.6%). Regrettably, responsiveness was found about the presence of peripheral neurological problems, diabetic foot disease and unexpected bereavement was found in 1(0.5%) case only. Each of the subjects were inquired if they were concerned about serious complications of diabetes. Conclusions: There was statistical difference in any of the parameters (individual education, residence, monthly income, occupation, family history) depending on the degree of anxiety. The parameters were statistically significant. Further development of diabetes education programs, such as the use of the media and participation in national education programs, can improve the awareness of self-regulation of diabetes, which may decrease the mortality and morbidity of patients with diabetes. Keywords: Diabetic complications, anxiety.


Author(s):  
М.М. Танашян ◽  
К.В. Антонова ◽  
А.А. Шабалина ◽  
О.В. Лагода ◽  
Т.И. Романцова

Введение. Сахарный диабет (СД) связан с формированием протромботического состояния и является фактором развития цереброваскулярных заболеваний (ЦВЗ). Гипергликемия приводит к повышенному образованию конечных продуктов гликирования (КПГ) и гликированию мембранных протеинов клеток крови. Не изучена роль КПГ в формировании протромбогенного потенциала крови у больных с ЦВЗ как на фоне СД 2-го типа, так и без него. Цель исследования: оценить изменения параметров гемостаза у больных с ЦВЗ во взаимосвязи с маркерами гликирования. Материалы и методы. В исследование включено 160 пациентов с ЦВЗ, группа 1 — 80 больных с СД 2-го типа, группа 2 — 80 больных без СД. Всем пациентам определяли стандартный биохимический профиль, измеряли уровень гликемии и гликированного гемоглобина, КПГ, АДФ-индуцированную (АДФ-АТ) и адреналин-индуцированную агрегацию тромбоцитов, развернутую коагулограмму с определением фибринолитической активности (ФА), индекса фибринолиза и Д-димера. Результаты. Распространенность перенесенных ранее нарушений мозгового кровообращения и гемодинамически значимых стенозов сонных артерий были выше у больных с СД 2-го типа, чем у больных без СД. Уровень КПГ статистически значимо был выше у больных СД — 473,0 ± 148,4 [390; 600] нг/мл против 325,8 ± 77,1 [250; 480] нг/мл у больных без СД, что сопровождалось повышением уровня Д-димера и снижением фибринолитических свойств крови. Показатели агрегации тромбоцитов у больных СД 2-го типа также превышали таковые у пациентов без СД. В обеих группах выявлены статистически значимые отрицательные корреляции уровня КПГ c ФА (r = –0,426117) и индексом фибринолиза (r = –0,36) и положительная корреляция между уровнем КПГ и АДФ-АТ (r = 0,4176). Заключение. У пациентов с ЦВЗ повышение образования КПГ сопровождалось активацией тромбоцитарного звена гемостаза, угнетением фибринолиза и способствовало формированию протромбогенного потенциала крови. При этом наличие СД 2-го типа обуславливало наиболее клинически тяжелое течение ЦВЗ, сопровождавшееся более выраженными протромботическими изменениями, коррелирующими с повышением уровня КПГ, и плохим гликемическим контролем. Introduction. Diabetes mellitus (DM) is associated with the formation of a prothrombotic state and is a factor in the development of cerebrovascular diseases (CVD). Hyperglycemia leads to increased formation of glycation end products (GEP) and glycation of membrane proteins of blood cells. The role of GEP in the formation of blood prothrombogenic potential in patients with CVD, both with DM type 2 and without it, has not been studied. Aim: to assess hemostatic parameters changes in patients with CVD in conjunction with glycation markers. Materials and methods. The study included 160 patients with CVD, group 1 — 80 patients with DM type 2, group 2 — 80 patients without DM. Standard biochemical profi le with determination of glycemia and glycated hemoglobin levels, GEP content, ADP-induced (ADP-AT) and adrenaline-induced platelet aggregation, detailed coagulogram with determination of fibrinolytic activity (FA), fi brinolysis index and D-dimer were determined in all patients. Results. The prevalence of earlier disorders in cerebral blood circulation and hemodynamically signifi cant stenoses of the carotid arteries were higher in patients with DM type 2 than in patients without DM. GEP level was statistically significantly higher in patients with DM — 473,0 ± 148.4 [390; 600] ng/ml vs. 325.8 ± 77.1 [250; 480] ng/ml in patients without DM that was accompanied by increasing of D-dimer content and decreasing of blood fi brinolytic properties. Parameters of platelet aggregation in patients with DM type 2 also exceeded those in patients without DM. In both groups, we revealed statistically significant negative correlations between GEP and FA (r = –0.426117), between GEP and fi brinolysis index (r = –0.36) and positive correlation between GEP and ADP-AT (r = 0.4176). Conclusion. In patients with CVD, increased GEP formation is accompanied by activation of platelet hemostasis, inhibition of fi brinolysis and contributes to the formation of prothrombogenic blood potential. In this case, the presence of DM type 2 causes the most clinically severe course of CVD, accompanied by more pronounced prothrombotic changes, correlating with an increase of GEP level and a poor glycemic profile.


