scholarly journals Tocotrienol-Rich Vitamin E (Tocovid) Improved Nerve Conduction Velocity in Type 2 Diabetes Mellitus Patients in a Phase II Double-Blind, Randomized Controlled Clinical Trial

Nutrients ◽  
2021 ◽  
Vol 13 (11) ◽  
pp. 3770
Author(s):  
Pei Fen Chuar ◽  
Yeek Tat Ng ◽  
Sonia Chew Wen Phang ◽  
Yan Yi Koay ◽  
J-Ian Ho ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Vitamin E ◽  
Growth Factor ◽  
Nerve Conduction ◽  
Sural Nerve ◽  
Motor Nerve ◽  
Serum Biomarkers

Diabetic peripheral neuropathy (DPN) is the most common microvascular complication of diabetes that affects approximately half of the diabetic population. Up to 53% of DPN patients experience neuropathic pain, which leads to a reduction in the quality of life and work productivity. Tocotrienols have been shown to possess antioxidant, anti-inflammatory, and neuroprotective properties in preclinical and clinical studies. This study aimed to investigate the effects of tocotrienol-rich vitamin E (Tocovid SuprabioTM) on nerve conduction parameters and serum biomarkers among patients with type 2 diabetes mellitus (T2DM). A total of 88 patients were randomized to receive 200 mg of Tocovid twice daily, or a matching placebo for 12 months. Fasting blood samples were collected for measurements of HbA1c, renal profile, lipid profile, and biomarkers. A nerve conduction study (NCS) was performed on all patients at baseline and subsequently at 2, 6, 12 months. Patients were reassessed after 6 months of washout. After 12 months of supplementation, patients in the Tocovid group exhibited highly significant improvements in conduction velocity (CV) of both median and sural sensory nerves as compared to those in the placebo group. The between-intervention-group differences (treatment effects) in CV were 1.60 m/s (95% CI: 0.70, 2.40) for the median nerve and 2.10 m/s (95% CI: 1.50, 2.90) for the sural nerve. A significant difference in peak velocity (PV) was also observed in the sural nerve (2.10 m/s; 95% CI: 1.00, 3.20) after 12 months. Significant improvements in CV were only observed up to 6 months in the tibial motor nerve, 1.30 m/s (95% CI: 0.60, 2.20). There were no significant changes in serum biomarkers, transforming growth factor beta-1 (TGFβ-1), or vascular endothelial growth factor A (VEGF-A). After 6 months of washout, there were no significant differences from baseline between groups in nerve conduction parameters of all three nerves. Tocovid at 400 mg/day significantly improve tibial motor nerve CV up to 6 months, but median and sural sensory nerve CV in up to 12 months of supplementation. All improvements diminished after 6 months of washout.

scholarly journals Electrophysiological Changes of Motor Nerves in Patients with Type 2 Diabetes Mellitus

1970 ◽  
Vol 5 (2) ◽  
pp. 14-17 ◽  
Author(s):  
S Sultana ◽  
N Begum ◽  
L Ali ◽  
MM Hossain ◽  
NB Bhowmik ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Nerve Conduction ◽  
Motor Nerve ◽  
Motor Nerve Conduction ◽  
Duration Of Diabetes ◽  
Motor Nerves ◽  
Type 2 Diabetic

