• Annals of Clinical Neurophysiology
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• 제16권1호
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• pp.8-14
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• 2014

Background: Early detection of neuropathy may prevent further progression of this complication in the diabetic patients. The purpose of this study was to evaluate the prevalence of early neuropathic complication in patients with newly diagnosed type 1 and type 2 diabetes. Methods: Nerve conduction studies (median, ulnar, posterior tibial, peroneal, and sural nerves) were performed for 49 type 1 (27 males, mean $14.1{\pm}7.5$ years) and 40 type 2 (27 males, $42.0{\pm}14.1$ years) diabetic patients at onset of diabetes. Children with age at onset under 4 years and adults over 55 years were excluded to eliminate the aging effect and the influence of obstructive arteriosclerosis. Neuropathy was defined as abnormal nerve conduction findings in two or more nerves including the sural nerve. Results: Mean HbA1c level was $12.6{\pm}3.3%$ for type 1 and $10.5{\pm}2.9%$ for type 2 diabetes. The prevalence of neuropathy was 12.2% for type 1, and 35.0% for type 2 diabetes, respectively. There were significant trends in the prevalence of neuropathy with increasing age (p<0.05). The effect of the mean level of glycosylated hemoglobin on the prevalence of polyneuropathy at onset of diabetes was borderline (p=0.0532). Neither sex of the patients nor the type of diabetes affected the neurophysiologic abnormalities at the diagnosis. Conclusions: Even in a population with diabetes at the diagnosis, the prevalence of subclinical neuropathy was not low. Neuropathy has been significantly associated with increasing age indicating the possibility of longer duration of undetected diabetes among them, especially in type 2 diabetes.

• 대한임상전기생리학회지
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• 제3권1호
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• pp.71-84
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• 2005

This study had performed with purposes to analyze the influence of the change of vestibular sens, visual and proprioceptive sense to the postural sway, so as to supply the necessary clinical materials through developing the physical therapeutic interventions and assessment format for the diabetic neuropathy patients. The sample consisted of fifteen diabetic neuropathy patients with sensory disorder in their lower limbs and fifteen age-matched normal control group. Then the effect of the GVS and the visual cue open and closed to the postural sway were measured by CoP. The summary of the comparison results were obtained below. In the comparison of diabetes neuropathy patients group and age matched normal control group, however diabetes neuropathy patients group had a decrease in superficial tactile sense(p<.001) and nerve conduction velocity(p<.001), they were able to control the posture and walk. So it is, diabetes neuropaty patients had more disturbance compared with AMC group on at a hard surface, particularly in the visual cue open(p<.001) and visual cue closed(p<.01). Moreover, since diabetes neuropathy patients group had more differences in visual cue open and closed(p<. 01), GVS(p<.01), it meant that they're affected largely by vestibular sense, visual sense. In addition, since there're the largest change in doubled sense disturbance such as visual cue open and closed under GVS, it meant that compensation of other senses were quite important for the diabetes neuropathy patients' postural control. In the conclusion, diabetes neuropathy patients who decrease or lose the somatosensory system, sensory training of visual and vestibular system are likely to be quite essential to control the posture and balance.

• 대한족부족관절학회지
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• 제17권4호
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• pp.251-256
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• 2013

Neuropathy is a common complication of diabetes. It is characterized by a progressive loss of peripheral nerve fibers. The development of the neuropathy is linked to poor glycemic control, age, and the duration of diabetes. Peripheral sensory polyneuropathy is the most common type in neuropathy. Diabetic neuropathy is the most significant etiologic factor of the foot ulcer that may leads to amputation. Current treatments in diabetic neuropathy have no definitive effects on repair or reverse the damaged nerve but only to relieve of symptoms, especially on pain. When the focal compressive neuropathy is combined with diabetic neuropathy, the nerve would be more vulnerable and symptoms might get worse. Surgery is indicated for decompression of an entrapped nerve, like posterior tibial nerve in tarsal tunnel, after failure of the initial conservative treatments.

• 가정∙방문간호학회지
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• 제22권2호
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• pp.206-215
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• 2015

Purpose: This study aimed to provide basic data to enhance self-nursing ability by investigating the symptoms of autonomic neuropathy and self-management activities in patients with diabetes accompanying hypertension. Methods: Subjects were 113 type-2 diabetic patients who were diagnosed as hypertensive in two primary medical institutions and taking anti-hypertensive treatments. The existence of postural hypotension was evaluated by blood pressure and pulse rate, and the subjective symptoms of autonomic neuropathy and self-management activities were checked by structured questionnaires. The collected data were analyzed by chi-square test, Fisher's exact test, t-test, Wilcoxon rank sum test and analysis of covariance. Results: Postural hypotension occurred in 4.4% of the subjects. Urinary frequency and dizziness during postural changes were the most frequent symptoms of autonomic neuropathy, and 57.5% of the subjects complained of symptoms in two or more domains. The group with autonomic neuropathy symptoms showed higher age, higher living stress, and fewer self-management activities in the diet and foot management domains as compared to the group without autonomic neuropathy symptoms. Conclusion: From these results, we learned that strengthening education on self-management for diet and foot management and customized interventions considering age and living stress are required through early identification of the symptoms of autonomic neuropathy in patients with diabetes accompanying hypertension.

• 한국자기공명학회논문지
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• 제22권4호
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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.

