scholarly journals Evaluation of the Degree of Agreement of Four Methods for Diagnosing Diabetic Autonomic Neuropathy

2021 ◽  
Vol 12 ◽  
Author(s):  
Yu Peng ◽  
Ying-shan Liu ◽  
Min-yi Wu ◽  
Chu-na Chen ◽  
Chu-qiao Li ◽  
...  
Keyword(s):  
Autonomic Neuropathy ◽  
Diagnostic Value ◽  
Diabetic Autonomic Neuropathy ◽  
Diabetic Patients ◽  
Type 2 Diabetic Patients ◽  
Diagnostic Values ◽  
Spearman’S Correlation ◽  
Type 2 Diabetic

Background: There are many methods to diagnose diabetic autonomic neuropathy (DAN); however, often, the various methods do not provide consistent results. Even the two methods recommended by the American Diabetes Association (ADA) guidelines, Ewing's test and heart rate variability (HRV), sometimes give conflicting results. The purpose of this study was to evaluate the degree of agreement of the results of the Composite Autonomic Symptom Score 31 (COMPASS-31), skin sympathetic reaction (SSR) test, Ewing's test, and HRV in diagnosing DAN.Methods: Patients with type 2 diabetes were recruited and each received the COMPASS-31, SSR, Ewing's test, and HRV for the diagnosis of DAN. Patients were categorized as DAN(+) and DAN(–) by each of the tests. Kappa consistency tests were used to evaluate the agreement of diagnosing DAN between any two methods. Spearman's correlation test was used to evaluate the correlations of the severity of DAN between any two methods. Receiver operating characteristic (ROC) analyses were used to evaluate the diagnostic value and the cutoff value of each method.Results: A total of 126 type 2 diabetic patients were included in the study. The percentages of DAN(+) results by HRV, Ewing's test, COMPASS-31, and SSR were 61, 40, 35, and 33%, respectively. COMPASS-31 and Ewing's test had the best agreement for diagnosing DAN (κ = 0.512, p < 0.001). COMPASS-31 and Ewing's test also had the best correlation with respect to the severity of DAN (r = 0.587, p < 0.001). Ewing's test and COMPASS-31 had relatively good diagnostic values (AUC = 0.703 and 0.630, respectively) in the ROC analyses.Conclusions: COMPASS-31 and Ewing's test exhibit good diagnostic consistency and severity correlation for the diagnosis of DAN. Either test is suitable for the diagnosis of DAN and treatment follow-up.

scholarly journals The relation between HbA1c variability and diabetic autonomic neuropathy among type-2 diabetic patients

2022 ◽  
Vol 6 (1) ◽  
pp. 89
Author(s):  
Md Azad Hossain ◽  
Mukul Kumar Sarkar ◽  
Imtiaj Mahbub ◽  
SM Shahinul Islam
Keyword(s):  
Type 2 Diabetes ◽  
Autonomic Neuropathy ◽  
Clinical Manifestations ◽  
Diabetic Autonomic Neuropathy ◽  
Diabetic Patients ◽  
Type 2 Diabetic Patients ◽  
Hba1c Variability ◽  
The Relationship ◽  
Type 2 Diabetic

Background: Diabetic autonomic neuropathy (DAN) is the most neglected major and widespread microvascular complication of type-2 diabetes mellitus, involving multiple body organs. DAN is a subtype of diabetic peripheral neuropathy.Objective: To investigate the relationship between the variability of HbA1c and diabetic autonomic neuropathy in type-2 diabetes patients.Materials and methods: This study recruited a total of 150 type-2 diabetic patients to screen for diabetic autonomic neuropathy and estimated quarterly levels of HbA1c were performed within the year before enrollment. With a noninvasive procedure, DAN was validated by careful history taking, anthropometric assessment, clinical manifestations and neurological assessment.Results: Out of 150 type- 2 diabetic patients, recruited randomly, where 81 were female and 69 were male. Among all patients 29 (19.33%) had been screened positive for DAN which showed higher HbA1c than non-DAN patients. Different autonomic neuropathic dysfunction among total diabetic patients were also studies and found that the highest prevalence of sexual dysfunction among all autonomic dysfunction prevalence which is 16.66% whereas the lowest prevalence was postural hypotension that is 6.66%. The second higher prevalence is urinary incontinence (10.66%). Abnormal sweating (9.33%) and nocturnal diarrheas (7.33%) are in third and fourth position respectively. No significant (p>0.05) differences were found in the case of BMI, sex, systolic, and diastolic blood pressure between DAN and non-DAN. Data shows a major (p<0.05) risk factor for DAN has also been the prolonged period of diabetes and older age.Conclusion: The study indicates that the increased level of HbA1c in type-2 diabetic patients is closely correlated with DAN and may be considered a potent predictor of DAN in the recruited patients.International Journal of Human and Health Sciences Vol. 06 No. 01 January’22 Page: 89-95

