• The Korean Journal of Nuclear Medicine
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• v.26 no.2
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• pp.299-306
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• 1992

Gastic emptying scan in diabetic patients is widely used to assess the degree of motility disturbance and the symtoms such as nausea, vomiting, bloating, abdominal pain and early gastric fullness which we can't find anatomic lesion by fiberoscopic or barium study In order to determine the relationship among diabetic gastropathy, neropathy, retinopathy and disease duration, gastric emptying scan using $^{99m}Tc-tin$ colloid labeled scramble egg in hamburger was performed in 10 healty male controls and 50 diabetic patients which were subdivided to no neuropathy, peripheral neuropathy and autonomic neuropathy groups according to the degree of diabetic neuropathy and no retinopathy, background retinopathy and proliferative retinopathy groups according to the degree of diabetic retinopathy. After medication of cisapride for 2 weeks, we observed the presence of improvement of gastric motility in diabetics. The results were as following: 1) In controls, gastric emptying time (GET1/2) was $75{\pm}13.6$ min and 2 hour gastric retension rate (GRR2) was $32{\pm}11.1%$. 2) In diabetics, GET/2 was prolonged more than 2 hours and GRR2 was $58{\pm}23.1%$. According to degree of neuropathy, GET1/2 was prolonged more than 2 hours in all three groups and GRR2 was $54{\pm}24.1%$ in no neuropathy group, $57{\pm}24.3%$ in peripheral neuropathy group and $69{\pm}24.6%$ in autonomic neuropathy group. According to degree of retinopathy, GET1/2 was $110{\pm}23.4$ min in no retinopathy group and prolonged more than 2 hours in other two groups and GRR2 was $45{\pm}21.6%$ in no retinopathy group, $71{\pm}19.7%$ in background retinopathy group and $73{\pm}21.5%$ in proliferative retinopathy group. 3) After cisapride medication for 2 weeks, GET1/2 and GRR2 were improved as $90{\pm}14.6$ min and $40{\pm}13.8%$ (initial GET1/2 and GRR2 were above 2 hours and $61{\pm}15.4%$). We can conclude from above findings that gastropathy in diabetic neuropathy suggesting main underlying factor in motility disorder The degree of retinopathy and disease duration were correlated with severity of gastropathy in diabetics. From the results of gastric emptying scan, we can conclude that cisapride was useful drug for improving diabetic gastropathy and gastric emptying scan was valuable for assessing severity of diabetic gastropathy as non-invasive method.

• Annals of Clinical Neurophysiology
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• v.21 no.1
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• pp.36-43
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• 2019

Background: Diabetic peripheral polyneuropathy (DPN) is associated with a variety of symptoms. Nerve conduction studies (NCSs) are considered to be the gold standard of nerve damage assessments, but these studies are often dissociated from the subjective symptoms observed in DPN patients. Thus, the aim of the present study was to investigate the correlations between NCS parameters and neuropathic symptoms quantified using the Michigan Neuropathy Screening Instrument (MNSI). Methods: Patients with type 2 diabetes mellitus (T2DM) with or without symptoms of neuropathy were retrospectively enrolled. Demographic data, clinical laboratory data, MNSI score, and NCS results were collected for analysis; DPN was diagnosed based on the MNSI score (${\geq}3.0$) and abnormal NCS results. Pearson's correlation coefficients were used to evaluate the relationships between MNSI score and NCS variables. Results: The final analyses included 198 patients (115 men and 83 women) with a mean age of $62.6{\pm}12.7$ years and a mean duration of diabetes of $12.7{\pm}8.4$ years. The mean MNSI score was 2.8 (range, 0.0-9.0), and 69 patients (34.8%) were diagnosed with DPN. The MNSI score was positively correlated with the median motor nerve latency and negatively correlated with the median motor, ulnar sensory, peroneal, tibial, and sural nerve conduction velocities (NCVs). When the patients were categorized into quartiles according to MNSI score, peroneal nerve conduction velocity was significantly lower in the second MNSI quartile than in the first MNSI quartile (p = 0.001). A multivariate analysis revealed that the peroneal NCV was independently associated with MNSI score after adjusting for age, sex, and glycosylated hemoglobin A1c (HbA1c) levels. Conclusions: The present results indicate that a decrease in peroneal NCV was responsible for early sensory deficits in T2DM patients.