• Diabetes and Metabolism Journal
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• 제42권6호
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• pp.544-545
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• 2018

• Diabetes and Metabolism Journal
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• 제42권6호
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• pp.546-547
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• 2018

• 기본간호학회지
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• 제13권2호
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• pp.225-234
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• 2006

Purpose: This study was done to investigate the effect of self-foot reflexology on peripheral blood circulation, peripheral neuropathy and to determine the feasibility of self-foot reflexology as a nursing intervention. Method: This was nonequivalent control pretest-posttest study with 76 patients with type 2 diabetes mellitus (ages between 40-79) recruited from public health centers in Busan city. Intervention was a 6 week self-foot reflexology, and outcome variables were peripheral blood circulation and peripheral neuropathy(tactile response to monofilament, intensity of symptoms of peripheral neuropathy). ANCOVA was used to do the statistical analysis. A.05 significance level was set for evaluating the effects of self-foot reflexology. Results: The self-foot reflexology was relatively effective not only in reducing peripheral neuropathy(especially tingling sensation and pain) but also in improving ability to sense the 10-g force monofilament. Conclusion: Even though self-foot reflexology was not effective in improving peripheral circulation, it had good effect on improving peripheral neuropathy. Therefore self-foot reflexology can be used as a nursing intervention program for promoting foot care for patients with DM patients.

• Journal of Nutrition and Health
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• 제34권8호
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• pp.912-919
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• 2001

The increased oxidative stress may play an important role on the pathogenesis of diabetes and diabetic complications, and the blood level of vitamin C and lipid peroxidation in NIDDM patients may be used as an indicator for oxidative stress. However there is only scanty evidence on the blood level of vitamin C in NIDDM patients with or without diabetic complications. The study population consisted of 90 NIDDM patients(diabetes without complication, 48, and diabetes with complications, 42) and 41 normal subjects. The 42 diabetic complications were divided into 3 groups : 15 diabetic nephropathy, 18 diabetic neuropathy, 9 diabetic retinopathy. The anthropometric data and blood biochemical data were studied. The dietary intake was determined by 24 hour recall methods and food frequency questionnaire. The plasma concentrations of MDA and vitamin C were determined by fluorophotometer and HPLC respectively. 1) In blood lipoprotein study, diabetes with complication had higher level of TG than diabetes without complications, while no significant differences in total cholesterol, HDL, and LDL were shown. Diabetic neuropathy had the highest TG level among diabetic complication groups. 2) The intakes of vitamin B complexes(vitamin B$_2$, vitamin B$_{6}$, not vitamin B$_1$) and antioxidant vitamins(vitamin A and vitamin E, not vitamin C) and certain minerals such as iron and calcium in diabetes were not sufficient but the intakes of energy, protein, niacin, and phosphorus in diabetes were sufficient. The dietary intakes between diabetes with-and without complications were not significantly different. Among diabetic complications, the diabetic retinopathy had the lowest intake of vitamin B$_2$ and B$_{6}$(p < 0.05). the diabetic neuropathy or nephropathy consumed extremely low amount of vitamin A. 3) The MDA concentrations of NIDDM was significantly higher than that in controls(p < 0. 05) while no significant difference in the MDA concentration between with and without complications was shown. Although there were no statistical differences, the diabetic nephropathy and diabetic neuropathy showed the higher concentration of MDA than the diabetes without complications or diabetic retinopathy. 4) The plasma concentration of vitamin C in controls was higher than that in diabetes(p < 0.05) while the plasma vitamin C in diabetes with and without complications were similar. In diabetic complications, no differences in plasma vitamin C concentration of three groups were shown. This study showed that the oxidative stress in NIDDM patients was highly increased and the vitamin C reserve was significantly depleted, as compared with normals, although their intakes of vitamin C met korean RDA, which means that diabetes need more vitamin C intake to decrease oxidative stress in NIDDM patients.nts.

• 대한한의학회지
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• 제19권2호
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• pp.137-152
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• 1998

Acute complications of diabetes mellitus were diminished after Banting and Best discovered insulin. But chronic complications of diabetes mellitus have been increased. The main complications of diabetes mellitus are diabetic retinopathy, diabetic nephropathy, diabetic neuropathy, diabetic foot lesion and macrovascular complication. These complications can result in renal failure, loss of sight, cerebral infarction and myocardial infarction. So it is very difficult to treat the complications of diabetes mellitus. In oriental medicine, the transformations(傳變症) of Sogal(消渴) are edema, carbuncle, loss of sight and so on. The comparative study between the trcmsformations(傳變症) of SogaI(消渴) and the complications of diabetes mellitus has come to the following conclusions. 1. In oriental medicine, diabetic retinopathy was expessed as loss of sight and the treament of diabetic retinopathy should be started at an early stage, to prevent vitreous hemorrhage and traction retinal detachment. 2. In oriental medicine. diabetic nephropathy was expressed as edema and the treatment should be started at an early stage of renal injury when the protein comes from urine.3. Symmetrical distal polyneuropathy is the main part of diabetic neuropathy and it was expressed as weakness of the lower limbs and pain of joints in the symptoms of Haso(下消). In Oriental medicine, acupuncture and herb medicine which effect is SopungHwalHyul can treat polyneuropathy. 4. Chief macrovascular complications are coronary artery disease and cerebrovascular disease, The cause of macrovascular complication is atherosclerosis. So the method of treating atherosclerosis should be studied in oriental medicine. 5. Diabetic foot were expressed as carbuncle and its main causes are decreasing perfusion of fool, diabetic neuropathy and infection. So these causes should be studied in oriental medicine. 6. The complications of diabetes mellitus afe very similar to the transfonnatiuns of Sogal(消渴).The control of blood glucose is indispensable to prevent and delay the complication of diabetes mellitus.