scholarly journals Risk factors cardiovascular autonomi c neuropathy in type 2 diabetes mellitus

2018 ◽  
Vol 23 (4) ◽  
pp. 309-313
Author(s):  
O.A. Stepura ◽  
B.N. Mankovsky
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Autonomic Neuropathy ◽  
Cardiac Autonomic Neuropathy ◽  
Type 2 Dm ◽  
Patients With Diabetes ◽  
Cardiovascular Tests

Cardiac autonomic neuropathy (CAN) is one of the lifethreatening complications of diabetes mellitus (DM), increasing the mortality of patients with diabetes, cardiovascular morbidity and chronic kidney disease. The aim of this study was to investigate risk factors of CAN in patients with type 2 diabetes mellitus. Materials and methods. We examined 127 patients, 51 men and 76 women with type 2 DM. The diagnosis of CAN was performed by studying the heart rate variability (R-R intervals on the electrocardiogram) based on 5 cardiovascular tests for D. Ewing and the Poly-SpectrumRhythm.NET program module. The diagnosis of CAN was confirmed in patients who had 2 positive tests of 5 and a definite CAN — 3 and more positive of 5.The data analysis by SPSS statistical package version 23.0 for Windows. Results. CAN was diagnosed in 81,9% patients, definite CAN in 55,1% patients with type 2 DM. We found positive correlation between the definite CAN with glomerular filtration rate (OR=7,01, p<0,05) and body mass index (OR=1,69, p<0,05), negative correlation between the definite CAN with age (OR= -2,66, p<0,05), diabetes duration (OR= -2,59, p<0,05) and diastolic blood pressure (OR= -5,07, p<0,05). Conclusion. We found such risk factors for cardiovascular autonomic neuropathy in type 2 DM as age, duration of diabetes, BMI, GFR, DBP, therefore presence of diabetic nephropathy and arterial hypertension. These data can suggest the pathogenetic role of the impairment of autonomic nervous system and somatic nervous damage are different.

Prevalence of Toenail Onychomycosis in Patients with Type 2 Diabetes Mellitus and Evaluation of Risk Factors

2011 ◽  
Vol 101 (1) ◽  
pp. 49-54 ◽  
Author(s):  
Aynur Gulcan ◽  
Erim Gulcan ◽  
Sukru Oksuz ◽  
Idris Sahin ◽  
Demet Kaya
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Fasting Blood Glucose ◽  
Diabetic Patients ◽  
Essential Components ◽  
Patients With Diabetes ◽  
Epidemiologic Risk

Background: We sought to determine the frequency of toenail onychomycosis in diabetic patients, to identify the causative agents, and to evaluate the epidemiologic risk factors. Methods: Data regarding patients’ diabetic characteristics were recorded by the attending internal medicine clinician. Clinical examinations of patients’ toenails were performed by a dermatologist, and specimens were collected from the nails to establish the onycomycotic abnormality. All of the specimens were analyzed by direct microscopy and culture. Results: Of 321 patients with type 2 diabetes mellitus, clinical onychomycosis was diagnosed in 162; 41 of those diagnoses were confirmed mycologically. Of the isolated fungi, 23 were yeasts and 18 were dermatophytes. Significant correlations were found between the frequency of onychomycosis and retinopathy, neuropathy, obesity, family history, and duration of diabetes. However, no correlation was found with sex, age, educational level, occupation, area of residence, levels of hemoglobin A1c and fasting blood glucose, and nephropathy. The most frequently isolated agents from clinical specimens were yeasts. Conclusions: Long-term control of glycemia to prevent chronic complications and obesity and to promote education about the importance of foot and nail care should be essential components in preventing onychomycosis and its potential complications, such as secondary foot lesions, in patients with diabetes mellitus. (J Am Podiatr Med Assoc 101(1): 49–54, 2011)

Cardiac sympathetic dysinnervation in Type 2 diabetes mellitus with and without ECG-based cardiac autonomic neuropathy

