• 제목/요약/키워드: diabetic neuropathy

검색결과 148건 처리시간 0.027초

난치성 당뇨 족부 궤양에 대한 임상적 고찰: 치료에 영향을 미치는 인자 분석 (Clinical Analysis of Intractable Diabetic Foot Ulcers: Accessing Risk Factors)

  • 박세진;이승희;박헌용;김장환;신헌규;김유진;최재열
    • 대한족부족관절학회지
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    • 제15권4호
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    • pp.232-239
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    • 2011
  • Purpose: Diabetic foot ulcer is one of the most important diabetic complications because it increases the risk of amputations. Moreover, it lowers the quality of patients' life and increases the social medical expenses. Authors analyzed risk factors of intractable diabetic foot ulcer using retrospective study. Materials and Methods: From January 2007 to December 2010, 40 patients who could not achieve complete healing despite more than 12 weeks of proper management among who had been diagnosed and treated as diabetic foot ulcer at our hospital were included and evaluated retrospectively. We compared the risk factors between two groups who were finally treated by amputation and non-amputation. Results: The sample was composed of 31 male patients (77.5%) and 9 female patients (22.5%). Comorbidity including hypertension and hyperlipidemia were 77.5% and 80% each. By Wagner classification, 30 patients (80%) had ulcerative lesion over the grade 3. From bacteriology results, 29 patients (72.5%) had polybacteria infection. 35 patients (87.5%) had neuropathy and 26 patients (65%) had vascular stenosis at least one level. The mean initial ankle-brachial index and toe-brachial index were 0.982 and 0.439. In comparison between amputation group and non-amputation group, ulcer severity, number of stenotic vessel and initial ankle-brachial index/toe-brachial index had statistical significance. Conclusion: The most commonly risk factor of intractable diabetic foot ulcer was peripheral neuropathy reaching 87.5% of cases. In comparison with non-amputation group, ulcer severity according to Wagner classification, number of stenotic vessel and initial ankle-brachial index/toe-brachial index were demonstrated as a risk factor of amputation in intractable diabetic foot ulcer.

PPG 2차 미분을 이용한 정상인과 당뇨병 환자의 말초혈관 탄성도 비교 (Comparison of peripheral vascular compliance between normal and diabetic group using second derivative of photoplethysmogram)

  • 김성우;이주형;강은석;김수찬;김덕원
    • 대한전기학회:학술대회논문집
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    • 대한전기학회 2007년도 심포지엄 논문집 정보 및 제어부문
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    • pp.67-69
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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 and diabetic group vascular compliance using the second derivative of PPG waveform in this study. The evaluated factors of second derivative of PPG are 'a', 'b', 'c', 'd', 'e' and b/a represents vascular compliance. Study found out that when vascular compliance is decreased, b/a is increased, the absolute value of b/a is decreased. The average vascular compliance of 50 diabetic patients with neuropathy is statistically lower than the normal group(p<0.05). We suggest an objective evaluation of peripheral vascular compliance for diabetic patients and prevention of vascular complication.

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Clinical Assessment of Usefulness, Effectiveness and Safety of Kyejibokryung-hwan on Various Neuropathies

  • Park, Seong-Uk;Jung, Woo-Sang;Kim, Yun-Kyung;Moon, Sang-Kwan;Kim, Young-Suk;Bae, Hyung-Sup;Cho, Ki-Ho;Ko, Chang-Nam
    • 대한한의학회지
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    • 제27권4호
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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.

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용적맥파 측정법을 이용한 신경병증 당뇨병 족부질환의 진단 (Diagnosis of neuropathic foot of diabetics using photo-plethysmography)

  • 남기창;유창용;정원혁;김진태;박중훈;김덕원
    • 대한전기학회:학술대회논문집
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    • 대한전기학회 2005년도 심포지엄 논문집 정보 및 제어부문
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    • pp.39-41
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    • 2005
  • The population of diabetes is continuously increasing because of the economic development and the lifestyle modification. If diabetes become chronic condition, it can cause various complications. Among many other complications, diabetic foot is the most fatal issue since it may require amputation of the legs. Diabetic foot has three different types such as neuropathic, neuro-ischemic and ischemic. Among these types, patients of neuropathic foot experience sensory abnormality. Nerve conduction velocity (NCV) is used for diagnosing neuropathic foot but this method uses strong electric stimulus to cause severe pain to the patients In this study, two channel photo-plethysmography was used as noninvasive screening tool for distinguish neuropathic foot and normal group by observing blood flow of both finger and toe simultaneously.

