scholarly journals Dynamic balance and neuropathic changes following ankle proprioceptive training in type II diabetic patients with peripheral neuropathy

2021 ◽  
Keyword(s):  
Peripheral Neuropathy ◽  
Stability Index ◽  
Diabetic Patients ◽  
Type Ii ◽  
Light Touch ◽  
Mean Values ◽  
Proprioceptive Training ◽  
Touch Sensation ◽  
The Mean ◽  
Anterior Posterior

Introduction: Peripheral neuropathy is one of the major complications of type II diabetes mellitus. Lower limb proprioceptive impairments due to neuropathy can lead to balance disorders in these patients. The present study aimed to investigate postural stability and neuropathic changes following ankle proprioceptive training in type II diabetic patients with moderate neuropathy. Materials and Methods: The present study was conducted on 24 type II diabetic patients with moderate neuropathy (9 females and 15 males) aged 40-65 years (with a mean age of 57.25 years). The treatment consisted of ankle proprioceptive training by the balance board and rocker for 10 consecutive days. Balance indices, including Overall Stability Index (OSI), Anterior-Posterior Stability Index (APSI), and Medial-Lateral Stability Index (MLSI), were measured with Biodex system before and after the treatment, as well as two weeks after treatment in two conditions: condition1: Eyes open, head straight, without using trunk, pelvis, thigh, and knee constrained orthosis. Condition 2: Eyes closed, head back (hyperextension), with using trunk, pelvis, thigh, and knee constrained orthosis. Plate-based Biodex stability was fixed at levels 6 and 8 for condition1 and level 8 for condition 2. The severity of neuropathy was assessed using Valk and Michigan questionnaires, as well as light touch sensation. The analysis of variance with repeated measure was used to evaluate alterations in the stability of patients. Furthermore, the correlation of neuropathic changes and stability parameters were assessed by the Pearson correlation coefficients. Results: Significant improvements were observed in OSI in all tests of condition 1 (Biodex Balance System (BBS) at level 8 (P=0.001) and level 6 (P=0.017), as well as test conditions 2 (level 8; P=0.004). After the treatment, at stability level 8, a significant improvement in the mean values of postural sways in the Anterior-Posterior (AP) direction demonstrated that the ankle strategy was improved in the patients. After the treatment, the scores of the Valk (P=0.02) and Michigan (P=0.001) questionnaires were significantly decreased. After two weeks of follow-up, the observed improvement was maintained in the mean values of balance indices (OSI, APSI) and neuropathy due to treatment. Conclusion: As evidenced by the obtained results, 10 sessions of targeted ankle proprioceptive training improved stability, neuropathy, and light touch sensation of the foot in type II diabetic patients with moderate neuropathy. Foot somatosensory information is one of the most important causes of balance alterations in these patients

scholarly journals Assessment of Hydroxyproline Levels in Non-Ischemic Diabetic Foot Ulcers During Recovery. A Prospective Case-Control Study

2015 ◽  
Vol 22 (4) ◽  
pp. 361-366
Author(s):  
Seyed Mansour Alamshah ◽  
Aliasghar Hemmati ◽  
Zahra Nazari
Keyword(s):  
Wound Healing ◽  
Granulation Tissue ◽  
Normal Skin ◽  
Repair Process ◽  
Foot Ulcers ◽  
Diabetic Patients ◽  
Control Groups ◽  
Mean Values ◽  
The Mean ◽  
Medical University