• Journal of Korean Medicine Rehabilitation
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• v.24 no.1
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• pp.13-30
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• 2014

Objectives This study was designed to investigate the effects of Bambusae caulis in liquamen and Bambusae concretio silicae on blood sugar reduction and improvement of peripheral nerve function in diabetic rat models. Methods Diabetic rat models induced by streptozotocin were divided into five groups. We fed experimental group I of rats basal diet and administered normal saline (3 ml, 1 time/1 day) for 6 weeks. We fed experimental group II of rats basal diet and administered Bambusae caulis in liquamen (100 mg/kg, 1 time/1 day) for 6 weeks. We fed experimental group III, IV, V of rats basal diet and administered Bambusae concretio silicae (100 mg/kg, 200 mg/kg, 400 mg/kg once a day) for 6 weeks. We investigated weight and glucose level of rats, and carried out touch test, hot plate test, sensory & motor nerve conduction velocity test and immunohistochemical study after 48 hours, 2 weeks, 4 weeks and 6 weeks. Results 1. The weight of all experimental group was gradually decreased. And glucose level was significantly decreased in the experimental group II, III, IV, V as compared with experimental group I. Especially experimental group II, IV, V were significantly decreased as compared with experimental group III. 2. In the quantitative analysis by touch test and hot plate test, mechanical pain threshold and heat pain threshold were significantly decreased in the other experimental groups as compared with experimental group I. Especially experimental group II, IV, V were significantly decreased as compared with experimental group III. 3. In the sensory and motor nerve conduction velocity test, sensory and motor nerve conduction velocity were significantly increased in the other experimental groups as compared with experimental group I. Especially experimental group II, IV, V were significantly increased as compared with experimental group III. 4. In the substance P immunohistochemical study, experimental group II, IV, V showed strong immune response in spinal cord. Conclusions Bambusae caulis in liquamen and Bambusae concretio silicae were probably useful to treat patients with diabetic peripheral neuropathy.

• Annals of Clinical Neurophysiology
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• v.12 no.1
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• pp.16-20
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• 2010

Background: The medial plantar nerve (MPN) is a distal branch of the posterior tibial nerve, and various methods of nerve conduction study for MPN have been introduced so far. Hemmi et al described a new method (Hemmi's method) for recording medial plantar sensory nerve action potentials (SNAPs), which is considered as a simple and reliable method for measuring medial plantar SNAPs. This study was aimed to establish the normal values for the MPN conduction study among Koreans and to compare the sensitivities of three different methods for MPN conduction study (Hemmi, Oh, and Saeed's method) in detecting evidence of peripheral neuropathy among diabetic patients. Methods: In 27 healthy subjects, MPN conduction study using Hemmi's method was performed and normal values were calculated. In 54 diabetic patients who showed normal routine nerve conduction studies, three different methods for MPN conduction study were performed and diagnostic sensitivity of each method were compared. Results: In normal subjects, the mean medial plantar SNAP amplitude and conduction velocities measured by Hemmi's method were $4.3{\pm}1.0$ uV and $38.3{\pm}6.8$ m/s respectively. Among 54 patients with diabetes who showed normal routine nerve conduction studies, medial plantar SNAP was not obtainable in 28, 31, and 6 patients by Hemmi, Oh and Saeed's method respectively. Conclusions: In terms of the diagnostic sensitivity for detecting diabetic neuropathy, there had been no significant statistical difference between three different methods. Our study suggested that MPN conduction study using Hemmi's method is simple and useful screening test for early diabetic neuropathy, and is comparable with Oh's method.