Peripheral neuropathy is a common disabling complication in patients with diabetes and this complication is related to the duration of the disease process. Nerve conduction study is widely used for the assessment of diabetic polyneuropathy not only to evaluate the degree of abnormality but also to document serial changes in the clinical course of the disease. This study was designed to characterize motor nerve conduction abnormalities in subjects having relatively shorter and longer duration of type 2 diabetes mellitus and also to assess whether time related variable like duration of diabetes has any influence on motor nerve function of the subjects. Forty-four type 2 diabetic subjects were included in two groups:- Group B consisted of 23 diabetic subjects having duration of diabetes for 5-10 years (shorter duration) and Group C consisted of 21 diabetic subjects having duration of diabetes for 10-15 years (longer duration). Twenty-five age and BMI matched healthy subjects without family history of diabetes were included as Group A (non-diabetic) subjects. Motor nerve conduction velocities, action potential amplitudes and latencies of ulnar and peroneal nerves were measured by standard Nerve Conduction Velocity- Electromyography (NCV-EMG) equipment. Motor conduction parameters like ulnar compound muscle action potential (U CMAP), peroneal compound muscle action potential (P CMAP) and peroneal  nerve conduction velocity (P NCV) were found to be significantly reduced (p<0.001, <0.01, <0.01 respectively) in diabetic group with shorter duration of diabetes(Group B) in comparison to non-diabetic control group (Group A). In the diabetic group with relatively longer duration of diabetes (Group C) motor nerve conduction parameters like U CMAP and P NCV were significantly reduced (p<0.001, <0.01 respectively). The results showed that in the type 2 diabetic population, motor nerve conduction parameters were affected early and there was gradual deterioration of motor function as duration of diabetes increased. Though previous studies on diabetic neuropathy suggest that abnormalities of sensory nerve conduction are early features of diabetic nerve damage and sensory nerves are more susceptible to fall prey to metabolic assaults, the present study indicates that motor nerves are also involved and the neuropathic changes assessed by electro diagnostic methods in motor nerves may occur early in patients with type 2 diabetes mellitus. So, there may be some genetic and biochemical basis (other than hyperglycaemia) for early motor involvement in type 2 diabetic population of Bangladesh. Key words: Diabetic neuropathy, electrophysiology, nerve conduction, electromyography. DOI: 10.3329/jafmc.v5i2.4576 JAFMC Bangladesh Vol.5(2) (December) 2009, pp.14-17

scholarly journals Evaluation of sural nerve automated nerve conduction study in the diagnosis of peripheral neuropathy in patients with type 2 diabetes mellitus

2016 ◽  
Vol 2 ◽  
pp. 390-393 ◽  
Author(s):  
Georgia Chatzikosma ◽  
Kalliopi Pafili ◽  
Maria Demetriou ◽  
Dimitrios Papazoglou ◽  
Konstantinos Vadikolias ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Peripheral Neuropathy ◽  
Nerve Conduction Study ◽  
Nerve Conduction ◽  
Sural Nerve

Clinical and pathogenetic features of intestinal lesions in patients with type 2 diabetes mellitus

2021 ◽  
Author(s):  
Y. Z. Dynia
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Growth Factor ◽  
Proinflammatory Cytokines ◽  
Transforming Growth Factor ◽  
Clinical Manifestations ◽  
Intestinal Damage ◽  
Hydrogen Breath Test

Objective — to study the incidence and clinical and pathogenetic features of intestinal injury in patients with type 2 diabetes mellitus. Materials and methods. Examinations involved 138 patients with type 2 diabetes mellitus (DM 2), aged from 39 to 67 years (mean age 53 ± 5 years), including 82 women (59 %) and 56 men (41 %). In addition to general clinical methods, investigations included plasma levels of the transforming growth factor‑b1 (TGF‑b1) and vascular endothelial growth factor (VEGF), the hydrogen breath test with lactulose, endoscopic examination of the intestine with biopsy followed by staining with hematoxylin‑eosin, immunohistochemical determining of claudin‑1 and VEGF, and conduction of PAS‑reaction. Results. Diabetic enterocolopathy (DECP) was diagnosed in 72 (52.2 %) patients with DM 2. Clinical manifestations were nonspecific and similar to those of irritable bowel syndrome (IBS). It has been found that DECP correlates with the duration of the DM 2 course and was diagnosed more often in middle‑aged patients (52.1 ± 4.1 years). In patients with DECP, the increase in the proinflammatory cytokines TGF‑b1 and VEGF significantly exceeded those in IBS patients. Histologically the inflammatory cell infiltration in patients with DECP was more intense and diverse, there were signs of subatrophy of the glands with a relative decrease in the number of vacuoles in the goblet cells. The immunohistochemical study revealed that VEGF in the colon mucosa was visualized mainly in patients with DECP. Moreover, a tendency to a decrease in the claudin‑1 levels was established in these patients. Conclusions. Intestinal damage was revealed in 67.4 % of patients with type 2 diabetes mellitus, and DECP was diagnosed in more than half of patients. Diabetic enterocolopathy had nonspecific clinical symptoms, required differential diagnosis with IBS, and was not always accompanied with abdominal pain. The presence of DECP more often correlated with the bacterial overgrowth syndrome, and levels of proinflammatory cytokines in the blood plasma and intestinal mucosa of these patients was raised.  

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