Neurosurgery ◽  
2011 ◽  
Vol 68 (1) ◽  
pp. 53-61 ◽  
Author(s):  
Adnan I. Qureshi ◽  
Nauman. Tariq ◽  
Ameer E. Hassan ◽  
Gabriela. Vazquez ◽  
Haitham M. Hussein ◽  
...  

Abstract BACKGROUND: Transient or permanent neurological complications can occur in the periprocedural period following intracranial angioplasty and/or stent placement. Which patients are at risk and the time period for maximum vulnerability among those who undergo intracranial angioplasty and/or stent placement have not been formally studied. OBJECTIVE: To assess the predictors and timing of neurological complications following intracranial angioplasty and/or stent placement in the periprocedural period in a consecutive series of patients. METHODS: We reviewed medical records and angiograms of consecutive patients treated with intracranial angioplasty and/or stent placement in 3 academic institutions. We evaluated the effect of demographic, clinical, intraprocedural, and angiographic risk factors on subsequent development of periprocedural neurological complications. Periprocedural neurological complications were defined as new or worsening transient or permanent neurological complications that occurred during or within 1 month of the procedure. We also recorded the timing and nature of neurological complications in the periprocedural period. RESULTS: A total of 92 patients were included in the study (mean age ± standard deviation: 59 ± 14 years; 59 were men). The overall rate of in-hospital neurological complications was 9.8% (9 of 92 patients). Eight out of 9 neurological complications occurred either during the procedure or within 6 hours thereafter. Presence of diabetes mellitus (P = .003) and use of balloon-expandable stent (P = .09) were associated with periprocedural neurological complications. The degree of pre- and post-procedure stenosis, morphological appearance, and length of lesion were unrelated to periprocedural complications. CONCLUSION: Patients with diabetes mellitus and those treated with balloon expandable stents are at high risk for periprocedural neurological complications. The first 6 hours following intracranial angioplasty and stent placement represent the period of highest risk.


2020 ◽  
Vol 11 (2) ◽  
pp. 71-79
Author(s):  
Elvis Godam ◽  
◽  
Wilson Hamman ◽  
Sunday Oladele ◽  
Modupeola Samaila ◽  
...  

Diabetic encephalopathy and its associated end organ damage have become a major global epidemic in many patients with diabetes mellitus. These diseased conditions are complex and poorly understood, therefore the need to seek for alternative management measures to attenuate the complications associated with it. The aim of this study was to evaluate the effects of co-administration of melatonin and magnesium on the cytoarchitecture of the hippocampus of streptozotocin (STZ) induced diabetic rats. STZ was used to induce type 1 diabetes mellitus. Fifty four rats: Forty eight diabetic and six normoglycaemic rats distributed in nine groups as follow; normal control, diabetic control (DC), melatonin low dose (MLD, 10 mg/kg), magnesium low dose (MgLD, 240 mg/kg), melatonin and magnesium combined dose (MMgLD, 10 mg/kg+240 mg/kg, respectively), melatonin high dose (MHD, 20 mg/kg), magnesium high dose (MgHD, 480 mg/kg), melatonin and magnesium high dose (MMgHD, 20 mg/kg+480 mg/kg, respectively) and insulin (IN, 500 mg/kg). Melatonin and insulin were administered through intraperitoneal injections while magnesium was orally. The control groups were given placebo and all treatments were for twenty-one days. Results showed distortion of hippocampal CA1 area in the diabetic control, MgLD, MgHD, MMgHD and IN groups. MLD, MHD and MMgLD groups showed organized structures of hippocampus CA1 area with no cellular distortions, while there were less positive GFAP in the MLD, MHD and MMgLD groups. The DC, MgLD. MgHD, MMgHD and IN groups showed strong GFAP reactivity. In conclusion, MLD, MHD and MMgLD increased neuroprotection of hippocampal neurocytes


