Effect of Duration of Diabetes on Sural Nerve Conduction Parameters in Subjects with Type-II Diabetes Mellitus -A Cross sectional Comparative Study (original) (raw)
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Sural Nerve Electrophysiologic Profile in Normals and Type2 Diabetics of Dissimilar Duration
https://www.ijhsr.org/IJHSR\_Vol.9\_Issue.5\_May2019/IJHSR\_Abstract.030.html, 2019
Background and Purpose: Diabetes is the disease of major concern of all in the present Era. The morbidity, mortality and economical burden due to this illness is escalating at a faster pace. The incidence of foot complications like ulcers and amputations are getting increased because of late diagnosis of distal symmetrical peripheral neuropathy which is the common complication of Diabetes. In this the distal sensory nerves are affected commonly due to length dependent relation. Sural nerve which carries sensory information from lateral aspect of sole is involved most frequently. The morbidity is increased due to pain, numbness, pins and needles sensations. So early detection of this sensory neuropathy by evaluating Sural NCS will help the individuals to decrease the complications and improve quality of life. Methods: 20 participants with type2 diabetes were selected into the study, they were distributed into 2 groups, 10 individuals with less than 10yrs of diabetes duration and 10 with more than 10 yrs of diabetes duration. 10 age matched normal individuals were taken in the control group. For all the participants electro physiologic parameters of Sural Nerve were recorded bilaterally by making use of EMG OCTOPUS clarity machine. Results: Results of latency, amplitude and conduction velocity were analysed by micro soft excel and Graph pad prism software. Statistical significance was measured with p value less than 0.05 Conclusion-All 20 Diabetic individuals have shown decrease in amplitude and conduction velocity and increase in latency when compared to normal individuals. The values were more altered in diabetics of longer duration.
JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH, 2018
Introduction: Diabetes is a metabolic disorder with debilitating complications which affects several million people worldwide. Neuropathy is the most common chronic complication of Type 2 Diabetes Mellitus (T2DM). Diagnosing peripheral neuropathy at subclinical stage and knowing the effect of duration of diabetes in it is important. Study of Sensory Nerve Conduction Velocity (SNCV) can help us to diagnose this problem at an early stage. Aim: To determine the correlation of duration of diabetes with SNCV of 'Median', 'Ulnar', 'Superficial Peroneal' and 'Sural nerves'. Materials and Methods: The present cross-sectional study was conducted in Department of Physiology, in collaboration with Rajeev Gandhi Centre for Diabetes and Endocrinology on patients of T2DM attending Diabetes clinic in Jawaharlal Nehru Medical College and Hospital (JNMCH) from 2014 to 2016 after approval from the Ethical Committee of JNMC. A total of 90 subjects were taken; among them 60 subjects were diagnosed cases T2DM, which were further divided in two groups on the basis of duration of diabetes. Rest 30 subjects were nondiabetic control group. SNCV study was done for assessing peripheral neuropathy. Statistical analysis was performed using SPSS version 21.0. One way ANOVA with Post-Hoc Tukey test were used for comparison of means between three groups. The association between continuous variables was tested by linear correlation using Pearson's coefficient. Results: In shorter duration of diabetes (3.31±1.72 years T2DM), significant (p<0.05) negative correlation was seen between duration of diabetes and SNCV of Median, Superficial Peroneal and Sural nerves, while in longer duration of Diabetes (12±4.42 years T2DM), there was significant (p<0.05) negative correlation between duration of diabetes and SNCV of all four nerves; namely Median, Ulnar, Superficial Peroneal and Sural. Conclusion: Chronic hyperglycaemia in diabetes leads to the degeneration and damage of peripheral nerves.
Impact of diabetes mellitus on nerves
International Journal of Research in Medical Sciences, 2020
Background: Involvement of the peripheral and autonomic nervous systems is probably the most common complication of diabetes. The main symptoms of diabetic polyneuropathy include negative symptoms (those related to nerve fiber loss or dysfunction) such as numbness and weakness, and positive symptoms (those related to abnormal function of surviving nerve fibers) such as tingling and pain. Methods: This was a cross-sectional study held in diabetic clinic of Nishter hospital, Multan, Pakistan. The study included any diabetic patients showing symptoms of neuropathy. Results: There were total of 140 in this study. This study included 85% of male and 15% of female. Most common symptoms of diabetic neuropathy were pain (70%) and tingling (70%) followed by numbness in 65% of patients. There were 28 patients in 5 years duration of diabetes, 35 people in 6-10 years duration, 21 patients in 11-15 years duration, and 14 patients in 20+ years duration. Conclusions: Neuropathy due to diabetes is ...
Background: Diabetes Mellitus(DM) a metabolic disorder is the most common cause of peripheral neuropathy. Nerve conduction studies(NCS) are commonly employed to detect the neuropathy. The present study was undertaken to find out the utility of NCS as an early indicator of neuropathy in diabetic patients. Materials & methods: Study was carried out in 50 diagnosed DM patients attending OPD in Medicine, Civil Hospital, Ahmedabad. Diabetic subjects were selected having FBS >110 mg/dL with duration of DM > 5 years. Their HbA1c levels were measured for glycaemic control. Diabetic patients with good glycaemic control were grouped in group A & that with poor glycaemic control in group B. 25 age matched non-diabetic & healthy subjects were selected for control group C. NCS was performed at Institute of Spine, Civil Hospital Campus, Ahmedabad. Nerve conduction parameters like compound muscle action potential(CMAP), sensory nerve action potential(SNAP), nerve conduction velocity(NCV) & distal latency(DL) were studied. Results: In our study there is increase in DL of peroneal, sural; median & ulnar sensory nerves in group B subjects. NCV of sensorimotor nerves is significantly decreased in group B subjects. SNAP of all nerves is reduced in group A & B. CMAP is reduced significantly in all nerves in group B. Conclusion: As DM progress further, it increases risk of neuronal involvement which can be accelerated by poor glycaemic control. Our result indicates demyelinating type of neuropathy with some changes of axonopathy. Therefore NCS is done for early detection of neuropathy in DM patients.
