• Title/Summary/Keyword: Diabetic neuropathy

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Use of SGLT2 inhibitor/metformin fixed dose combination in Korea (SGLT2 저해제/metformin 고정용량복합제의 국내 사용 현황)

  • Choi, Ha Eun;Lee, Ji Won;Je, Nam Kyung;Jeong, Kyeong Hye
    • Korean Journal of Clinical Pharmacy
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    • v.32 no.1
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    • pp.13-19
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    • 2022
  • Background: The use of combination therapy and fixed-dose combination therapy is increasing for the treatment of type 2 diabetes. Sodium glucose cotransporter-2 inhibitor (SGLT2i) is a drug class used in combination with metformin. Methods: Type 2 diabetes patients on SGLT2i/metformin combination therapy were extracted from the 2019 Health Insurance Review & Assessment Service-National Patients Sample. On July 1, 2019, SGLT2i and metformin fixed-dose combination (SGLT2i/metformin FDC) and two-pill combination (TPC) groups were identified, and a chi-square test and multiple logistic regression were performed. Results: Of total 2,992 patients, 1,077 (36%) were prescribed SGLT2i/metformin FDC and 1,915 (64%) were prescribed TPC. We found that the most common comorbidities were in the order of dyslipidemia, gastrointestinal disease, and hypertension. Multiple logistic regression analysis showed that the use of SGLT2i/metformin FDC was lower than TPC in patients with diabetic neuropathy (OR=0.76, p=0.008). Clinic (OR=2.09, p<0.001) and general hospital (OR=1.40, p=0.019) showed higher tendency to prescribe SGLT2i/metformin FDC compared to tertiary hospital. The tendency of prescribing SGLT2i/metformin FDC was lower in Kyeonggi (OR=0.79, p=0.037), Gyeongsang (OR=0.77, p=0.025) and Chungcheong (OR=0.68, p=0.007) than Seoul. Conclusion: Factors related to the use of SGLT2i/metformin FDC in patients with type 2 diabetes were complication, medical institution and region. The tendency to prescribe SGLT2i/metformin FDC was relatively higher in clinics than in tertiary general hospitals and in Seoul than in other regions.

Evaluation of reference value of anti-Glutamic acid decarboxylase antibody for cerebrospinal fluid (뇌척수액에서 항 Glutamic acid decarboxylase 항체검사의 참고치 설정)

  • Park, Min-Ho;Shin, Sun-Young;Youn, Tae-Seok;Shin, Hi-Jung;Noh, Gyeong-Woon
    • The Korean Journal of Nuclear Medicine Technology
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    • v.21 no.2
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    • pp.28-30
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    • 2017
  • Purpose Anti-Glutamic acid decarboxylase antibody test (GAD Ab) has been used as a predictor of type 1 diabetes. GAD Ab has also been shown to be highly potent in cerebrospinal fluid (CSF) of patients with suspected diabetic peripheral neuropathy. Recently, it has been known that clinical significance of GAD Ab using CSF is useful for the neurological disorders. However, the reference value of anti-GAD Ab has been provided only for serum. In this experiment, we estimated the reference value of anti-GAD antibody for CSF in neurological patients. Materials and Methods A total of 211 neurological patients were enrolled. Serum and CSF were analyzed by radioimmunoassay (RIA) using commercial RIA anti-GAD Ab kit (RSR, London, United Kingdom). Normal saline was used as the normal CSF control because CSF is most similar to 0.9% normal saline. Results The mean value of normal CSF control was 1.97 U/mL, and two standard deviations (2SD) was 1.44 U/mL. Based on this data, the expected reference range of CSF could be estimated from 0.54 U/mL to 3.40 U/mL Conclusion The reference range of normal CSF control using normal saline obtained with Hoffmann's method. However, there will be a need to validate the CSF reference values using human normal CSF.