2002 ◽  
Vol 55 (7-8) ◽  
pp. 329-332
Author(s):  
Andrea Peter

Introduction Charcot joints are considered to be chronic complications of diabetes mellitus. Although it is not a common disease, due to its progressive character, it can lead to permanent immobility and reduces quality of life in these patients. It is known that evolution of Charcot joints has three stages and the best results of therapy can only be achieved in the first stage. Later, only surgical treatment can be considered with very poor results. Case report This is a case report of a young patient with a very severe form of diabetic arthropathy and other complications of diabetes. This 27-year old woman suffered from diabetes for 10 years and her family history showed that her grandfather and uncle had diabetes too. During physical examination severe deformities of the foot and malleolus were detected. Detection of chronic complications required evaluation of the level of neuropathy. Discussion Chronic complications of diabetes are very frequent. A severe form of complications are Charcot joints that can lead to permanent immobility. That is why it is important to recognize the early signs and symptoms of these changes in order to treat them in the early phase when best results are expected.


2021 ◽  
Vol 77 (3) ◽  
pp. 111-119
Author(s):  
Larysa Zhuravlyova ◽  
Mariia Oliinyk ◽  
Yulia Sikalo

The number of patients with diabetes mellitus in the world has been progressively increasing in recent years, therefore, the fight against complications of diabetes mellitus is an important problem of our time. The purpose of our review is to analyze the literature data on the risks of osteoporosis in patients with diabetes mellitus, effective diagnostic methods, as well as current recommendations for the treatment and prevention of osteoporosis in this category of patients. Results. We have processed and analyzed literary sources and internationalrecommendations, which identify the main mechanisms and risk factors that contribute to the development of osteoporosis in patients with type 1 and 2 diabetes mellitus; methods for the timely diagnosis of osteoporosis are indicated, methods for correcting the condition of patients with diabetes mellitus, which can help prevent the development of osteoporosis in this group of patients, are given. The current recommendations for the treatment of osteoporosis in men and women are presented. Conclusions. Taking into account the data of the analysis of literary sources, osteoporosis can be considered one of the complications of diabetes mellitus. Today, densitometry and fracture risk assessment FRAX are quite sensitive methods for early diagnosis of osteoporosis in patients with type 1 diabetes mellitus, but not sufficient for patients with type 2 diabetes mellitus, therefore there is a need to determine the trabecular bone index during densitometry, as well as additional actions when assessing the risk of fractures on the FRAX scale. Therapy of patients with osteoporosis with concomitant diabetes mellitus should be based on the achievement of target glycemic levels and the use of bisphosphonates with target level of calcium and vitamin D.


2021 ◽  
pp. 25-30
Author(s):  
K. A. Makhinov ◽  
P. R. Kamchatnov

Diabetes mellitus (DM) causes damage to various body systems, including the peripheral nervous system. The main variants of peripheral nerve damage in diabetes mellitus are considered. Information on the development of this kind of lesion, in particular, on the formation of neuropathic pain syndrome, is given. The therapeutic possibilities of drugs from various pharmacological groups for the treatment of patients with neurological complications of diabetes are analyzed.


Diabetes ◽  
1986 ◽  
Vol 35 (9) ◽  
pp. 999-1003 ◽  
Author(s):  
M. Brownlee ◽  
H. Vlassara ◽  
A. Cerami

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