scholarly journals Falls among Older Adults with Type 2 Diabetes Mellitus with Peripheral Neuropathy

2021 ◽  
Vol 72 (2) ◽  
pp. 92-98
Author(s):  
Mantana Vongsirinavarat
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Peripheral Neuropathy ◽  
Muscle Strength ◽  
Clinical Test ◽  
Balance Performance ◽  
Functional Reach Test ◽  
History Of

Objective: The high incidence and prevalence of falls among older people with type 2 diabetes mellitus (ODM) have been documented. The risk factors of falls among ODM were identified as poor diabetic control, diabetic peripheral neuropathy (DPN) and balance impairment. This study aimed to investigate the contribution of DPN to history of falls. The differences of balance performance and lower limb muscle strength among ODM with and without DPN were also explored. Methods: This cross-sectional study interviewed 112 ODM for their falls occurrences within the previous 6 months. DPN was determined by the score of the Michigan Neuropathy Screening Instrument. Balance performance tests included Clinical Test of Sensory Interaction and Balance (mCTSIB), Functional Reach Test (FRT) and Timed Up and Go Test (TUG). Leg muscle strength was also measured. The logistic regression analysis was performed. Results: The history of falls was reported 30.6% of ODM with DPN and 10.4% of ODM without DPN. Presenting of DPN influenced falls with odds ratio of 3.46 among ODM. Differences were found of mCTSIB in the condition of eyes closed on firm and foam surfaces, FRT, and TUG between those with and without DPN. Knee extensor strength differed between those with and without DPN. Conclusion: DPN was more prominent among fallers. Balance performance and leg strength were lower in ones with DPN. Falls prevention programs including balance training and therapeutic exercise to improve balance performance and muscle strength should be emphasized among ODM, especially before the onset of DPN.

scholarly journals The Influence of Peripheral Neuropathy, Gender, and Obesity on the Postural Stability of Patients with Type 2 Diabetes Mellitus

2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Aline Herrera-Rangel ◽  
Catalina Aranda-Moreno ◽  
Teresa Mantilla-Ochoa ◽  
Lylia Zainos-Saucedo ◽  
Kathrine Jáuregui-Renaud
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Peripheral Neuropathy ◽  
Postural Stability ◽  
Static Posturography ◽  
Gender And Age ◽  
Soft Surface ◽  
History Of

Aim.To assess the influence of peripheral neuropathy, gender, and obesity on the postural stability of patients with type 2 diabetes mellitus.Methods.151 patients with no history of otology, neurology, or orthopaedic or balance disorders accepted to participate in the study. After a clinical interview and neuropathy assessment, postural stability was evaluated by static posturography (eyes open/closed on hard/soft surface) and the “Up & Go” test.Results.During static posturography, on hard surface, the length of sway was related to peripheral neuropathy, gender, age, and obesity; on soft surface, the length of sway was related to peripheral neuropathy, gender, and age, the influence of neuropathy was larger in males than in females, and closing the eyes increased further the difference between genders. The mean time to perform the “Up & Go” test was 11.6 ± 2.2 sec, with influence of peripheral neuropathy, gender, and age.Conclusion.In order to preserve the control of static upright posture during conditions with deficient sensory input, male patients with type 2 diabetes mellitus with no history of balance disorders may be more vulnerable than females, and obesity may decrease the static postural control in both males and females.

scholarly journals Sarcopenia Is Associated With a Risk of Mortality in People With Type 2 Diabetes Mellitus

2021 ◽  
Vol 12 ◽  
Author(s):  
Fuyuko Takahashi ◽  
Yoshitaka Hashimoto ◽  
Ayumi Kaji ◽  
Ryosuke Sakai ◽  
Takuro Okamura ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Muscle Strength ◽  
Propensity Score ◽  
Risk Of Mortality ◽  
All Cause Mortality ◽  
History Of

BackgroundSarcopenia has reportedly been associated with increased risk of mortality in general populations. However, few studies have investigated the association between sarcopenia and mortality in older people with type 2 diabetes mellitus (T2D). This study aimed to investigate the effect of sarcopenia on incident all-cause mortality in older people with T2D.MethodsLow muscle strength were set at handgrip strength <28 kg for men and <18 kg for women, and low skeletal muscle mass index (SMI), evaluated using the impedance body composition analyzer, were set at SMI <7.0 kg/m2 for men and <5.7 kg/m2 for women. People who had both low muscle strength and low SMI were diagnosed with sarcopenia. Due to a low incidence of all-cause mortality, the propensity score was used. The propensity score was evaluated using multivariable logistic regression models with the following parameters: age, sex, duration of diabetes, history of heart disease, history of cancer, smoking, exercise, alcohol, sodium-glucose cotransporter-2 inhibitor, glucagon-like peptide-1 receptor agonist, insulin, corticosteroid, hypertension, body mass index, glycosylated hemoglobin A1c, triglycerides, and creatinine, and the C-statistic was 0.89.ResultsIn this prospective cohort study, 396 people with an average age and duration of diabetes of 71.3 (6.3) years and 16.3 (11.3) years, respectively, were included. Of those included, 14.6% had sarcopenia. During the average 40.5 (16.5) months of follow-up, 13 people (6 out of the 338 without sarcopenia and 7 out of the 58 with sarcopenia) died. Incident rate were 5.1/1000 person years of follow-up in people without sarcopenia and 41.3/1000 person years of follow-up in people with sarcopenia. According to Cox regression analysis, sarcopenia was associated with all-cause mortality (adjusted hazard ratio: 6.12, 95% confidence interval: 1.52–24.7, p = 0.011).ConclusionSarcopenia is associated with incident all-cause mortality in older outpatients with T2D.

