scholarly journals Diabetic Distal Symmetrical Polyneuropathy: Correlation of Clinical, Laboratory, and Electrophysiologic Studies in Patients with Type 2 Diabetes Mellitus

2020 ◽  
Vol 2020 ◽  
pp. 1-11
Author(s):  
Yi-Ching Weng ◽  
Sung-Sheng Tsai ◽  
Rong-Kuo Lyu ◽  
Chun-Che Chu ◽  
Long-Sun Ro ◽  
...  

This cross-sectional study is aimed at determining the prevalence of distal symmetrical polyneuropathy (DSPN) and diabetic peripheral neuropathic pain (DPNP) in participants with type 2 diabetes mellitus (T2DM); finding the risk factors for DSPN and DPNP via biochemical tests; and correlating DSPN and DPNP with the results of electrophysiologic studies, quantitative sensory tests, and neurologic examination. The 145 participants with T2DM enrolled were divided into the DSPN (abnormal nerve conduction studies (NCS) with signs of polyneuropathy), subclinical DSPN (abnormal NCS without signs of polyneuropathy), minimal DSPN (normal NCS with signs of polyneuropathy), and no DSPN groups. The biochemical risk factors of diabetic peripheral neuropathy were investigated. Neurologic examinations, laboratory tests, NCS, vibration threshold tests, and thermal threshold tests were conducted. The modified Michigan Neuropathy Screening Instrument (mMNSI) and Douleur Neuropathique 4 were used to evaluate the severity of DSPN and DPNP, respectively. In all, 30% of participants had DSPN and 11% had DPNP. DSPN correlated strongly with male gender and higher glycohaemoglobin levels; NCS abnormality correlated with higher glycohaemoglobin levels; DSPN severity correlated with NCS of each stimulating nerve. DPNP commonly occurred with clinical and electrophysiologic evidence of DSPN. Symptomatic diabetic polyneuropathy significantly correlated with longer disease duration, higher glycohaemoglobin levels, and abnormal vibration tests. The thermal threshold test combined with nerve conduction tests could detect most of the patients with DSPN, subclinical DSPN, and minimal DSPN. Poor diabetic control was independently associated with the development of DSPN. DPNP was associated with DSPN. The combination of thermal threshold tests with NCS can potentially provide the diagnosis of DSPN.

2017 ◽  
pp. 35-44
Author(s):  
Dinh Toan Nguyen

Background: Studies show that diabetes mellitus is the greatest lifestyle risk factor for dementia. Appropriate management and treatment of type 2 diabetes mellitus could prevent the onset and progression of mild cognitive impairment to dementia. MoCA test is high sensitivity with mild dementia but it have not been used and studied widespread in Vietnam. Aim: 1. Using MoCA and MMSE to diagnose dementia in patients with type 2 diabetes mellitus. 2. Assessment of the relationship between dementia and the risk factors. Methods: cross-sectional description in 102 patients with type 2 diabetes mellitus. The Mini-Mental State Examination(MMSE) and the Montreal Cognitive Assessment (MoCA) were used to assess cognitive function. The diagnosis of dementia was made according to Diagnostic and Statistical Manual of Mental Disorders. Results: The average value for MoCA in the group of patients with dementia (15.35 ± 2.69) compared with non-dementia group (20.72 ± 4.53). The sensitivity and specificity of MoCA were 84.8% and 78.3% in identifying individuals with dementia, and MMSE were 78.5% and 82.6%, respectively. Using DSMIV criteria as gold standard we found MoCA and MMSE were more similar for dementia cases (AUC 0.871 and 0.890). The concordance between MoCA and MMSE was moderate (kappa = 0.485). When considering the risk factors, the education,the age, HbA1c, dyslipidemia, Cholesterol total related with dementia in the type 2 diabetes. Conclusion: MoCA scale is a good screening test of dementia in patients with type 2 diabetes mellitus.When compared with the MMSE scale, MoCA scale is more sensitive in detecting dementia. Key words: MoCA, dementia, type 2 diabetes mellitus, risk factors


2019 ◽  
Vol Volume 15 ◽  
pp. 167-175 ◽  
Author(s):  
Oana Albai ◽  
Mirela Frandes ◽  
Romulus Timar ◽  
Deiana Roman ◽  
Bogdan Timar

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