2002 ◽  
Vol 16 (3) ◽  
pp. 220-227 ◽  
Author(s):  
Oliver Schnell ◽  
Katja Hammer ◽  
Daniela Muhr-Becker ◽  
Anette-Gabriele Ziegler ◽  
Mayo Weiss ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Autonomic Neuropathy ◽  
Cardiac Autonomic Neuropathy

scholarly journals Diabetic Cardiovascular Autonomic Neuropathy: Effects of Simvastatin and Omega-3 Polyunsaturated Fatty Acids on Insulin Resistance and Lipid Profile Parameters

2021 ◽  
Vol 2-3 (35-36) ◽  
pp. 8-15
Author(s):  
V. Serhiyenko ◽  
◽  
M. Hotsko ◽  
S. Azhmi ◽  
O. Serhiyenko ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Fatty Acids ◽  
Type 2 Diabetes Mellitus ◽  
Polyunsaturated Fatty Acids ◽  
Autonomic Neuropathy ◽  
Density Lipoprotein ◽  
Blood Lipid ◽  
Cardiac Autonomic Neuropathy

Introduction. Currently, there is no unified treatment algorithm of cardiac autonomic neuropathy (CAN) in patients with type 2 diabetes mellitus (T2DM). The aim of the study was to investigate the effects of simvastatin (SIM) and -3 polyunsaturated fatty acids (-3 PUFAs) on blood lipid profile and insulin resistance (IR) in patients with type 2 diabetes mellitus and definite cardiac autonomic neuropathy. Materials and methods. The study involved 72 patients with T2DM and definite CAN. Patients were divided into four groups: 1st - received standard hypoglycemic therapy - control (n = 15); 2nd (n = 22) – in addition simvastatin (SIM) 20.0 mg/q.d.; 3rd (n = 18) - in addition 1 capsule/q.d. of the ω-3 PUFAs; 4th (n = 17) - in addition SIM 10.0 mg/q.d and 1 capsule/q.d of the ω-3 PUFAs for three months. The concentration of glucose, glycated hemoglobin A1c, immunoreactive insulin (IRI), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triglycerides (TG) in the blood were determined. Homeostasis model assessment IR (HOMA-IR), atherogenic coefficient (AC), TG/LDL-C, TG/TC, TG/LDL-C and TG and glucose index (TyG) were calculated. Results. Prescription of SIM was accompanied by a statistically significant decrease in TC, LDL-C, TG concentrations. In parallel, SIM induced a decrease of AC, TG/HDL-C, increase in HDL-C, and does not affect the IRI, HOMA-IR, TG/LDL-C, TG/TC, TC/LDL-C/HDL-C, TyG. The use of ω-3 PUFAs has contributed to a significant reduction in TG, AC, TG/LDL-C, TG/TC, TG/HDL-C, TyG index, increase in HDL-C, and was not accompanied by changes in IRI content, HOMA-IR, TC, LDL-C, and TC/LDL-C/HDL-C. The combined prescription of SIM and -3 PUFAs was accompanied by more pronounced, statistically significant changes in the blood lipid spectrum, as well as a decrease in the IRI and HOMA-IR. Conclusions. Obtained results justify the appropriateness of combined simvastatin and -3 polyunsaturated fatty acids prescription to patients with type 2 diabetes mellitus and definite cardiac autonomic neuropathy. Keywords: diabetes mellitus, cardiac autonomic neuropathy, treatment.

scholarly journals DYNAMICS OF CARDIAC AUTONOMIC NEUROPATHY IN PATIENTS WITH ISCHEMIC STROKE DURING VERTICALIZATION

2021 ◽  
pp. 39-49
Author(s):  
V.A. Pavlova ◽  
D.A. Pavlov ◽  
V.V. Mashin
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Ischemic Stroke ◽  
Autonomic Neuropathy ◽  
Blood Pressure Monitoring ◽  
Cardiac Autonomic Neuropathy ◽  
Rank Test ◽  
Signed Rank Test