Abstract Background and aims: Proline hydroxylation is essential for collagen synthesis in wound healing. Therefore, hydroxyproline quantification may be a suitable marker of wound healing in diabetic tissue. Material and method: This is a prospective casecontrol clinical study including 90 referral patients from our clinics in Golestan hospital affiliated to Jundishapour Medical University, Ahwaz-Iran, during a period of 18 months. Three groups were recruited: intervening diabetics with non-ischemic foot ulcers, diabetics without foot ulcers (normal diabetics) and non-diabetics without foot ulcers (normal non-diabetics) as control groups (n=30 per group). 500 mg of granulation tissue from ulcers after treatment and 500 mg of normal skin from both control groups were taken for the measurement of hydroxyproline levels. Results: 13 (43.3%) males and 17 (56.7%) females in trial group were analysed. There was no significant differences in age, gender, and BMI between groups. Mean hydroxyproline concentration in wound granulation tissue (140.44 μg/g) was statistically different from the mean concentration in the skin content of normal diabetics (173.22 g/g,) and the skin content of nondiabetics (178.83 μg/g) (p=0.001). There were no statistically significant differences between the mean values of normal diabetics and non-diabetics (p=0.63). Conclusion: Our results showed the presence of a lower quantity of hydroxyproline in diabetic patients with foot ulcers compared to control groups. This raises the issue of its effectiveness in delaying the repair process in diabetics. Therefore, compensating for tissue hydroxyproline deficit can be a clue in improving diabetic tissue repair.

scholarly journals Comparison of Cross Sectional Areas of Median Nerve in Type 2 Diabetic Patients with Peripheral Neuropathy with Healthy Adult Subjects Measured by 2 D-B Mode High Resolution Ultrasonography

2017 ◽  
Vol 8 (1) ◽  
pp. 47-51
Author(s):  
Md Towhidur Rahman ◽  
AS Mohiuddin ◽  
Md Mofazzal Sharif ◽  
Jafreen Sultana ◽  
Fahmida Yeshmine ◽  
...  
Keyword(s):  
Peripheral Neuropathy ◽  
Median Nerve ◽  
Healthy Adult ◽  
Diabetic Patients ◽  
Type 2 Diabetic Patients ◽  
Cross Sectional ◽  
The Mean ◽  
The Difference ◽  
Type 2 Diabetic

Background: Patients with diabetic peripheral neuropathy (DPN) have distal, symmetrical form of the disorder characterized by numbness, burning feet, pins-and-needles sensations and lightning pain. This study was designed to find out the difference between 2 Dimentional (D)-Brightness (B) mode high resolution ultrasonographically measured cross sectional areas of median nerve in type 2 diabetic patients with peripheral neuropathy and those of non-diabetic healthy adult subjects.Methods: This case-control study was done on 180 subjects aged 27-67 years in the department of Radiology and Imaging, BIRDEM from January 2012 to December 2013. Out of them 90 diabetic patients with peripheral neuropathy diagnosed electrophysiologically by nerve conduction study (NCS) were considered study group and age, sex and weight compatible 90 healthy subjects were considered as control group. Measurement of cross sectional areas of median nerve was performed first by the investigator himself purposefully, consecutively and subsequently confirmed by a radiologist in the department of Radiology and Imaging, BIRDEM, who did not know the subjects’ condition to eliminate bias. The major axis, minor axis and the cross sectional areas (CSA) of the median nerve were measured at the carpal tunnel.Results: In this study, the mean cross sectional areas (mm2) of median nerve healthy subjects was 7.78±1.00 mm2 and in diabetic patients with peripheral neuropathy was 13.67±2.97 mm2. The difference mean CSA of median nerve of diabetic subjects with peripheral neuropathy and control subjects were statistically significant (p<0.05) in unpaired ‘t’ test.Conclusion: This study showed that there is a significant difference between the cross sectional areas of median nerve in diabetic subjects with peripheral neuropathy and healthy adult subjects. The mean cross sectional areas of median nerve were increased in diabetic patients with peripheral neuropathy compared to control group.Birdem Med J 2018; 8(1): 47-51

scholarly journals Oxidative stress in chronic periodontitis patients with type II diabetes mellitus

2018 ◽  
Vol 12 (02) ◽  
pp. 225-231 ◽  
Author(s):  
Ruby Ramya Vincent ◽  
Devapriya Appukuttan ◽  
Dhayanand John Victor ◽  
Aruna Balasundaram
Keyword(s):  
Oxidative Stress ◽  
Diabetes Mellitus ◽  
Periodontal Disease ◽  
Diabetic Patients ◽  
Clinical Parameters ◽  
Type Ii ◽  
Chronic Periodontal Disease ◽  
Significant Difference ◽  
The Mean ◽  
Group 1

