• Annals of Clinical Neurophysiology
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• v.10 no.1
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• pp.29-32
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• 2008

Although various criteria on the diagnosis of diabetic neuropathy are applied from trial to trial, being tailored in concert with its purpose, the utmost evidences of the diagnosis are subjective symptoms and objective signs of neurologic deficit. The application and interpretation of auxiliary electrophysiological test including nerve conduction study (NCS) should be made on the context of clinical pictures. The evaluation of the functions of small, thinly myelinated or unmyelinated nerve fibers has been increasingly stressed recently with the advent of newer techniques, e.g., measurement of intraepidermal fiber density, quantitative sensory testing, and autonomic function test. And the studies with those techniques have shed light to the nature of the evolution of diabetic neuropathy. The practical application of these techniques to the diagnosis of diabetic neuropathy in the individual patients, however, should be made cautiously due to several shortcomings: limited accessibility, wide overlapping zone between norm and abnormality with resultant unsatisfactory sensitivity and specificity, difficulty in performing subsequent tests, unproven quantitative correlation with clinical deficit, and invasiveness of some technique. NCS, as an extension of clinical examination, is still the most reliable electrophysiological test in evaluating neuropathy and gives the invaluable information about the nature of neuropathy, whereas the newer techniques need more refinement of the procedure and interpretation, and the accumulation of large scaled data of application to be considered as established diagnostic tools of peripheral neuropathy.

• The Journal of Internal Korean Medicine
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• v.37 no.2
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• pp.232-236
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• 2016

Objective: Diabetic neuropathy is a common complication of diabetes mellitus. Patients with this disease suffer from various peripheral sensory symptoms that are not easily alleviated. We report on a case of a patient with diabetic neuropathy whose symptoms were alleviated after traditional Korean medical treatment.Methods: A patient with hand and foot numbness and coldness diagnosed with diabetic neuropathy was treated with Palmijihwang-tang (Bai Wei Di Huang Wa, 八味地黃湯) three times a day. The progress was evaluated with the numerical rating scale (NRS), neuropathy disability score (NDS), and neuropathy symptom score (NSS).Results: The improvement of symptoms appeared to be faster and more effective than that of conventional treatment. The improvement was observed from the second day of the treatment.Conclusions: This case study shows that Palmijihwang-tang may be an effective treatment for diabetic neuropathy.

• The Korean Journal of Food And Nutrition
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• v.21 no.4
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• pp.430-435
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• 2008

The main cause of diabetic neuropathy, one of the most debilitating complications, is the chronic hyperglycemia, the increase sorbitol or the decrease of nerve growth factor(NGF). NGF, a protein, plays a major role in the development and maintenance of peripheral nervous system. Systemic administration of NGF prevents manifestations of neuropathy in rodent models of diabetic neuropathy. In the previous investigation, we report the hypoglycemia effect of Dioscorea rhizoma extract(DRE) in diabetic mice. The present study shows protective effect of DRE on diabetic neuropathy by induction of NGF protein. We investigated the NGF level in salivary gland and sciatic nerve of normal mouse and the effect of DRE on sciatic nerve conductivity and thermal hyperalgesia test in Type 2 db/db mouse. DRE increased endogenous NGF level in salivary gland and sciatic nerve of mouse. And sensory nerve conductivity velocity(SNCV), motor nerve conductivity velocity(MNCV) and thermal hyperalgesia increased in DRE treatment mice compared with control group. On the basis of our results, we conclude that DRE increase induction of endogenous NGF level and have protective effect on diabetic neuropathy by induction of NGF. Therefore, we propose that long-term use of DRE might help prevention of diabetes-associated complication; diabetic neuropathy.

• Korean Journal of Psychosomatic Medicine
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• v.1 no.1
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• pp.52-58
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• 1993

Before studying the effectiveness of amitriptyline in alleviating the pain of diabetic neuropathy, this study was designed to compare the severity and nature of depressive symtoms of diabetic patients with neuropathy with those of diabetic patients without neuropathy and patients with somatoform disorder whose complaints were mainly somatic pain, respectively. The authors administered Beck Depression Inventory(BDI) to the three groups of patients. The mean total scores of BDI were relatively low in all groups and not significantly different among the three groups. The mean scores of four subscales of BDI were also not significantly different among the three groups. These results might suggest that the pain of diabetic neuropathy did not influence on the severity and the nature of depressive symptoms of preexisting diabetes.

• Proceedings of the KIEE Conference
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• 2007.04a
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• pp.77-79
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• 2007

The purpose of this study was to suggest a new detection method for early diagnosing diabetic neuropathic foot by obtaining a ratio of toe to figer blood flow using photoplethysmography(PPG). Nerve conduction velocity (NCV) has been routinely used for diagnosing neuropathic foot, but it applies strong electric stimulus to peripheries resulting in stress and pain. The blood flow ratio of diabetic neuropathy(0.96${\pm}$0.20) was significantly higher in comoarison to normal control group(0.46${\pm}$0.15, left : p<0.05, right : p<0.05) and non-neuropathy diabetic group(0.49${\pm}$0.21, left: p<0.05. right: p<0.05).