Study of prevalence and determinants of peripheral neuropathy in patients with type 2 diabetes mellitus

2021 ◽  
Vol 18 (3) ◽  
pp. 10-14
Author(s):  
S Bethiun ◽  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Peripheral Neuropathy ◽  
Blood Sugar ◽  
Fasting Blood Sugar ◽  
Age Group ◽  
Duration Of Diabetes ◽  
History Of

Background: India is witnessing a depressing situation due to escalating incidence and prevalence of type 2 diabetes mellitus (T2DM) and its inevitable outcomes of cardiovascular diseases (CVD), diabetic neuropathy, nephropathy and retinopathy. Present study was aimed to investigate peripheral neuropathy in adult patients with type 2 diabetes. Material and Methods: Present study was hospital based, prospective, observational study conducted in subjects recruited from the diabetes OPD of both gender ≥ 30 years, known case of type 2 diabetes mellitus. The screening for DPN was conducted using the Michigan Neuropathy Screening Instrument (MNSI). Results: In present study, 256 subjects satisfying study criteria were considered for study. Most of patients were from 51-65 years age group (39.8%) followed by 31-50 years age group (37.1%). Male subjects (54.3%) were more than females (45.7%). Mean duration of type 2 diabetes mellites was 10.6 ± 6.3 years. Mean HbA1c was 9.3 ± 2.8% and 65.6% had HbA1c≥7%. Common high risk factors were hypertension (52.3%), alcoholic > 60 mg/day (30.5%), BMI > 30kg/m2 (26.6%), smoking habits >1 pack/day (18.0 %), history of peripheral artery disease (12.5 %) and history of prior ulcer (12.1%). Prevalence of peripheral neuropathy in subjects with type 2 diabetes mellitus in present study was 35.2%, calculated as per reduced perception/absent monofilament test. Vibration perception test was absent in 22.7 % subjects and ankle reflex was absent in 13.3 % subjects. Age, duration of diabetes, fasting blood sugar, BMI, HbA1c ≥ 7 % and alcoholic (> 60 mg/day) were statistically significant in subjects of type 2 diabetes mellitus with peripheral neuropathy and difference was statistically significant. Conclusion: Diabetic peripheral neuropathy was significantly and positively associated with age, duration of diabetes, fasting blood sugar, BMI, HbA1c ≥ 7 % and alcoholic (> 60 mg/day). Regular screening of patients with diabetes mellitus for peripheral neuropathy may be recommended for early diagnosis and treatment.

scholarly journals Endocrinological and metabolic characteristics in patients who are non-obese and have polycystic ovary syndrome and different types of a family history of type 2 diabetes mellitus

2021 ◽  
Vol 49 (5) ◽  
pp. 030006052110166
Author(s):  
Yuan Wang ◽  
Hua Gao ◽  
Wen Di ◽  
Zhuowei Gu
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Family History ◽  
Polycystic Ovary Syndrome ◽  
Polycystic Ovary ◽  
Ovary Syndrome ◽  
History Of ◽  
Second Degree

Objective We aimed to investigate whether patients with polycystic ovary syndrome (PCOS) and a family history (FH) of type 2 diabetes mellitus (T2DM) are at increased risk of endocrinological and metabolic abnormalities, and whether this risk differs between first-degree and second-degree relatives, and between maternal and paternal transmission. Methods A total of 680 patients with PCOS were enrolled in this retrospective, single-center study. Endocrine and glycolipid metabolism parameters were compared. Results The free androgen index (FAI), and levels of fasting blood glucose (FBG), fasting insulin (FINS), homeostatic model assessment-insulin resistance (HOMA-IR), total cholesterol (TC), and low-density lipoprotein cholesterol were significantly higher, whereas sex hormone binding globulin (SHBG) levels were significantly lower in patients with PCOS and a FH of T2DM. In patients with PCOS with a FH of T2DM in first-degree relatives, age and levels of FBG, FINS, and HOMA-IR were significantly higher than those who had a FH of T2DM in second-degree relatives. A maternal history of T2DM was associated with a higher body mass index, FAI, and TG levels, and lower SHBG levels. Conclusions Patients with PCOS and a FH of T2DM have more severe hyperandrogenism and metabolic disorders, especially in those with maternal transmission.