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An Electrophysiologic Study on the Median Digital Nerves in Healthy Adults (정상 성인의 정중지단신경에 대한 전기생리학적 연구)

  • Kim, Jong-Soon;Lee, Hyun-Ok;Ahn, So-Youn;Koo, Bong-Oh;Nam, Kun-Woo;Ryu, Jae-Kwan;Ryu, Jae-Moon
    • The Journal of Korean Physical Therapy
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    • v.17 no.3
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    • pp.329-338
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    • 2005
  • The determination of peripheral nerve conduction velocity is an important part to electrodiagnosis. Its value as neurophysiologic investigative procedure has been known for many years but normal value of digital nerve was not reported in Korea. To evaluate of digital nerve conduction velocity of median nerve for obtain clinically useful reference value and compare difference in each fingers. 71 normal volunteers(age, 19-65 years; 142 hands) examined who has no history of peripheral neuropathy, diabetic mellitus, chronic renal failure, endocrine disorders, anti-cancer medicine, anti-tubercle medicine, alcoholism, trauma, radiculopathy. Nicolet Viking II was use for detected conduction velocity and amplitude of digital nerves in median nerve. Data analysis was performed using SPSS. Descriptive analysis was used for obtain mean and standard deviation, ANOVA was used to compare each fingers and independent t-test was used to compare between Rt and Lt side also compare between different in genders. Conduction velocity of the right thumb was 49.77m/sec, index finger was 56.80m/sec, middle finger was 56.15m/sec and ring finger was 53.38m/sec. The left thumb was 50.48m/sec, index finger was 56.76m/sec, middle finger was 55.99m/sec and ring finger was 53.23m/sec. Amplitude of the right thumb was $64.30{\mu}V$, index finger was $73.95{\mu}V$, middle finger was $77.97{\mu}V$ and ring finger was $43.92{\mu}V$. The left thumb was $74.21{\mu}V$, index finger was $85.72{\mu}V$, middle finger was $88.06{\mu}V$ and ring finger was $47.28{\mu}V$. There were significantly difference between thumb, index, middle and ring fingers(p<.01) but there were no statistically difference between conduction velocity and amplitude of index and middle fingers(p>.01). The conduction velocity of index finger are faster than other fingers and amplitude of middle finger are greater than other fingers. The present results revealed that electodiagnosis can easily perform in index and middle finger for digital nerve of median nerve study.

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An Electrophysiologic Study on the Median Motor Nerve and Ulnar Motor Nerve (정중운동신경과 척골운동신경의 전기생리학적 연구)

  • Kim, Jong-Soon;Lee, Hyun-Ok;Ahn, So-Youn;Koo, Bong-Oh;Nam, Kun-Woo;Kim, Young-Jick;Kim, Ho-Bong;Ryu, Jae-Kwan;Ryu, Jae-Moon
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.11 no.2
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    • pp.62-70
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    • 2005
  • The determination of peripheral nerve conduction velocity is an important part to electrodiagnosis. Its value as neurophysiologic investigative procedure has been known for many years but normal value of median and ulnar motor nerve was poorly reported in Korea. To evaluate of median and ulnar motor nerve terminal latency, amplitude of CMAP(compound muscle action potential), conduction velocity and F-wave latency for obtain clinically useful reference value. 71 normal volunteers(age, 19-65 years; 142 hands) examined who has no history of peripheral neuropathy, diabetic mellitus, chronic renal failure, endocrine disorders, anti-cancer medicine, anti-tubercle medicine, alcoholism, trauma, radiculopathy. Nicolet Viking II was use for detected terminal latency, amplitude of CMAP, conduction velocity and F-wave latency of median and ulnar motor nerve. Data analysis was performed using SPSS. Descriptive analysis was used for obtain mean and standard deviation, independent t-test was used to compare between Rt and Lt side also compare between different in genders. The results are summarized as follows: 1. Median motor nerve terminal latency was right 3.00ms, left 2.99ms and there was no significantly differences between right and left side and genders. 2. Median motor nerve amplitude of CMAP was right 17.26mV, left 1750mV and there was no significantly differences between right and left side and genders. 3. Median motor nerve conduction velocity was right 57.89m/sec, left 58.03m/sec and there was no significantly differences between right and left side and genders. 4. Median motor nerve F-wave latency was right 25.74ms, left 25.59ms and there was significantly differences between genders. 5. Ulnar motor nerve terminal latency was right 2.38ms, left 2.45ms and there was significantly differences between right and left side. 6. Ulnar motor nerve amplitude of CMAP was right 15.99mV, left 16.02mV and there was no significantly differences between right and left side and genders. 7. Ulnar motor nerve conduction velocity was right 60.35m/sec, left 59.73m/sec and there was no significantly differences between right and left side and genders. 8. Ulnar motor nerve F-wave latency was right 25.53ms, left 25.57ms and there was significantly differences between genders.