• Journal of the Korean Magnetic Resonance Society
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• v.22 no.4
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• pp.149-157
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• 2018

Diabetes is known to be one of common causes for several types of peripheral nerve damage. Diabetic neuropathy (DN) is a significant complication lowering the quality of life that can be frequently found in diabetes patients. In this study, the metabolomic characteristic of DN and Diabetes was investigated with NMR spectroscopy. The sera samples were collected from DN patients, Diabetes patients, and healthy volunteers. Based on the pair-wise comparison, three metabolites were found to be noticeable: glucose, obviously, was upregulated both in DN patients (DNP) and Diabetes. Citrate is also increased in both diseases. However, the dietary nutrient and biosynthesized metabolite from glucose, ascorbate, was elevated only in DNP, compared to healthy control. The multivariate model of OPLS-DA clearly showed the group separation between healthy control-DNP and healthy control-Diabetes. The most significant metabolites that contributed the group separation included glucose, citrate, ascorbate, and lactate. Lactate did not show the statistical significance of change in t-test while it tends to down-regulated both in DNP and Diabetes. We also conducted the ROC curve analysis to make a multivariate model for discrimination of healthy control and diseases with the identified three metabolites. As a result, the discrimination model between healthy control and DNP (or Diabetes) was successful while the model between DNP and Diabetes was not satisfactory for discrimination. In addition, multiple combinations of lactate and citrate in the OPLS-DA model of healthy control and diabetes group (DNP + Diabetes patients) gave good ROC value of 0.952, which imply these two metabolites could be used for diagnosis of Diabetes without glucose information.

• Journal of Korean Biological Nursing Science
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• v.24 no.3
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• pp.171-180
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• 2022

Purpose: The purpose of this study was to investigate the nutritional intake status, according to the risk of diabetic complications in Type 2 diabetes patients. Methods: This was a secondary data analysis study that included 83 patients. The nutritional intake was assessed, using 24-hour dietary recall. The risk of diabetic complications was measured, using the Framingham Risk Score (FRS) and Michigan Neuropathy Screening Instrument Questionnaire (MNSIQ). The nutritional intake was analyzed using the CAN-pro 4.0 program. Data were analyzed using descriptive statistics, Chi-square test, and Independent t-test, using the SPSS WIN 26.0 program. Results: The mean FRS and MNSIQ scores for the participants was 14.46± 4.09 and 2.30± 2.22, respectively. Thirty two participants (38.6%) were in the high-risk groups for cardiovascular disease and peripheral neuropathy. The participants consumed high amounts of grain and low amounts of vegetables, fruits, and dairy products when compared to the recommended intake. However, the nutritional intake did not differ according to FRS or MNSIQ levels. Consumption of vegetables and fruits were significantly different between high and low risk groups of MNSIQ. Conclusion: It is necessary to consider the composition of dietary intake to improve the imbalanced diet in Type 2 diabetes patients and prevent diabetic complications. Type 2 diabetes patients should reduce the intake of grains and sodium, and increase vegetable intake. More deliberate future studies are needed, to investigate the relationship between food intake and the risk status for diabetic complication.

• Korean Journal of Adult Nursing
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• v.18 no.1
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• pp.81-91
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• 2006

Purpose: The purpose of this study was to investigate foot ulcer risk factors, foot care knowledge, and foot care practice in patients with type 2 diabetes. Method: One hundred fifty type 2 diabetic patients were in and out-patients in a large urban hospital. The data were collected using a self-report questionnaire, chart review and foot examination. The questionnaires were developed by the researchers through the experts consultation and literature review. High risk for foot ulcer was evaluated by peripheral neuropathy(PN), peripheral vascular disease(PVD), and prior foot ulcer. Foot risk scores(FRS) means numbers of present risk factors. Results: 31.3% of subjects show 1 FRS, and 13.3% showed 2 FRS. Mean foot care frequency was 3.5 times per week. There were significant differences in foot care knowledge according to DM education (t=2.96, p=.004) and foot care education (t=3.65, p=.001). There were significant differences in the foot care practice activities according to duration of DM (t=3.48, p=.010) and educational levels. Conclusion: There were high proportion of foot ulcer risk among the patients. It is necessary to screen high risk foot ulcer patients and provide practical education for foot care practice of diabetic patients.