Acute cerebrovascular accidents remain an urgent problem in neurology. Heterogeneous pathologies accompanying stroke determine its course and development of complications. Such pathologies require early remodeling during the rehabilitation process. Understaging the symptoms of cardiac autonomic neuropathy (CAN) associated with type 2 diabetes mellitus (DM 2) worsens the patient prognosis after an ischemic stroke. The aim of the paper is to study the manifestations of cardiac autonomic neuropathy in patients with ischemic stroke associated with type 2 diabetes mellitus and to assess their dynamics during verticalization. Materials and Methods. The study involved 60 patients of both sexes (aged 45–75) with acute ischemic stroke (IS). The first group consisted of 30 patients with DM 2, the second group enrolled 30 patients without diabetes. At the beginning of the study, we collected complaints, anamnesis, analyzed risk factors for CAN, examined the patients according to the NIH Stroke Scale and the Rankin Scale, carried out cardiovascular tests (CVT) for CAN detection, electrocardiography, 24-hour blood pressure monitoring, and electroneuromyography. The patients underwent passive verticalization for 12 days, which was followed by neurological examination, CVT and ECG. We used both descriptive (calculating the median, 25th and 75th quartiles) and nonparametric statistics (Mann–Whitney U-test, Wilcoxon signed-rank test, Cochran's Q test) for data processing. Results. Initially, patients with DM 2 demonstrated significant changes in all CVTs, and a predominance of the advanced CAN. Confirmed CAN prevailed in the patients of the second group. After verticalization, some positive changes in neurological scales, CVT, and CAN severity were observed in patients of both groups. However, at the end of the trial, the decrease in CAN manifestation in patients with IS associated with DM 2 was less pronounced as compared with patients without DM. Conclusion. Passive verticalization helps to reduce CAN manifestations in patients with IS, including those with associated DM 2. Keywords: cardiac autonomic neuropathy, verticalization, ischemic stroke, diabetes mellitus. Острые нарушения мозгового кровообращения остаются актуальной проблемой неврологии. Гетерогенные патологии, сопутствующие инсульту, обусловливают особенности его течения, развитие осложнений, что требует своевременной коррекции при составлении реабилитационных программ. Недооценка симптомов кардиальной автономной нейропатии (КАН) на фоне сахарного диабета 2-го типа (СД 2) ухудшает прогноз при ишемическом инсульте. Цель работы – изучить проявления кардиальной автономной нейропатии у пациентов с ишемическим инсультом на фоне СД 2 и оценить их динамику при проведении вертикализации. Материалы и методы. В исследовании участвовали 60 пациентов обоего пола 45–75 лет с ишемическим инсультом (ИИ) в острейшем периоде. Первую группу составили 30 пациентов с СД 2, вторую группу – 30 пациентов без данного заболевания. В начале исследования проводились сбор жалоб, анамнеза, анализ факторов риска КАН, оценка по шкалам NIHSS, Рэнкин, кардиоваскулярные тесты (КВТ) на выявление КАН, электрокардиография, суточное мониторирование артериального давления, электронейромиография. На протяжении 12 дней пациентам осуществлялась пассивная вертикализация. Затем повторно проводились неврологический осмотр, КВТ и ЭКГ. Для статистической обработки данных использовалась описательная (подсчет медианы, 25-го и 75-го квартилей) и непараметрическая статистика (критерии Манна–Уитни, Вилкоксона, Кохрена). Результаты. Исходно у пациентов с СД 2 выявлены выраженные изменения всех КВТ, преобладание прогрессирующей формы КАН. Во второй группе преобладала подтвержденная форма КАН. После курса вертикализации отмечена положительная динамика по неврологическим шкалам, КВТ, степени выраженности КАН в обеих группах при сохранении различий между ними. У пациентов с ИИ на фоне СД 2 уменьшение проявлений КАН в конце исследования было менее выраженным по сравнению с пациентами без СД. Выводы. Пассивная вертикализация способствует уменьшению проявлений КАН у пациентов с ИИ, в т.ч. на фоне СД 2. Ключевые слова: кардиальная автономная нейропатия, вертикализация, ишемический инсульт, сахарный диабет.

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