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An Electrophysiologic Study on the Ulnar Digital Nerves (척골 지단 신경의 전기생리학적 연구)

  • Kim, Jong-Soon;Lee, Hyun-Ok;Ahn, So-Youn;Koo, Bong-Oh;Nam, Kun-Woo;Kim, Ho-Bong;Ryu, Jae-Kwan;Ryu, Jae-Moon
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.11 no.2
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    • pp.13-18
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    • 2005
  • The ulnar nerve extends down the arm, across the elbow, and into the hand. It provides sensation to the little and ring fingers and activates many of the small muscles in the hand. The determination of peripheral nerve conduction velocity is an important part of ulnar nerve evaluation. The electrodiagnostic value as neurophysiologic investigative procedure has been known for many years but normal value of digital nerve was not reported in Korea. The purpose of this investigation was to measure the digital nerve conduction velocity of ulnar nerve for obtain clinically useful reference value and compare difference in each fingers and then compare with the other countries. 71 normal Korean volunteers (age, 19-65 years; 142 hands) examined who has no history of peripheral neuropathy, diabetic mellitus, chronic renal failure, endocrine disorders, anti-cancer medicine, anti-tubercle medicine, alcoholism, trauma, radiculopathy. Nicolet Viking II (EMG machine) was use for detected conduction velocity and amplitude of digital nerves in ulnar nerve. Data analysis was performed using SPSS. Descriptive analysis was used for obtain mean and standard deviation and independent t-test was used to compare with ring and little finger. Conduction velocity of the right ring finger was 57.44m/sec and little finger was 55.32msec. The left ring finger was 55.55msec and little finger was 54.11msec. Amplitude of the right ring finger was $30.28{\mu}V$ and little finger was $48.36{\mu}V$. The left ring finger was $30.67{\mu}V$ and little finger was $52.76{\mu}V$. There were significantly difference between ring and little in amplitude (p<.05) but there were no statistically difference between conduction velocity of ring and little finger (p>.05). The amplitude of little finger are greater than ring finger. The present results revealed that electodiagnosis can easily perform in little finger for digital nerve of ulnar nerve study.

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Treatment Pattern of Patients with Neuropathic Pain in Korea (한국인 신경병성 동통 환자의 치료 양태 연구)

  • Han, Sung-Hee;Lee, Ki-Ho;Kim, Mee-Eun;Kim, Ki-Suk
    • Journal of Oral Medicine and Pain
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    • v.34 no.2
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    • pp.197-205
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    • 2009
  • The purpose of this study was to investigate the treatment pattern of patients with neuropathic pain (NeP) in Korea through computerized database of Health Insurance Review and Assessment Service (HIRAS) over three years' period from 2003 to 2005. The results showed that the numbers of treatment visits were the highest for diabetic neuropathy (DN), followed by postherpetic neuralgia (PHN) and trigeminal neuralgia (TN) in order. Top 3 specialties for treatment visits due to NeP conditions were neurology, neurosurgery and anesthesiology. While cost of a treatment visit was higher in anesthesiology and emergency clinics compared to other clinics, there was a tendency to increase costs for visits to clinics of rehabilitation medicine and family medicine over the three years. Cost of dental visits was relatively high for TN, atypical facial pain (AFP) and atypical odontalgia (AO). Surgeries frequently applied to patients with NeP were sympathetic plexus or ganglion block, block of peripheral branch of spinal nerve and cranial nerve or its peripheral branch block. Most common prescribed medication were anticonvulsants, anti-inflammatory analgesics and anti-psychotic drugs while anti-inflammatory analgesics were overwhelmingly frequently prescribed for AO and glossodynia. Based on the results of this study, NeP disorders more relevant to dentists were AO, TN and AFP, TN of which seems to be the most important in terms of patients' number and cost for treatment visits. This indicates that dentists, especially oral medicine specialists should actively participate in management of TN, AO and AFP and share relevant information with patients and community.