• The Journal of Korean Medicine
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• v.27 no.4
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• pp.135-141
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• 2006

We were to assess clinical effectiveness, safety and usefulness of Kyejibokryung-hwan (KBH), which has been used for Er-hyul similar with vascular or neurologic disorders causing sensory or motor abnormalities. This study is a retrospective single case series. Two hundred ninety five patients were treated with KBH for various neuropathies in our hospital. Of them, 120 cases were excluded because of insufficient medical records or failure to follow up; the remaining 175 were included in the analysis. There were 18 patients with sensory abnormalities and 28 with motor abnormalities after stroke. Of peripheral type, there were 14 with diabetic neuropathy, 12 with carpal tunnel syndrome, 41 with spinal radiculopathies, and 62 with idiopathic neuropathies, for which the effectiveness was assessed as 55.6%, 21.4%, 64.3%, 83.3%, 45.0%, and 56.5%, respectively. Adverse effects including indigestion or diarrhea were seen in 3.4% of the total patients. Taking the effectiveness and the safety together into consideration, the usefulness was assessed as 55.6%, 21.4%, 64.3%, 83.3%, 45.0%, and 54.8% for treating post-stroke sensory and motor abnormalities, diabetic neuropathy, carpal tunnel syndrome, spinal radiculopathies, and idiopathic neuropathies, respectively. In conclusion, we suggest that KBH is a useful herbal medicine for various neuropathies, especially of sensory type.

• Journal of the Institute of Electronics Engineers of Korea SC
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• v.44 no.4 s.316
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• pp.15-20
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• 2007

Recently the prevalence rate of diabetes in Korea has been increasing rapidly due to high growth of economy and changes in dietary lifestyle. Vascular complication is one of diabetic complications which have frequently occurred by obesity, hyperglycemia and impaired glucose metabolism. Photoplethysmogram(PPG) measured from finger and toe is very useful for evaluation of vascular aging and sclerosis level since the PPG signal represents characteristics of peripheral vascular Several researchers have reported that second derivative of the finger PPG waveform was useful to evaluate vascular compliance and developed various analysis methods for vascular compliance. However, peripheral vascular compliance study for diabetic patient was never evaluated by using second derivative of PPG. Therefore, we aimed to objectively compare and to assess normal(n=850) and diabetic(n=50) groups vascular compliance using the second derivative of PPG waveform in this study. The evaluated factors of the second derivative of PPG are 'a', 'b', 'c', 'd', 'e' and b/a rapresents vascular compliance. This study found out that when vascular compliance is decreased, the absolute value of b/a is decreased. The average vascular compliance of 50 diabetic patients with neuropathy, $-1.09{\pm}0.14$ is statistically lower than the normal group, $-0.81{\pm}0.09$ (p<0.05). In conclusion, we suggest an objective evaluation of peripheral vascular compliance for diabetic patients and prevention of vascular complication.

• The Journal of Korean Physical Therapy
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• v.18 no.4
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• pp.11-17
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• 2006

Purpose: This study aims to suggest clinical basis of physical therapy to skeletal system complication in type II diabetic patients through a variety of analysis methods. Methods: 75 subjects(type II diabetic patients; age from 40 to 80) of this study were participated in BMD(Bone Mineral Density) and Dual energy X-ray absorptiometry, blood test to their skeletal system. Results: Incidence of osteopenea was higher than normal group as women(91.2%) and men(53.5%) in diabetes group. However, women were showed no significantly difference in comparison group. Above age 60(in diabetes group; men and women) showed to highly incidence of osteopenea as well as significantly difference in osteopenea(peripheral neuropathy). As a result of analyzing blood through presence and absence of osteopenea in diabetes group, men were showed significantly difference in DPD/creatinine ratio and women were showed significantly difference in Alkaline phosphatase, Corrected Calcium. Conclusion: This study shows that decreased BMD and increased osteopenea through type II diabetes. Women were particularly lower BMD and higher incidence of osteopenea than men and men influence of type II diabetes on change of BMD was greater than women.