scholarly journals Electrophysiological Changes of Motor Nerves in Patients with Type 2 Diabetes Mellitus

1970 ◽  
Vol 5 (2) ◽  
pp. 14-17 ◽  
Author(s):  
S Sultana ◽  
N Begum ◽  
L Ali ◽  
MM Hossain ◽  
NB Bhowmik ◽  
...  

Peripheral neuropathy is a common disabling complication in patients with diabetes and this complication is related to the duration of the disease process. Nerve conduction study is widely used for the assessment of diabetic polyneuropathy not only to evaluate the degree of abnormality but also to document serial changes in the clinical course of the disease. This study was designed to characterize motor nerve conduction abnormalities in subjects having relatively shorter and longer duration of type 2 diabetes mellitus and also to assess whether time related variable like duration of diabetes has any influence on motor nerve function of the subjects. Forty-four type 2 diabetic subjects were included in two groups:- Group B consisted of 23 diabetic subjects having duration of diabetes for 5-10 years (shorter duration) and Group C consisted of 21 diabetic subjects having duration of diabetes for 10-15 years (longer duration). Twenty-five age and BMI matched healthy subjects without family history of diabetes were included as Group A (non-diabetic) subjects. Motor nerve conduction velocities, action potential amplitudes and latencies of ulnar and peroneal nerves were measured by standard Nerve Conduction Velocity- Electromyography (NCV-EMG) equipment. Motor conduction parameters like ulnar compound muscle action potential (U CMAP), peroneal compound muscle action potential (P CMAP) and peroneal  nerve conduction velocity (P NCV) were found to be significantly reduced (p<0.001, <0.01, <0.01 respectively) in diabetic group with shorter duration of diabetes(Group B) in comparison to non-diabetic control group (Group A). In the diabetic group with relatively longer duration of diabetes (Group C) motor nerve conduction parameters like U CMAP and P NCV were significantly reduced (p<0.001, <0.01 respectively). The results showed that in the type 2 diabetic population, motor nerve conduction parameters were affected early and there was gradual deterioration of motor function as duration of diabetes increased. Though previous studies on diabetic neuropathy suggest that abnormalities of sensory nerve conduction are early features of diabetic nerve damage and sensory nerves are more susceptible to fall prey to metabolic assaults, the present study indicates that motor nerves are also involved and the neuropathic changes assessed by electro diagnostic methods in motor nerves may occur early in patients with type 2 diabetes mellitus. So, there may be some genetic and biochemical basis (other than hyperglycaemia) for early motor involvement in type 2 diabetic population of Bangladesh. Key words: Diabetic neuropathy, electrophysiology, nerve conduction, electromyography. DOI: 10.3329/jafmc.v5i2.4576 JAFMC Bangladesh Vol.5(2) (December) 2009, pp.14-17

Author(s):  
Aiswarya Roy Karintholil ◽  
Akshatha Rao Aroor ◽  
Joel Sabu ◽  
Joshua Chacko

Introduction: Diabetic patients are found to have reduced lung functions compared to their controls and their relationship with the duration of diabetes, glycaemic control, and Body Mass Index (BMI) is poorly characterised. Aim: To determine the correlation between the pulmonary function abnormalities with anthropometry, glycaemic control, and duration of diabetes in type 2 diabetic patients. Materials and Methods: A total of 80 type 2 diabetic patients were studied. BMI, Waist Circumference (WC), Waist-Hip Ratio (WHR), Fasting, postprandial blood sugar and glycosylated haemoglobin (HbA1c) were assessed from July to September 2018. Spirometry was done in accordance with the guidelines from the American Thoracic Society (ATS). Reduced pulmonary functions were defined as patients with restrictive (FEV1/FVC≥0.7 and FVC< 80% predicted) or obstructive (FEV1/FVC<0.7) impairment. Statistical analysis was done using ANOVA test and Karl Pearson Correlation coefficient. Results: The mean values of FEV1/FVC (0.8±0.08) and FVC% predicted (60.29±11.39) showed a restrictive pattern. FEF (25-75%) (r=0.241, p=0.031) and PEFR (r=0.245, p=0.029) positively correlated with duration of diabetes. BMI had a negative correlation with FVC% predicted (r=0.239, p=0.033). A negative correlation between FEV1% and Waist Circumference (WC) was observed (r=-0.232, p=0.038). HbA1c negatively correlated to FEV1/FVC (r=-0.227, p=0.043). Conclusion: Patients with type 2 Diabetes Mellitus (DM) were found to have an asymptomatic restrictive pulmonary impairment. Increased duration of diabetes, increased BMI, increased WC was associated with decreased lung functions in diabetics.