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A novel therapeutic approach of Hachimi-jio-gan to diabetes and its complications

  • Yokozawa, Takako;Yamabe, Noriko;Cho, Eun-Ju
    • Advances in Traditional Medicine
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    • 제5권2호
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    • pp.75-91
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    • 2005
  • Great efforts have been made to improve both the quality of life and life expectancy of diabetes by treating problems associated with chronic complications such as neuropathy, retinopathy and nephropathy. In particular, diabetes is an increased risk of developing several types of kidney disease, and the predominant cause of end-stage renal disease in patients with this disorder is diabetic nephropathy. Therefore, prevention of the occurrence and progression of diabetes and its complications has become a very important issue. The scientific observations of an animal model of streptozotocin-induced diabetes, spontaneously occurring diabetes and diabetic nephropathy in this study suggest that one of the Kampo prescriptions, Hachimi-jio-gan comprising eight constituents, is a novel therapeutic agent.

당뇨병을 가진 LUDWIG'S ANGINA 환자에 대한 치험례;증례보고 (LUDWIG'S ANGINA IN PATIENT WITH DIABETIC MELLITUS;REPROT OF CASE)

  • 류수장;양영철
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제19권3호
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    • pp.311-318
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    • 1997
  • Ludwig's angina has been defined as a potentially lethal, rapidly spreading cellulitis, involving the sublingual and submandibular spaces, and is manifesed by a brawny, suprahyoid induration, tender swelling in the floor of mouth, elevation and posterior displacement of tongue. This paper is of interest not only because of severity of infection but also because of associated diabetic mellitus. Diabetes mellitus is a complex syndrome of disordered metabolism and elevated blood glucose, it results from deficiency of insulin secretion of combination of insulin resistance and inadequate insulin secretion. The effects of diabetic mellitus include neuropathy, vascular insufficiency, decreased leukocytic function, hematologic change etc. Clinically this may be refelected by the increased severity of infections seen in diabetics. The treatment of infections in diabetics are reduction of number of microbes through the use of appropriated antimicrobial agents and proper surgical drainage and improvement of the host factors by tight control of insulin replacement and immediate intervention to correct abnormalities of the local factors by drainage, debriment, and removal of avoidance of foreign bodies. The authors present the report of the Ludwig's angina in patient with diabetic mellitus, with literature review and good clinical result.

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하지 감각이상 및 통증을 호소하는 당뇨병성 다발신경병증 환자에 대한 복합 한의치험 1례 (Case Report: Lower Extremity Paresthesia and Pain with Diabetic Polyneuropathy Combated with Complex Korean Medical Treatment)

  • 정성훈;이영선;성시윤;이한결;조기호;문상관;정우상;권승원
    • 대한한방내과학회지
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    • 제44권2호
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    • pp.231-243
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    • 2023
  • Background: Diabetic polyneuropathy is the most common complication in diabetics, occurring in 50% of all cases. About 10-20% of all diabetics are accompanied by neurological pain, showing a tendency to increase with age. Clinical aspects are very diverse, from mild abnormalities on nerve conduction tests to severe abnormalities in all sensory, motor, and autonomic nerves; however, sensory symptoms usually precede motor symptoms. Patients typically express sensory symptoms, such as positive and negative symptoms, which decrease the quality of life and have marked clinical implications, such as increased morbidity and mortality. Although Western medical drugs, such as tricyclic antidepressants, anticonvulsants, and narcotic analgesics, are used for diabetic polyneuropathy, a standard treatment has not been established. Case report: A 65-year-old male with paresthesia and pain due to diabetic polyneuropathy was treated with Uchashinki-hwan, acupuncture, electroacupuncture, moxibustion, and Jungsongouhyul pharmacopuncture for 10 days. We used the Toronto Clinical Neuropathy Scoring System, EuroQol-5 Dimension, and Visual Analog Scale to evaluate symptoms. Subsequently, the Neuropathy Scoring System, EuroQol-5 Dimension, and subjective discomfort improved. Conclusion: The present case report suggests that combined Korean medicine treatment might be an effective treatment for paresthesia and pain with diabetic polyneuropathy. Several follow-up studies should be conducted to clarify the effectiveness of the treatment.