ABSTRACT Objective: Oxidative stress (OS) refers to the disequilibrium between free radicals and antioxidant defense mechanisms and is significantly implicated in the pathogenesis of chronic degenerative and inflammatory diseases such as chronic periodontal disease (CP) and diabetes mellitus (DM). This study aimed to evaluate the total antioxidants capacity (TAOC) and total oxidants status (TOS) in the gingival crevicular fluid (GCF) in CP participants with type II DM. Materials and Methods: A total of 80 participants were allotted into four groups as follows: Group 1: Generalized CP (GCP) without type II DM (n = 20); Group 2: GCP with type II DM (n = 20); Group 3: Type II DM without CP (n = 20); and Group 4: Systemically and periodontally healthy (PH) (n = 20). Clinical parameters such as plaque index, gingival index, probing pocket depth, and clinical attachment level were recorded. Pooled GCF was collected followed by the estimation of TAOC, TOS, and OS index (OSI) using Erel O Colorimetric analysis. Results: The clinical parameters recorded showed the statistically significant difference (P < 0.001) between the groups. The mean TAOC value was the highest in PH group. The mean TOS and OSI were higher in Group 1, 2, and 3 participants when compared to the PH participants. All the biochemical parameters evaluated showed a statistically significant difference (P < 0.001) between groups. Conclusions: The study further validates the use of OSI as a marker for periodontal disease activity and emphasizes the role of OS in the pathogenesis of Type II diabetic patients with the chronic periodontal disease.

scholarly journals Evaluation of sweet taste sensitivity in type-II Diabetes Mellitus patients

2020 ◽  
pp. 10-12
Author(s):  
Z. Naveen Kumar ◽  
B.N.S. Gowri Kumari
Keyword(s):  
Diabetes Mellitus ◽  
Type Ii Diabetes ◽  
Type Ii Diabetes Mellitus ◽  
Sweet Taste ◽  
Cross Sectional Study ◽  
Taste Sensitivity ◽  
Diabetic Patients ◽  
Type Ii ◽  
Cross Sectional ◽  
The Mean

Background: The objective is to evaluate the sweet taste sensitivity among type-II diabetes mellitus patients. Methods:  This is a cross sectional study consisted of 227 subjects (127 type-II Diabetic patients & 100 non diabetic individuals) of both the genders and age matched. Sweet taste sensitivity tests were done using different concentrations of glucose solution and compared among the diabetic patients with FBS more than 180mg/dl and diabetic patients with FBS less than 180mg/dl and also compared among the diabetic patients and non diabetic individuals.  The final concentration at which patient was able to perceive the taste was recorded. statistical analysis was done using Student’s unpaired T test. P­values of < 0.05 were considered to be statistically significant. Results: The mean of sweet taste sensitivity among diabetic patients with FBS >180 mg/dl was 6245 mg/l and the mean of sweet taste sensitivity in the diabetic patients with FBS <180 mg/dl was 2249mg/l with P<0.001 which is significant. The mean of sweet taste sensitivity among diabetic patients with FBS >180 mg/dl was 6245mg/l and the mean of sweet taste sensitivity in the non diabetic individuals was 1979mg/l with P<0.01 which is significant. the mean of sweet taste sensitivity among diabetic patients with FBS <180 mg/dl was 2249 mg/l and the mean of sweet taste sensitivity in the non diabetic individuals was 1979mg/l  with P>0.05 which is not significant. Conclusion: In our study it was concluded that type-II Diabetes Mellitus patients have lesser sensitivity for the sweet taste. Loss of sensitivity leads to the increase in sugar consumption being the risk factor for worsening the disease.

scholarly journals The Relationship of Illness Perception and Medication Adherence in Patients With Diabetes Mellitus Type II