Author(s):  
Sonali Das Pradhan ◽  
Sumana Panja ◽  
Shiuli Roy ◽  
Saktipada Pradhan ◽  
Kaushik Samajdar

Background: Type 2 diabetic patients have a higher prevalence of thyroid disorders, particularly hypothyroidism.  Peripheral neuropathy is a common and disabling complication of diabetes mellitus. Peripheral nervous system involvement in hypothyroidism is also a well-documented fact. Nerve conduction studies are generally considered to be the most sensitive and reproducible in the assessment of peripheral neuropathies. This study helped to determine the prevalence of peripheral neuropathy in diabetic hypothyroid patients as well as to compare it in diabetic patients with or without hypothyroidism. It compared the onset latency, amplitude, conduction velocity and F- wave latency of some nerves in type 2 diabetes mellitus patients with or without hypothyroidism.Methods: With RMS, EMG, EP MARK-II, nerve conduction studies are done in 30 cases (type 2 diabetes mellitus patients with hypothyroidism) and 30 controls (type 2 diabetes mellitus patients of diabetes without hypothyroidism) respectively, attending the Diabetic Clinic and Biochemistry Laboratory of North Bengal Medical College.Results: Data were treated with Unpaired t-Test. The study reveals that type 2 diabetes mellitus patients with hypothyroidism have higher prevalence of peripheral neuropathy. There is statistically significant (p<0.00) decrease in motor nerve conduction study in both right and left median nerves in diabetic patients with hypothyroidism than in diabetic patients without hypothyroidism.Conclusions: All diabetic patients should be screened for early detection of hypothyroidism as type 2 diabetic patients with hypothyroidism have higher prevalence of peripheral neuropathy. The nerve conduction study remains the most reliable, accurate, and sensitive method to evaluate peripheral nerve function.


Nutrients ◽  
2021 ◽  
Vol 13 (11) ◽  
pp. 3770
Author(s):  
Pei Fen Chuar ◽  
Yeek Tat Ng ◽  
Sonia Chew Wen Phang ◽  
Yan Yi Koay ◽  
J-Ian Ho ◽  
...  

Diabetic peripheral neuropathy (DPN) is the most common microvascular complication of diabetes that affects approximately half of the diabetic population. Up to 53% of DPN patients experience neuropathic pain, which leads to a reduction in the quality of life and work productivity. Tocotrienols have been shown to possess antioxidant, anti-inflammatory, and neuroprotective properties in preclinical and clinical studies. This study aimed to investigate the effects of tocotrienol-rich vitamin E (Tocovid SuprabioTM) on nerve conduction parameters and serum biomarkers among patients with type 2 diabetes mellitus (T2DM). A total of 88 patients were randomized to receive 200 mg of Tocovid twice daily, or a matching placebo for 12 months. Fasting blood samples were collected for measurements of HbA1c, renal profile, lipid profile, and biomarkers. A nerve conduction study (NCS) was performed on all patients at baseline and subsequently at 2, 6, 12 months. Patients were reassessed after 6 months of washout. After 12 months of supplementation, patients in the Tocovid group exhibited highly significant improvements in conduction velocity (CV) of both median and sural sensory nerves as compared to those in the placebo group. The between-intervention-group differences (treatment effects) in CV were 1.60 m/s (95% CI: 0.70, 2.40) for the median nerve and 2.10 m/s (95% CI: 1.50, 2.90) for the sural nerve. A significant difference in peak velocity (PV) was also observed in the sural nerve (2.10 m/s; 95% CI: 1.00, 3.20) after 12 months. Significant improvements in CV were only observed up to 6 months in the tibial motor nerve, 1.30 m/s (95% CI: 0.60, 2.20). There were no significant changes in serum biomarkers, transforming growth factor beta-1 (TGFβ-1), or vascular endothelial growth factor A (VEGF-A). After 6 months of washout, there were no significant differences from baseline between groups in nerve conduction parameters of all three nerves. Tocovid at 400 mg/day significantly improve tibial motor nerve CV up to 6 months, but median and sural sensory nerve CV in up to 12 months of supplementation. All improvements diminished after 6 months of washout.