Diabetes mellitus is now considered a major health problem worldwide, with serious socio-economic impacts. The metabolic dysregulation associated with diabetes causes secondary pathophysiologic changes in multiple organ systems. Both microvascular and macrovascular complications predominate the scenario of diabetes mainly due to delayed diagnosis and late presentation of the disease. Diabetic neuropathy is the most common and troublesome complication of diabetes, leading to great mortality and morbidity. Diabetic polyneuropathy worsens gradually without clinical symptoms until the condition is fairly advanced, hence the need for early diagnosis. Electrophysiological studies are the most sensitive and specific methods for detecting diabetic polyneuropathy. The present study was designed to evaluate and compare nerve conduction study parameters in sensory nerves in patients of diabetes mellitus and in normal healthy controls in and around Dibrugarh. The study included 30 healthy controls and 60 known cases of diabetes, all aged 40-60 years. Of the 60 diabetics, 30 presented with symptoms of neuropathy and 30 presented without symptoms of neuropathy. Nerve conduction studies were performed using the equipment Neuro Perfect 4-channel EMG NCV EP and latencies, amplitudes and conduction velocities were evaluated. The latency, amplitude and velocity of sensory nerves in cases differed highly significantly from those in controls. The mean latencies, mean amplitudes and mean velocities of median and ulnar nerves of cases differed highly significantly as compared to controls.
Bangabandhu Sheikh Mujib Medical University Journal, 2010
Peripheral neuropathy is a common and disabling complication of diabetic mellitus. Although the exact etiology and pathogenesis of neuropathy is still uncertain, many investigators reported that metabolic changes contribute to diabetic neuropathy 1. Symmetrical sensory polyneuropathy, the most common of the diabetic neuropathy is considered to have a metabolic cause 2. There is evidence that the duration of impaired diabetic control, in particular, contributes to disturbed nerve function 3. In diabetic neuropathic disorder, sensory, motor and autonomic functions are affected in varying degrees with sensory function predominating 4. In diabetic polyneuropathy, sensory nerve conduction is believed to be more impaired than motor nerve conduction; sensory
Acta Neuropathologica, 2001
Nerve fibre pathology is poorly described in diabetic patients with mild neuropathy and has not been adequately related to clinical evaluation, quantitative sensory examination and neurophysiology. Sural nerve myelinated and unmyelinated fibre pathology was morphometrically quantified and related to the presence of pain and conventional measures of neuropathic severity in 15 diabetic patients with mild neuropathy and 14 control subjects. Diabetic patients demonstrated a significant (P<0.01) reduction in myelinated fibre density, but no change in fibre/axonal area, or g-ratio, compared to control subjects. Unmyelinated fibre degeneration was evidenced by an increase in the percentage of unassociated Schwann cell profiles (P<0.0001) and a reduction in axon density (P<0.0008) in diabetic patients. This was associated with a significant reduction in unmyelinated axon diameter (P<0.001) with a shift of the size frequency distribution to the left (P<0.02). Neurophysiology, quantitative sensory testing and nerve fibre pathology failed to differentiate diabetic patients with painful and painless neuropathy and failed to correlate with any measure of unmyelinated fibre pathology.
Asian Journal of Pharmaceutical and Clinical Research
Objectives: Peripheral neuropathy is the one of the frequently encountered complication of type 2 diabetes mellitus (T2DM). Although, the prevalence of diabetic peripheral neuropathy is associated with the diabetes duration, in some cases, the state of neuropathy is evident at the time of diagnosis. In this backdrop, the present study was carried out to evaluate the nerve conduction abnormalities in newly diagnosed T2DM. Methods: This was a prospective study carried out on 30 newly diagnosed T2DM within a time range of 1 month. The patient symptoms such as weakness, burning and tingling senzation, hyperesthesia, and foot ulcer and gait abnormalities were recorded. Nerve conduction analysis of upper limb and lower limb of non-dominant hand side was done using neuro pack S1 machine. Results: Thirty newly diagnosed T2DM patients were enrolled in the present study. The mean age of the patients was found to be 58.12±15.28 years. Distal motor latencies were elevated in T2DM patients as co...
2016
Diabetes mellitus is characterized by “chronic hyperglycemia with disturbance of carbohydrate, fat, and protein metabolism resulting from defects in insulin secretion, insulin action or both.” India leads the world with largest number of diabetic subjects earning the dubious distinction of being termed the “Diabetes capital of the world”. The primary objective of the study would be to diagnose the changes taking place in Sural nerve in Diabetic persons in initial stages of Diabetic Neuropathy. The secondary objective will be to establish NCV study as preventive diagnostic tool for prevention and treatment of Diabetic Neuropathy. Materials and Methods:the study was observational. It consisted 90 participants. The participants were divided into three groups consisting of 30 participants each. The sample included participants who fulfilled the inclusion and exclusion criteria and were willing to participate in the study.Sampling design for the study was Convenientsampling. Results: Des...