2021 ◽  
Author(s):  
Sina Sabeti Bilondi ◽  
Ali Delshad Noghabi ◽  
Hosein Aalami
Keyword(s):  
Medication Adherence ◽  
Type Ii Diabetes ◽  
Pearson Correlation ◽  
Illness Perception ◽  
Personal Control ◽  
Diabetic Patients ◽  
Type Ii ◽  
Diabetes Clinic ◽  
The Mean ◽  
The Relationship

Abstract Background: One of the most well-known chronic diseases in the world is diabetes. Disease perception is the patient's organized cognitive representation of his or her illness and can affect treatment adherence. The aim of this study was to investigate the relationship between illness perception and adherence to the medical regimen in patients with type II diabetes. Methods: This descriptive-analytical cross-sectional study was performed on 260 patients with type II diabetes referred to Gonabad Diabetes Clinic by systematic random sampling in 2019. Data collection tools were demographic questionnaire, Morisky medication Adherence Scale (MMAS-8), and Brief illness Perception Questionnaire (BIPQ). Data were analyzed by SPSS 20 software. And using descriptive statistics, Pearson correlation coefficient. P < 0.05 was considered significant. Results: The results showed that the mean score of illness perception of type II diabetes was 46.39 ± 9.45 (range 0-70) and the mean score of medication Adherence was 2.93 ± 1.9 (range 0-8). The results of Pearson correlation test showed a significant relationship between illness perception and medication Adherence (P <0.001, r = 0.199). Also, the regression model showed that the dimensions of disease comprehension and personal control from illness perception were significantly related to medication Adherence of type II diabetic patients (P <0.001). Conclusion: By measuring the level of illness perception, the degree of medication Adherence can be predicted. Therefore, strengthening the illness perception in order to medication Adherence seems to be an important therapeutic strategy in educational interventions. Keywords: illness perception, medication Adherence, type II diabetes

scholarly journals Resistive index of retinal arterial blood flow in type-II diabetics without retinopathy

2015 ◽  
Vol 47 (1-2) ◽  
pp. 7-11
Author(s):  
Mashah Binte Amin ◽  
Khaleda Parvin Rekha ◽  
Farzana Shegufta ◽  
Md Towhidur Rahman ◽  
Nafisa Abedin ◽  
...  
Keyword(s):  
Blood Flow ◽  
Flow Velocity ◽  
Doppler Ultrasonography ◽  
Resistive Index ◽  
Diabetic Patients ◽  
Type Ii ◽  
Type Ii Diabetics ◽  
Healthy Control ◽  
Retinal Artery ◽  
The Mean

Diabetic retinopathy is a vascular disorder affecting the microvasculature of retina. It is caused by changes in the blood vessels of retina. If untreated, it may lead to blindness. Therefore if diagnosed and treated promptly, blindness is usually preventable. In ophthalmology, Colour Doppler Imaging is a new method that enables us to assess the orbital vasculature. Duplex color Doppler ultrasonography is the investigation of choice to assess retinal arterial flow velocities very quickly without any invasive procedure for qualitative and quantitative assessment of blood flow velocities. This study was performed to observe the difference between Doppler flow velocity indices of retinal artery in Type-II Diabetics subjects without retinopathy and those of normal control subjects. This case-control study was carried out in the Radiology department, BIRDEM for two years. All the selected subjects underwent Duplex Doppler ultrasonography of both eyes using 5 to 7.5 MHz linear phase transducer. Findings included spectral analysis, those were PSV, EDV and RI. Unpaired ttest was done to compare blood flow velocity indices of retinal artery in type-II diabetic patients without retinopathy and that of healthy control adult subjects and a P value <0.05 was taken as significant. Majority (42.5%) of patients were in 4th decade in diabetic subjects with male predominant, which was 58.7%. The mean duration of diabetes was 4.56 + 2.1 years. In the current study, it was found that the mean resistive index (RI) in 80 diabetic patients without retinopathy was (0.75 + 0.04) ranging 0.66-0.81. And that of 80 healthy subjects was (0.64 + 0.02) ranging 0.600.70.1n this study the mean differences of retinal arterial RI in diabetic eyes without retinopathy and healthy control eyes was statistically significant (p<0-05) in unpaired 't' test. From the result of present study it can be concluded that, there is statistically significant increased retinal arterial resistivity index of type-II diabetic patients without retinopathy. Higher RI in type-II diabetics may predict the early haemodynamic changes in the retinal artery of these patients before the clinical onset of retinopathy. DOI: http://dx.doi.org/10.3329/bmjk.v47i1-2.22555 Bang Med J (Khulna) 2014; 47 : 7-11