당뇨로 인한 우측(右側 ) 족저부(足底部) 및 좌수지(左手指) 궤양(潰瘍)을 동반한 환자 치험 1 예 (A Case Study of One Patient Who Has Diabetic Gangrene in Foot and Finger Due to Diabetes)

  • 이상기;이경로;송정모
    • 사상체질의학회지
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    • 제16권3호
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    • pp.129-132
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    • 2004
  • 1. Objectives Besides Diabetes Mellitus, its complications are matter of concerns as well. Its following complications are cardiovascular disease, glomerulopathy, retinopathy, neuropathy and diabetic gangrene. These complications can cause overall damage in major organs. In traditional oriental medicine it has been perceived that gangrene is mainly caused by "hwa(火)" but under sasang constitutional medicine its has been diagnosed as Taeumin superficial-disease(太陰人 表病) and Taeumin Jowiseungchung-tang(調胃升淸湯) was prescribed. As a result, significal improvments was noted and thefore we report the outcome. 2. Methods We have given Taeumin Jowiseungchung-tang(太陰人 調胃升淸湯) to a patient for treating diabetes complications. 3. Results This patient was treated with Sasang Constitional Medicine and acupuncture for about three weeks. After treatment, ulcer and whole body edema were improved considerbly. 4. Conclusions We have dianosed the patient as Taeumin superficial-disease(太陰人 表病) by undergoing several diagnostic method used in sasang constutional medicine. Therefore we have given Taeumin Jowiseungchung-tang(太陰人 調胃升淸湯) to the patient and has obtained satisfactory results in curing several diabetic complications especially ulcer due to diabetes.

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죽력(竹瀝)과 천축황(天竺黃)이 Streptozotocin으로 당뇨가 유발된 백서의 혈당강하 및 말초신경기능회복에 미치는 영향 (The Effects of Bambusae caulis in liquamen and Bambusae concretio silicae on Blood Sugar Reduction and Improvement of Peripheral Nerve Function in Diabetic Rats Induced with Streptozotocin)

  • 박수곤;배길준;이욱재;김선종;정민영
    • 한방재활의학과학회지
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    • 제24권1호
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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.

산약의 항당뇨 특성 연구(1) - 혈당 강하 효과 - (Characteristics of Antidiabetic Effect of Dioscorea rhizoma(1) - Hypoglycemic Effect -)

  • 강동호;최상진;이태호;손미원;김선여
    • 한국식품영양학회지
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    • 제21권4호
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    • pp.425-429
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    • 2008
  • Diabetes mellitus is a group of metabolic diseases characterized by hyperglycemia resulting from defects in insulin secretion, insulin action, or both. Type 1 diabetes, or juvenile-onset diabetes, results from a cellular-mediated autoimmune destruction of the ${\beta}$-cells of the pancreas. Type 2 diabetes, or adult-onset diabetes, is a term used for individuals who have insulin resistance, a condition that makes it harder for the cells to properly use insulin, and usually have relative insulin deficiency. The diabetes causes the onset of chronic complications and diabetic neuropathy is one of the most debilitating complications. In this study, the hypoglycemic effect and the preventive effect of diabetic complications of Dioscorea rhizoma extract(DRE) were examined in rodent model. We investigated the glucose tolerance test and long term hypoglycemic effect of DRE in Type 1 streptozotocin-induced diabetic rats and Type 2 diabetic db/db mice. DRE showed a hypoglycemic effect on blood glucose levels than that of control group in Type 1 streptozotocin-induced diabetic rats and Type 2 diabetic db/db mice. On the basis of our results, we conclude that long-term use of DRE might help decrease blood glucose level and prevention of diabetes-associated complication.