2021 ◽  
Vol 28 (Supplement_1) ◽  
Author(s):  
S Lee ◽  
J Zhou ◽  
CL Guo ◽  
WKK Wu ◽  
WT Wong ◽  
...  

Abstract Funding Acknowledgements Type of funding sources: None. Introduction Acute myocardial infarction (AMI) and sudden cardiac death (SCD) are major cardiovascular adverse outcomes in patients with type 2 diabetic mellitus. Although there are many risk scores on composite outcomes of major cardiovascular adverse outcomes or cardiovascular mortality for diabetic patients, these existing scores did not account for the difference in pathogenesis and prognosis between acute coronary syndrome and lethal ventricular arrhythmias. Furthermore, recent studies reported that HbA1c and lipid levels, which were often accounted for in these risk scores, have J/U-shaped relationships with adverse outcomes. Purpose The present study aims to evaluate the application of incorporating non-linear J/U-shaped relationships between mean HbA1c and cholesterol levels into risk scores for predicting for AMI and non-AMI related SCD respectively, amongst type 2 diabetes mellitus patients. Methods This was a territory-wide cohort study of patients with type 2 diabetes mellitus above the age 40 and free from prior AMI and SCD, with or without prescriptions of anti-diabetic agents between January 1st, 2009 to December 31st, 2009 at government-funded hospitals and clinics in Hong Kong. Risk scores were developed for predicting incident AMI and non-AMI related SCD. The performance of conditional inference survival forest (CISF) model compared to that of random survival forests (RSF) model and multivariate Cox model. Results This study included 261308 patients (age = 66.0 ± 11.8 years old, male = 47.6%, follow-up duration = 3552 ± 1201 days, diabetes duration = 4.77 ± 2.29 years). Mean HbA1c and high-density lipoprotein-cholesterol (HDL-C) were significant predictors of AMI under multivariate Cox regression and were linearly associated with AMI. Mean HbA1c and total cholesterol were significant multivariate predictors with a J-shaped relationship with non-AMI related SCD. The AMI and SCD risk scores had an area-under-the-curve (AUC) of 0.666 (95% confidence interval (CI)= [0.662, 0.669]) and 0.677 (95% CI= [0.673, 0.682]), respectively. CISF significantly improves prediction performance of both outcomes compared to RSF and multivariate Cox models. Conclusions A holistic combination of demographic, clinical, and laboratory indices can be used for the risk stratification of type 2 diabetic patients against AMI and SCD.


2017 ◽  
Vol 125 (09) ◽  
pp. 598-602 ◽  
Author(s):  
Zihang Wang ◽  
Yuhong Zhang ◽  
Weiwei Liu ◽  
Benli Su