scholarly journals The relationship between Fear of Hypoglycemia and Sleep Quality among type II Diabetic Patients

2019 ◽  
Author(s):  
Leili Yekefallah ◽  
Farzaneh Talebi ◽  
Ali Razaghpoor ◽  
Mohammmad Hossein Mafi
Keyword(s):  
Sleep Quality ◽  
Significant Relationship ◽  
Diabetic Patients ◽  
Poor Sleep ◽  
Type Ii ◽  
Poor Sleep Quality ◽  
Fear Of Hypoglycemia ◽  
The Mean ◽  
The Relationship

Abstract Introduction and Objective Fear of hypoglycemia can result in anxiety, stress, anger, depression and severe avoidance behaviors that it affects the sleep quality of diabetic patients. Therefore, the present study was conducted with the aim of investigating the relationship between fear of hypoglycemia and sleep quality among type II diabetic patients. Methods The present cross-sectional study was conducted on 400 type II diabetic patients referred to endocrinology clinic of Velayat Hospital and Boali Hospital in Qazvin, in 2018. Data were collected using a checklist for demographic variables, the Fear of Hypoglycemia Survey (FHS-W), and the Pittsburgh sleep quality index (PSQI). Descriptive statistics and Spearman correlation test were performed for data analysis using SPSS v24. Results In this study, the mean age of diabetic patients was 55.75±10.31. The majority of the participants were female (n=299, 74.8%) and were treated with oral anti-diabetic drugs (n=174, 43.5%). The mean score of sleep quality in patients was 8.98±3.64 and the fear of hypoglycemia was 21.27±11.92. The results of this study showed that there was a significant relationship between the fear of hypoglycemia and the poor sleep quality among patients (p<0.001, r=0.305). Conclusion The fear of hypoglycemia has a direct and significant relationship with poor sleep quality in diabetic patients; so that this fear reduces the quality of sleep in diabetic patients. Therefore, in order to provide adequate sleep to prevent inappropriate sleep complications, great attention should be paid to the issue of fear of hypoglycemia, and consider some actions to reduce this fear.

scholarly journals The Efficacy of Adding Electromagnetic Therapy or Laser Therapy to Medications in Patients With Diabetic Peripheral Neuropathy

2020 ◽  
Vol 11 (1) ◽  
pp. 20-28 ◽  
Author(s):  
Alsayed A. Shanb ◽  
Enas F. Youssef ◽  
Waleed I. Al Baker ◽  
Fahd A. Al-Khamis ◽  
Ali Hassan ◽  
...  
Keyword(s):  
Peripheral Neuropathy ◽  
Laser Therapy ◽  
Diabetic Peripheral Neuropathy ◽  
Diabetic Control ◽  
Common Disease ◽  
Diabetic Patients ◽  
Mean Values ◽  
Conduction Velocities ◽  
Significant Burden ◽  
Magnetic Therapy