The Cardiovascular Events in Metabolic Surgery Compared to the New Classes of Glucose-Lowering Agents in Patients with T2DM

2021 ◽  
Author(s):  
Najla Shamsi
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Metabolic Surgery ◽  
Cardiovascular Events ◽  
Controlled Trials ◽  
Glucose Lowering ◽  
Randomized Controlled ◽  
History Of

Type 2 Diabetes Mellitus is a prevalent chronic disease with several macrovascular and microvascular complications. Cardiovascular diseases including coronary artery disease and stroke are common macrovascular complication that reduces the quality of life and lead to early mortality. Additionally, they pose enormous socioeconomic burden on the societies and the governments. Therefore, any intervention that reduces the cardiovascular events in patients with diabetes will have positive impact of the patients and the society. Thus, this systematic review aimed to evaluate the cardiovascular events after metabolic surgery in comparison with the new classes of glucose lowering agents in patients with type 2 diabetes mellitus. The review included 11 randomized controlled trials to both GLP-1 RA and SGLT-2 i groups. It also included 7 metabolic surgery studies, 2 of these are randomized controlled trials and the other 5 are observational studies. These studies were the most relevant studies to the research question. The results revealed different baseline demographic and clinical characteristics between the medication trials and metabolic surgery studies. Moreover, it revealed significant reduction in cardiovascular events in metabolic surgery studies when compared to medication trials. It also showed significant HbA1c and weight reduction in the metabolic surgery group. The remission of diabetes was very high in the metabolic surgery group while none of medication trials accomplished diabetes recovery. However, both medication and surgery groups had adverse events. In conclusion, the review is consistent with previous literature. It suggests that metabolic surgery is more effective than medical therapy in reducing cardiovascular events. Although this conclusion should be interpreted with caution due to the differences in baseline characteristics between studies. In general, the review recommends younger adult diabetic patients with obesity and history of established cardiovascular diseases to undergo metabolic surgery. Whereas, older patients with history of cardiovascular disease should be advised to take one of the medications that has been proved to reduce cardiovascular events. Future studies that compare metabolic surgery and the new classes of the glucose lowering agents is recommended to confirm the findings in this review.

scholarly journals The prevalence and risk factors of peripheral neuropathy among patients with type 2 diabetes mellitus; the case of Jordan

2018 ◽  
Vol 10 (1) ◽  
Author(s):  
Nahla Khawaja ◽  
Jawad Abu-Shennar ◽  
Mohammed Saleh ◽  
Said S. Dahbour ◽  
Yousef S. Khader ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Peripheral Neuropathy

scholarly journals New clusters of type 2 diabetes mellitus and their outcomes: relation between pharmacological treatment and previous cardiovascular events

2021 ◽  
Vol 31 (Supplement_2) ◽  
Author(s):  
Claudio Santos ◽  
Sonia Brito-Costa ◽  
Luis Margalho ◽  
Pedro Monteiro
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Pharmacological Treatment ◽  
Cardiovascular Events ◽  
Glycated Haemoglobin ◽  
Research Unit ◽  
Clinical Research Unit ◽  
History Of

Abstract Background Type 2 Diabetes Mellitus (T2DM) is the most common form of diabetes in adults, with 90% to 95% of cases. This study aims to establish clusters and have knowledge about the relationship between previous cardiovascular events and pharmacological treatment for T2DM. Methods 191 participants (EG) with T2DM with the average of 70.3 years (SD = 8.3) and 36 with pre-diabetes (CG) with an average of 62 years (SD = 10.3) who participated in clinical trials at Clinical Research Unit in Cardiology of Coimbra Hospital and Universitary Centre without cognitive difficulties, were divided in 5 different clusters. These were established based on six different variables: body mass index (BMI), age of each individual, age at diagnosis of DMT2, glycated haemoglobin value (HbA1c), homeostatic model that estimates the function of β cells (HOMA2-B) and insulin resistance (HOMA2-IR). Results Cluster 1 presented pre-diabetic individuals (15.9%), while diabetic individuals were divided into clusters 2 (1.8%), 3 (17.6%), 4 (21.1%) and 5 (43.6%). Regarding the study of the prevalence of previous cardiovascular events, the majority of individuals present in the different clusters had history of acute myocardial infarction (AMI). As for the prevalence of pharmacological treatment for DMT2, it was found that metformin was the most used drug. It was observed a relationship between previous AMI and metformin administration in clusters 3 (P = 0.0027; P < 0.05) and 5 (P = 0.0059; P < 0.05). Conclusions It was possible to create different clusters in a sample of the Portuguese population and to observe the existence of dependency relationships between different previous cardiovascular events and pharmacological treatment.

Sign in / Sign up

Export Citation Format

Share Document