• The Journal of Internal Korean Medicine
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• v.31 no.2
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• pp.372-379
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• 2010

Objective : The purpose of this study was to report the effect of Bogijetong-tang on diabetic peripheral neuropathy. Methods : Nine patients who were diagnosed or suspected with diabetic peripheral neuropathy enrolled in this study. They took Bogijetong-tang 2 or 3 times a day and were given acupuncture therapy. To evaluate the therapeutic effect, Visual Analog Scale (VAS) or Total Symptom Score (TSS) were examined at intervals of about 7 days. Result : TSS score decreased an average of 2.74 points and VAS scores decreased an average of 3.67 points. As the pain decreased, accompanied gait disturbance also improved in some patients. Conclusion : Bogijetong-tang is effective in treating diabetic peripheral neuropathy, but study of the concrete mechanism and efficacy is needed.

• Journal of Digital Contents Society
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• v.19 no.4
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• pp.615-620
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• 2018

Evaluation of clinical usefulness of current perception threshold test and vibration sense perception threshold test in diagnosing the diabetic poly-neuropathy patients is one of the diagnosis methods for diabetic poly-neuropathy. Up to the present, some diagnostic methods were used for diabetic poly neuropathy patients. For example, there are neuropathy impairment score test of lower limbs, nerve conduction test, cooling detection threshold test, heat-pain threshold test and so on. However, most of the above tests require very expensive cost and take a lot of time in test. In this paper, a new apparatus estimating vibration sense ability is introduced. For this purpose, the VCM(voice coil motor) stimulating patient's peripheral nerve and current amplifier were manufactured. Also, softwares sensing and driving the vibration detection threshold test in order to measure the quantitative vibration sensory levels in diabetic poly-neuropathy patients were developed.

• The Korean Journal of Pain
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• v.35 no.2
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• pp.160-172
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• 2022

Background: The authors established an in vitro model of diabetic neuropathy based on the culture system of primary neurons and Schwann cells (SCs) to mimic similar symptoms observed in in vivo models of this complication, such as impaired neurite extension and impaired myelination. The model was then utilized to investigate the effects of insulin on enhancing neurite extension and myelination of diabetic neurons. Methods: SCs and primary neurons were cultured under conditions mimicking hyperglycemia prepared by adding glucose to the basal culture medium. In a single culture, the proliferation and maturation of SCs and the neurite extension of neurons were evaluated. In a co-culture, the percentage of myelination of diabetic neurons was investigated. Insulin at different concentrations was supplemented to culture media to examine its effects on neurite extension and myelination. Results: The cells showed similar symptoms observed in in vivo models of this complication. In a single culture, hyperglycemia attenuated the proliferation and maturation of SCs, induced apoptosis, and impaired neurite extension of both sensory and motor neurons. In a co-culture of SCs and neurons, the percentage of myelinated neurites in the hyperglycemia-treated group was significantly lower than that in the control group. This impaired neurite extension and myelination was reversed by the introduction of insulin to the hyperglycemic culture media. Conclusions: Insulin may be a potential candidate for improving diabetic neuropathy. Insulin can function as a neurotrophic factor to support both neurons and SCs. Further research is needed to discover the potential of insulin in improving diabetic neuropathy.

• Annals of Clinical Neurophysiology
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• v.24 no.1
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• pp.7-16
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• 2022

Background: There is inadequate information on the validation of diabetic microvascular complications in the Korean National Health Insurance Service data set. We aimed to validate the diagnostic algorithms regarding the nephropathy, neuropathy, and retinopathy of diabetes. Methods: From various secondary and tertiary medical centers, we selected 6,493 patients aged ≥ 40 years who were diagnosed with diabetic microvascular complications more than once based on codes in the 10th version of the International Classification of Diseases (ICD-10). During 2019 and 2020, we randomly selected the diagnoses of 200 patients, 100 from each of two hospitals. The positive predictive value (PPV), negative predictive value, error rate, sensitivity, and specificity were determined for each diabetic microvascular complication according to the ICD-10 codes, laboratory findings, diagnostic studies, and treatment procedure codes. Results: Among the 200 patients who visited the hospital more than once and had the diagnostic codes of diabetic microvascular complications, 142, 110, and 154 patients were confirmed to have the gold standard of diabetic nephropathy (PPV, 71.0%), diabetic neuropathy (PPV, 55.0%), and diabetic retinopathy (PPV, 77.0%), respectively. The PPV and specificity of diabetic nephropathy (PPV, 71.0-81.4%; specificity, 10.3-53.4%), diabetic neuropathy (PPV, 55.0-81.3%; specificity, 66.7-76.7%) and diabetic retinopathy (PPV, 77.0-96.6%; specificity, 2.2-89.1%) increased after combining them with the laboratory findings, diagnostic studies, and treatment procedures codes. These change trends were observed similarly for both hospitals. Conclusions: Defining diabetic microvascular complications using ICD-10 codes and their related examination codes may be a feasible method for studying diabetic complications.

• The Journal of Internal Korean Medicine
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• v.42 no.5
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• pp.958-966
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• 2021

Objective: This study investigated the effectiveness of bee venom acupuncture for a diabetic neuropathy patient. Methods: A diabetic neuropathy patient received twenty-one bee venom acupuncture treatments for a total of 99 days. The Neuropathy Pain Scale (NPS) was used to evaluate the weekly peak pain during the treatment period. Results: After the treatments, the NPS scores improved, and the frequencies of peak pain decreased. Conclusions: This clinical case indicates that bee venom acupuncture combined with Korean medicine may be effective for treating diabetic neuropathy patients.