Introduction: Diabetes mellitus (DM) is a common disease with a highly significant burden among the Saudi population. This study aimed to investigate the effects of adding either magnetic or laser therapy to medications in patients with diabetic peripheral neuropathy (DPN). Methods: Seventy-one medically controlled diabetic patients were randomly assigned to 1) Magnetic group: 26 patients were exposed to magnetic therapy for 20 minutes/session, 2 sessions/week, for 3 months 2) Laser group: 25 patients were exposed to laser therapy with intensity 5.7 J/cm2 for 30 minutes/session, 2 times/week, for 3 months. 3) Drug group: 20 patients received only the regular medications for diabetic control and pain analgesia. Pain and neuropathy were assessed by the visual analog scale (VAS) and the Toronto Clinical Neuropath Scoring System (TRCNSS). Conduction velocities and amplitudes of peroneal and sural nerves were measured by electromyography. Results: The results showed significant increases in conduction velocities and amplitudes in both magnetic and laser groups in parallel with significant reductions in TRCNSS. Non-significant changes were obtained only after using only medications (P>0.05). The mean values of VAS reduced significantly in the three groups. The least significant differences showed significant changes among the three groups, whereas non-significant differences were obtained between both magnetic and laser groups. Conclusion: There were non-significant differences between both magnetic and laser therapy groups. Addition of either magnetic or laser therapy to medications could bring extra positive benefits to patients with DPN. Both magnetic and laser therapy can be applied with medications for the treatment of patients with DPN.

scholarly journals Influence of Clinical and Tumor Factors on Interfraction Setup Errors With Rotation Correction for Vacuum Cushion in Lung Stereotactic Body Radiation Therapy

2021 ◽  
Vol 11 ◽  
Author(s):  
Hua Chen ◽  
Lingxiang Liu ◽  
Hao Wang ◽  
Yan Shao ◽  
Hengle Gu ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Stereotactic Body Radiation Therapy ◽  
Setup Errors ◽  
Mean Values ◽  
Stereotactic Body Radiation ◽  
Location Parameters ◽  
The Mean ◽  
Nsclc Patients ◽  
Logistic Regression Test ◽  
Anterior Posterior

PurposeTo explore the influence of clinical and tumor factors over interfraction setup errors with rotation correction for non-small cell lung cancer (NSCLC) stereotactic body radiation therapy (SBRT) patients immobilized in vacuum cushion (VC) to better understand whether patient re-setup could further be optimized with these parameters.Materials and MethodsThis retrospective study was conducted on 142 NSCLC patients treated with SBRT between November 2017 to July 2019 in the local institute. Translation and rotation setup errors were analyzed in 732 cone-beam computed tomography (CBCT) scans before treatment. Differences between groups were analyzed using independent sample t-test. Logistic regression test was used to analyze possible correlations between patient re-setup and clinical and tumor factors.ResultsMean setup errors were the largest in anterior–posterior (AP) direction (3.2 ± 2.4 mm) compared with superior–inferior (SI) (2.8 ± 2.1 mm) and left–right (LR) (2.5 ± 2.0 mm) directions. The mean values were similar in pitch, roll, and rtn directions. Of the fractions, 83.7%, 90.3%, and 86.6% satisfied setup error tolerance limits in AP, SI, and LR directions, whereas 95% had rotation setup errors of &lt;2° in the pitch, roll, or rtn directions. Setup errors were significantly different in the LR direction when age, body mass index (BMI), and “right vs. left” location parameters were divided into groups. Both univariate and multivariable model analyses showed that age (p = 0.006) and BMI (p = 0.002) were associated with patient re-setup.ConclusionsAge and BMI, as clinical factors, significantly influenced patient re-setup in the current study, whereas all other clinical and tumor factors were not correlated with patient re-setup. The current study recommends that more attention be paid to setup for elderly patients and patients with larger BMI when immobilized using VC, especially in the left–right direction.

Effects of transcutaneous electrostimulation (TENS) in treatment of peripheral neuropathy pain in type II diabetic patients

2001 ◽  
Vol 18 (Supplement 21) ◽  
pp. 127
Author(s):  
M. Bulut ◽  
M. Bababalim ◽  
T. Çakan ◽  
C. Çulha ◽  
N. Ünal
Keyword(s):  
Peripheral Neuropathy ◽  
Diabetic Patients ◽  
Type Ii
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