AbstractThe present study aimed to evaluate the diagnostic value of echocardiography in measuring the thickness of epicardial adipose tissue (EAT) of the patients of type 2 diabetes mellitus (T2DM) and its correlation with the intimal-medial thickness of the carotid artery (cIMT) to investigate the relationship between EAT and cIMT. 68 patients of T2DM were enrolled and were divided into 2 groups: group of T2DM with duration≤10 years (35 cases) and group of T2DM with duration>10 years (33 cases). And 30 healthy subjects were enrolled as the control group. The thickness of EAT and cIMT were measured by echocardiography and high-frequency ultrasonography. The thickness of EAT and IMT of the carotid artery of 2 type 2 diabetic groups (duration≤10 years and>10 years) were significantly higher than that of the control group (all p<0.05), and the thickness of EAT and cIMT of the group of T2DM with duration>10 years were significantly higher than that of the group of T2DM with duration≤10 years (p<0.05). In univariate analysis, the thickness of EAT was positively and significantly associated with age (r=0.412, p<0.05), BMI (r=0.566, p<0.05), waist circumference (r=0.475, p<0.05), LDL (r=0.425, p<0.05), TG (r=0.496, p<0.05), duration of diabetes (r=0.384, p<0.05) and cIMT (r=0.456, p<0.05). In multiple stepwise regression analyses, age, BMI and IMT of carotid artery were appeared to be significantly associated with EAT (p<0.05 for all). In conclusion, routine screening of EAT and cIMT by ultrasonography in type 2 diabetic patients helps us to predict cardiovascular risks and prevent further development of cardiovascular complications.


2021 ◽  
Vol 8 (37) ◽  
pp. 3334-3338
Author(s):  
Satish Kumar

BACKGROUND Type 2 diabetes mellitus is common in the Indian population and awareness regarding the disease and its complications is low among the patients with diabetes. There is lack of studies regarding awareness of complications of diabetes among type 2 diabetic patients. The purpose of this study was to assess the awareness of diabetic complications among type 2 diabetic patients. METHODS This is an institutional based observational study. The sample comprised of 150 adult patients with type 2 diabetes mellitus who underwent treatment in the Department of Medicine, Medical College Kottayam and the patient’s age ranged from 18 - 77 years. RESULTS Majority of patients were in the age group 38 to 57 and the sample comprised of 56 % males and 44 % female patients. Out of 150 patients involved in the study, 120 patients (80 %) were aware of the complications of diabetes mellitus. Among the male patients, 70 (83.33 %) and among females, 50 (75.75 %) were aware of the complications in diabetes. In the study sample, 92 (61.33 %) were aware of the foot problems, 120 patients (80 %) were aware of renal complications, 91 patients were aware regarding eye problems of diabetes, 38 (25.33 %) regarding development of hypertension, 62 (41.33 %) regarding heart attack, 42 (28 %) patients were aware regarding development of stroke and 78 patients (52 %) had awareness regarding occurrence of recurrent infections. CONCLUSIONS Awareness regarding diabetes and its complications is fairly good among the diabetic patients in Kerala. Awareness regarding all complications of diabetes was higher among males than females. Providing awareness to type 2 diabetic patients by various educational programs may be of further help to prevent complications and to decrease the mortality and morbidity in type 2 diabetes patients. KEYWORDS Awareness, Diabetes


2019 ◽  
Vol 6 (3) ◽  
pp. 786
Author(s):  
Eda Dayakar ◽  
C. Sathya Sree ◽  
E. Sanjay

Background: Diabetes mellitus is a common health problem globally. Dyslipidaemia is a major risk factor to develop cardiovascular disease in diabetics. They present study was undertaken to find out the prevalence of dyslipidaemia in type 2 diabetic patients.Methods: The present study was a cross sectional study consisting of 46 (23 male and 23 female) known type 2 diabetes mellitus patients. Age, gender, duration of diabetes, body mass index (BMI) was recorder in all the diabetic patients.  Fasting blood glucose levels, total cholesterol, triglycerides, HDL, LDL, VLDL levels were measured using standard methods and recorded.Results: The average total cholesterol, triglycerides, LDL, HDL and VLDL were 200±42mg/dl, 169.62±89.79mg/dl, 132.45±36.38mg/dl,39.1±16.6mg/dl and 35.85±17.09mg/dl respectively. The incidence of occurrence of hypercholesterolemia was 58.6% and hypertriglyceridemia 36.9%. Increased levels of LDL were observed in 30 (65.2%) patients and reduced HDL was observed in 43 (93.4%) patients. The incidence rate of dyslipidaemia was higher in female diabetic patients when compared to male diabetic patients.Conclusions: Awareness on the dyslipidaemia and its risk factors should be provided to the type 2 diabetic patients as they are more prone to get cardiovascular disease and lipid profile also should be monitored regularly along with blood glucose levels.


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