Autologous Skin Fibroblast and Keratinocyte Grafts in the Treatment of Chronic Foot Ulcers in Aging Type 2 Diabetic Patients

2011 ◽  
Vol 101 (1) ◽  
pp. 55-58 ◽  
Author(s):  
Matteo Monami ◽  
Maria Vivarelli ◽  
Carla Maria Desideri ◽  
Giulio Ippolito ◽  
Niccolò Marchionni ◽  
...  
Keyword(s):  
Healing Time ◽  
Lower Limbs ◽  
Foot Ulcers ◽  
Diabetic Patients ◽  
Consecutive Series ◽  
Type 2 Diabetic Patients ◽  
Skin Cell ◽  
Type 2 Diabetic

Background: We assessed the tolerability and efficacy of autologous skin cell grafts in older type 2 diabetic patients with chronic foot ulcers. Methods: Treatment with Hyalograft 3D and Laserskin Autograft was proposed to a consecutive series of type 2 diabetic patients older than 65 years affected by long-standing (&gt;6 months) foot ulcers with an area greater than 15 cm2. Ulcer healing rates and measurements of ulcer area were determined monthly for 12 months. Results: Seven patients with 12 ulcers, nine of which received the described treatment, were enrolled. During 12-month follow-up, all of the ulcers healed except one. In the remaining eight ulcers, the median healing time was 21 weeks (interquartile range, 4–29 weeks). Conclusions: Autologous skin cell grafts are feasible, well tolerated, and apparently effective in the treatment of diabetic ulcers of the lower limbs in advanced age. Age did not seem to moderate healing times. (J Am Podiatr Med Assoc 101(1): 55–58, 2011)

scholarly journals Effectiveness of Diabetes Community Sharp Disposal Education Module in Primary Care: An Experimental Study in North-East Peninsular Malaysia

2019 ◽  
Vol 16 (18) ◽  
pp. 3356
Author(s):  
Ummu Atiyyah Hasan ◽  
Suhaily Mohd Hairon ◽  
Najib Majdi Yaacob ◽  
Aziah Daud ◽  
Anees Abdul Hamid ◽  
...  
Keyword(s):  
Intervention Group ◽  
Knowledge Score ◽  
Peninsular Malaysia ◽  
Diabetic Patients ◽  
Type 2 Diabetic Patients ◽  
North East ◽  
Type 2 Diabetic ◽  
Significant Increment

Background: Structured education is needed to cultivate safe sharp disposal behavior among diabetic patients. Thus, this study aimed to assess the effectiveness of the Diabetes Community Sharp Disposal Education Module in improving knowledge and sharp disposal practice among Malaysian Type 2 diabetic patients. Methods: This quasi-experimental study was conducted at primary health clinics in two districts in Kelantan, a state in the North-East Region of Peninsular Malaysia. A total of 132 Type 2 diabetic patients on insulin therapy were involved, with 68 participants in each control and intervention group. The health education intervention was based on the validated Diabetes Community Sharp Disposal Education Module. The knowledge and practices were measured using a validated questionnaire at baseline, one month, and three months after the intervention. Results: There was a significant increment in the mean knowledge score for intervention group; from baseline to one month follow up and from baseline to three months follow up [Greenhouse-Geisser; F(1.5, 199.7) = 62.38, p < 0.001; effect size (η2) = 0.318]. Intervention group had significantly higher mean knowledge score as compared to control group; at one month and three months follow up [F(1, 134) = 17.38, p < 0.001; effect size (η2) = 0.115]. There was a statistically significant increment in the proportion of participants in the intervention group who practiced the proper community sharp disposal method over time, X2(2) = 52.061, p < 0.001. Conclusions: The Diabetes Community Sharp Disposal Education Module was an effective health education tool to improve knowledge and encourage Malaysian diabetic patients to engage with proper sharp disposal practices.

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