Dataset Information

Diabetic neuropathy: a cross-sectional study of the relationships among tests of neurophysiology.

ABSTRACT:

Objective

To determine the relationships among large, small, and autonomic fiber neurophysiological measures in a cross-sectional study of patients with diabetes.

Research design and methods

We assessed 130 individuals: 25 healthy subjects and 105 subjects with diabetes. Subjects were classified by the presence or absence of neuropathy by physical examination. All subjects underwent autonomic testing, nerve conduction studies, quantitative sensory testing, and nerve-axon reflex vasodilation in addition to quantifiable neurological examination and symptom scores. Correlation and cluster analysis were used to determine relationships between and among different neurophysiological testing parameters.

Results

Results of neurophysiological tests were abnormal in patients with clinical evidence of diabetic neuropathy compared with results in healthy control subjects and in those without neuropathy (P < 0.01, all tests). The correlations among individual tests varied widely, both within (r range <0.5->0.9, NS to <0.001) and between test groups (r range <0.2->0.5, NS to <0.01). A two-step hierarchical cluster analysis revealed that neurophysiological tests do not aggregate by typical "small," "large," or "autonomic" nerve fiber subtypes.

Conclusions

The modest correlation coefficients seen between the different testing modalities suggest that these techniques measure different neurophysiological parameters and are therefore not interchangeable. However, the data suggest that only a small number of neurophysiological tests are actually required to clinically differentiate individuals with neuropathy from those without. The natural clustering of both patients and healthy control subjects suggests that variations in the population will need to be considered in future studies of diabetic neuropathy.

SUBMITTER: Gibbons CH

PROVIDER: S-EPMC2992203 | biostudies-literature | 2010 Dec

REPOSITORIES: biostudies-literature

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Publications

Diabetic neuropathy: a cross-sectional study of the relationships among tests of neurophysiology.

Gibbons Christopher H CH Freeman Roy R Veves Aristidis A

Diabetes care 20100830 12

<h4>Objective</h4>To determine the relationships among large, small, and autonomic fiber neurophysiological measures in a cross-sectional study of patients with diabetes.<h4>Research design and methods</h4>We assessed 130 individuals: 25 healthy subjects and 105 subjects with diabetes. Subjects were classified by the presence or absence of neuropathy by physical examination. All subjects underwent autonomic testing, nerve conduction studies, quantitative sensory testing, and nerve-axon reflex va ...[more]

PMID: 20805259

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Project description:IntroductionChewing well is essential for successful diet therapy and control of blood glucose level in patients with diabetes. In addition, long-term hyperglycemia is a risk factor for microvascular complications, which are the main cause of morbidity and mortality in these patients. Hence, it is plausible that masticatory disorder may be relevant to diabetic microvascular complications which is caused by long-term hyperglycemia. The aim of this study was to investigate whether masticatory disorders are relevant to diabetic microvascular complications.MethodsThis cross-sectional study included 172 patients with type 2 diabetes who underwent educational hospitalization in the Department of Endocrinology and Diabetic Medicine, Hiroshima University Hospital, from April 2016 to March 2020. Masticatory efficiency was determined quantitatively by using the GLUCO SENSOR GS-Ⅱ. Multivariable linear regression models were constructed to examine which factors were related to masticatory efficiency. Statistical significance was defined as a two-sided p value of < 0.05.ResultsAccording to the bivariable analysis, masticatory efficiency was significantly correlated with duration of diabetes (p = 0. 049), number of remaining teeth (p < 0.0001), the number of moving teeth (p = 0.007) and condition of diabetic neuropathy (p < 0.0001). Moreover, the number of remaining teeth (p < 0.0001) and diabetic neuropathy (p = 0.007) remained significantly correlated with masticatory efficiency in the multivariable analysis.ConclusionsFor the first time, we demonstrated that patients with type 2 diabetes who developed diabetic neuropathy had significantly reduced masticatory efficiency. Effective mastication is an important factor in successful diet therapy for diabetes. To prevent the progression of diabetic complications, especially in patients with diabetic neuropathy, it may be necessary to combine individualized therapies from dentists and nutritionists with consideration for the level of masticatory dysfunction.

Project description:BackgroundPainful Diabetic Neuropathy (PDN) is a complication that affects up to one third of people living with diabetes. There is limited data on the prevalence of PDN from countries in the Middle East and North Africa. The aim of this study was to estimate the point prevalence of PDN in adults in Eastern Libya using the self-report Leeds Assessment of Neuropathic Symptoms and Signs (S-LANSS) pain scale.MethodsWe invited patients attending the Benghazi Diabetes Centre who had diabetes for ??5?years to take part in the study. Patients provided consent and completed the Arabic S-LANSS. Anthropometrics, marital status, socioeconomic and education information was recoded and fasting plasma glucose concentration determined.ResultsFour hundred and fifty participants completed the study (age?=?19 to 87?years, BMI?=?17.6 to 44.2?kg/m2, 224 women). One hundred and ninety five participants (43.3%) reported pain in their lower limbs in the previous 6?months and 190/195 participants (97.4%) reported a S-LANSS score of ??12 suggesting they had neuropathic pain characteristics. Thus, 42.2% (190/450) of participants with diabetes were categorised as experiencing pain with neuropathic characteristics. Mean ± SD duration of diabetes for participants with PDN (20.4?±?6.5?years) was significantly higher compared with those without PDN (11.1?±?4.6?years). Participants with PDN smoked tobacco for more years than those without pain (7.9?±?12.3?years versus 1.1?±?3.9?years respectively); had significantly higher fasting plasma glucose concentration (143.6?±?29.3?mg/dl versus 120.0?±?17.3?mg/dl) and had a significantly higher levels of education and employment status. The most significant predictors of PDN were duration of diabetes (OR?=?25.85, 95% CI?=?13.56-49.31), followed by smoking for men (OR?=?8.28, 95% CI?=?3.53-9.42), obesity (OR?=?3.96, 95% CI?=?2.25-6.96) and high fasting plasma glucose concentration (OR?=?3.51, 95% CI?=?1.99-6.21).ConclusionThe prevalence of PDN in people with diabetes in Eastern Libya was 42.2%. Risk factors for developing PDN were high fasting plasma glucose concentration, long duration of diabetes, and higher level of educational and employment status.

Dataset Information

Diabetic neuropathy: a cross-sectional study of the relationships among tests of neurophysiology.

Objective

Research design and methods

Results

Conclusions

Publications

Diabetic neuropathy: a cross-sectional study of the relationships among tests of neurophysiology.

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