• The Journal of Korean Physical Therapy
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• v.19 no.5
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• pp.51-63
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• 2007

Diabetic foot ulcers result from abnormal mechanical loading of the foot, such as repetitive pressure applied to the plantar aspect of the foot while walking. Diabetic peripheral neuropathy causes changes in foot structure, affecting foot function and subsequently leading to increased plantar foot pressure, which is a predictive risk factor for the development of diabetic foot ulceration. To early identify the insensitive foot makes it possible to prevent diabetic foot ulceration and to protect the foot at risk from abnormal biomechanical loading. Abnormal foot pressures can be reduced using several different approaches, including callus debridement, prescription of special footwear, foot orthosis. injection of liquid silicone, Achilles tendon lengthening, and so forth. Off-loading of the diabetic wound is a key factor to successful wound healing as it is associated with reduced inflammatory and accelerated repair processes. Pressure relief can be achieved using various off-loading modalities including accommodative dressing, walking splints, ankle-foot orthosis, total contact cast, and removable and irremovable cast walkers.

• Proceedings of the Korean Society of Precision Engineering Conference
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• 2005.10a
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• pp.260-263
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• 2005

In this study, we analyzed the plantar shear stress and pressure of diabetic foot patients during walking by using in-shoe local shear force and plantar pressure measurement system. Twelve normal subjects and three diabetic foot patients with diabetic neuropathy in lateral heel were participated in this study. The center of pressure in diabetic foot patients moved more medially and directed toward 1st, 2nd metatarsal heads and hallux during late stance period, making pressure at the medial heel and 2nd metatarsal head significantly higher than in the normal. Shear stress at the heel were changed significantly in early stance and the magnitude of shear stresses in each metatarsal head were also changed. Further studies would be very helpful to design foot orthoses in patients with diabetic neuropathy or other diseases.

• Journal of Nutrition and Health
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• v.34 no.8
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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.

• The Journal of Korean Medicine
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• v.19 no.2
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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.

• Physical Therapy Korea
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• v.5 no.3
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• pp.11-20
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• 1998

The purposes of this study were to determine the effect of different degrees of severity of diabetic neuropathy on balance function, and to evaluate dynamic balance and functional performance in diabetes patients. Twenty-four subjects with diabetes mellitus were divided into three groups according to results of sensory nerve conduction study. All subjects were evaluated for dynamic balance which was measured using computerized dynamic posturography, and functional performance which was measured using the Berg balance scale. One-way analysis of variance was used to determine whether there were any statistically differences of dynamic balance function and functional performance among the three groups. The Spearrnan's rank correlation was used to determine statistical significance between dynamic balance and age. The results were as follows: 1. Dynamic balance measured using computerized dynamic posturography was significantly lower in the no response group than in the normal amplitude group (p<0.05). 2. Functional performance tested by the Berg balance scale was not statistically different among the three groups (p>0.05). 3. an inverse relationship was found between dynamic balance measured using computerized dynamic posturography and age (r=-0.68, p<0.05). These results suggest that patients with severe diabetic neuropathy have loss of dynamic balance function. Therefore, patients with severe diabetic neuropathy need to have their balance evaluated and receive appropriate education.

• The Monthly Diabetes
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• s.288
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• pp.68-71
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• 2013

• Herbal Formula Science
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• v.9 no.1
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• pp.386-386
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• 2001

Diabetic neuropathy may affect every part of the nervous system with the possible exception of the brain. While it is rarely a direct cause of death, it is a major cause of morbidity. Distinct syndromes can be recognized, and several different types of neuropathy may be present in the same patient. The most common picture is that of peripheral polyneuropathy. Usually bilateral, the symptoms include numbness, paresthesias, severe hyperesthesias and pain. The pain, which may be deep-seated and severe, is often worse at night. In this case, chief complaints were numbness and paresthesia of lower extremities and the symptoms were improved through Oriental medical treatment.

• Herbal Formula Science
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• v.9 no.1
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• pp.387-395
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• 2001

Diabetic neuropathy may affect every part of the nervous system with the possible exception of the brain. While it is rarely a direct cause of death, it is a major cause of morbidity. Distinct syndromes can be recognized, and several different types of neuropathy may be present in the same patient. The most common picture is that of peripheral polyneuropathy. Usually bilateral, the symptoms include numbness, paresthesias, severe hyperesthesias and pain. The pain, which may be deep-seated and severe, is often worse at night. In this case, chief complaints were numbness and paresthesia of lower extremities and the symptoms were improved through Oriental medical treatment.

• Journal of Korean Physical Therapy Science
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• v.7 no.2
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• pp.559-565
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• 2000

This studies were to investigate the effects of low power Helium-Neon Infra-Red (He-Ne IR) laser on the healing of the peripheral neuropathy in diabetic rats. The twenty one Spraque-Dewley adult male rats were assigned to the 3 groups: the control group (7), the diabetic group (7) and the laser group (7). The diabetic group was induced with a single intravenous injection of 50mg/kg body weight streptozotocin dissolved to 0.01mol/L citrate buffer, pH 4.5. The experimental laser group was irradiated low power He-Ne IR laser for 5 minutes every day during 21 days to the diabetic group. The results were as follows: For on and two weeks with laser treatment, there were significantly increased the terminal latencies of the laser treatment group than those of diabetic group, but that was significantly decreased to be similar to the control group on the laser treatment group for three weeks. The change of the amplitude on the laser treatment groups for three weeks was significantly increased to be similar to normal group than that of the diabetic group. As the result, we thank that there were activately effected of lower power He-Ne IR laser on the heeling of the peripheral neurophathy in diabetic rats.

• The Korean Journal of Nuclear Medicine
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• v.34 no.1
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• pp.55-61
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• 2000

Purpose: We performed this study to evaluate the changes of gallbladder ejection fraction (GBEF) in diabetic patients with or without autonomic neuropathy. Materials and Methods: This study included 37 diabetic patients (25 women, 12 men, mean age 51 years) and 24 normal controls (10 women, 14 men, mean age 38 years). After intravenous injection of 185 MBq of $^{99m}Tc$-DISIDA, serial anterior abdominal images were acquired before and after fatty meal. Regions of interest were applied on gallbladder and right hepatic lobe on 60 and 90 minute images to calculate GBEF. Results: GBEF was significantly reduced in diabetes with autonomic neuropathy ($43{\pm}12.3%$) and without autonomic neuropathy ($57.5{\pm}13.2%$) compared with normal controls ($68{\pm}11.6%$, p<0.05). And also, GBEF was significantly reduced in diabetes with autonomic neuropathy compared with diabetes without autonomic neuropathy (p<0.05). Fasting blood glucose level, age, sex, hemoglobin Alc, body mass index, serum lipid level were not different in these two diabetic patient groups (p>0.05). When 50.2% of GBEF was used as the criteria for diabetic autonomic neuropathy, the sensitivity and specificity were 80%, 76.5%, respectively. The area under receiver operating characteristic curve was 0.846. Conclusion: GBEF of diabetic patients with autonomic neuropathy was significantly reduced than that of diabetic patients without autonomic neuropathy.