In-shoe Plantar Pressure Distribution in Nonneuropathic Type 2 Diabetic Patients in Singapore

2011 ◽  
Vol 101 (6) ◽  
pp. 509-516 ◽  
Author(s):  
Jasper W. K. Tong ◽  
U. Rajendra Acharya ◽  
Kuang C. Chua ◽  
Peck H. Tan

Background: We sought to establish the in-shoe plantar pressure distribution during normal level walking in type 2 diabetic patients of Chinese, Indian, and Malay descent without clinical evidence of peripheral neuropathy. Methods: Thirty-five patients with type 2 diabetes mellitus without loss of tactile sensation and foot deformities and 38 nondiabetic individuals in a control group had in-shoe plantar pressures collected. Maximum peak pressure and peak pressure-time integral of each foot were analyzed as separate variables and were masked into 13 areas. Differences in pressure variables were assessed by analysis of covariance, adjusting for relevant covariates at the 95% confidence interval. Results: No significant differences were noted in maximum peak pressures after adjusting for sex, race, age, height, and body mass. However, patients with diabetes mellitus had significantly higher mean ± SD pressure-time integrals at the right whole foot (309.50 ± 144.17 kPa versus 224.06 ± 141.70 kPa, P < .05) and first metatarsal (198.65 ± 138.27 kPa versus 121.54 ± 135.91 kPa, P < .05) masked areas than did those in the control group after adjustment. Conclusions: Patients without clinical observable signs of foot deformity (implying absence of motor neuropathy) and sensory neuropathy had similar in-shoe maximum peak pressures as controls. This finding supported the notion that either component of neuropathy needs to be present before plantar pressures are elevated. Patients with diabetes mellitus demonstrated greater pressure-time integrals, implying that this variable might be the first clinical sign observable even before peripheral neuropathy could be tested. (J Am Podiatr Med Assoc 101(6): 509–516, 2011)

2008 ◽  
Vol 27 (3) ◽  
pp. 376-382 ◽  
Author(s):  
Tatjana Cvetković ◽  
Predrag Vlahović ◽  
Vidosava đorđević ◽  
Lilika Zvezdanović ◽  
Dušica Pavlović ◽  
...  

The Significance of Urinary Markers in the Evaluation of Diabetic Nephropathy Oxidative stress is considered to be a unifying link between diabetes mellitus (DM) and its complications, including nephropathy (DN). The aim of this study was to determine the parameters of oxidative injury of lipids and proteins as well as the activity of ectoenzymes in the urine of DN patients. The study included 40 individuals: 10 patients with type 2 diabetes mellitus and microalbuminuria (DMT2-MIA), 10 type 2 diabetic patients with macroalbuminuria (DMT2-MAA), 10 patients with type 1 diabetes and microalbuminuria (DMT1-MIA) and 10 age- and sex-matched healthy subjects (control). In the urine we determined TBA reactive substances (TBARS), reactive carbonyl groups (RCG), and the activity of ectoenzymes N-acetyl-β-d-glucosaminidase (NAG), plasma cell differentiation antigen (PC-1), aminopeptidase N (APN) and dipeptidyl peptidase IV (DPP IV). A higher concentration of TBARS in the urine was found in DMT2-MIA and DMT1-MIA, compared to the control group (p<0.001 and P<0.05). The urine concentration of RCD shows similar results with a significant elevation in the groups with DMT2-MAA and DMT1-MIA, compared to the DMT2-MIA (p<0.001) and control group (p<0.001). Activities of NAG, APN and DPPIV were significantly higher in the urine of DMT2-MAA, compared to the control (p<0.01). The activity of PC-1 was slightly increased in that group, but not significantly. In conclusion, the level of oxidative stress markers and activities of brush border ectoenzymes in the urine may be a useful non-invasive and easily repeatable test in DN.


2010 ◽  
Vol 13 (2) ◽  
pp. 84-89
Author(s):  
Ivan Petrovich Gorshkov ◽  
Vladimir Ivanovich Zoloedov ◽  
Anna Petrovna Volynkina

Aim. To study Actovegin efficacy in oxidative stress (OS) correction at diabetic polyneuropathy (DPN) in patients with diabetes mellitus type 2 (DM2)and arterial hypertension (AH).Materials and Methods. 51 patients (24 women and 27 men) aged 53.4?0.7 with the average duration of DM2 5.6?0.2 years, DPN - 4.9?0.2years and AH - 6.0?0.2 years were examined. Daily albuminuria, glomerular filtration rate (GRF) were evaluated, standard methods for diagnosisof DPN were used. 26 patients took Actovegin therapy during 6-8 weeks, the rest 25 patients were in the control group. Parameters of the OS werestudied. Results. The increase of total oxidative capacity, the decrease of total antioxidant capacity and the rise of levels of antibodies to oxidated LDL wererevealed in patients with DM2, DPN and AH. Antioxidant and anti-hypoxic effects of 400 mg/day of Actovegin were established in this group of patients.Conclusions. Actovegin impacts oxidative stress parameters and improves the clinical manifestation of diabetic polyneuropathy.


2021 ◽  
pp. 8-9
Author(s):  
Murugesan Thinakaran ◽  
Thangadurai Chitra

Background and objects: Patients with diabetes mellitus are at high risk of cardiovascular events because of abnormal lipid status. Dyslipidemia is common in diabetes mellitus and is associated with cardiovascular complications. Early diagnosis and treatment is the main cornerstone in the prevention of its multiple complications. The aim of the study was to determine the prevalence of abnormal lipid prole levels. Materials and Method: The study population was made up of Eighty-ve (85) already diagnosed type 2 diabetic patients and Ninety-two (92) with an age range of 28 to 70 years, who come from routine health, follow up at various tertiary hospitals in Erode. The samples were analyzed using the chemical analyzer COBAS INTEGRA 400. Results and Conclusion: Dyslipidemia was found in 63.52% in type2 diabetes patients and 43.47% in non-diabetic patients. High TG, high LDL-C, high TC and low HDL-C exhibited an increasing trend in the proportion of patients with dyslipidemia. The following risk factors namely female sex, age above 50- years, BMI (overweight and obese), poor glycemic control, central obesity and physical inactivity were associated with diabetic dyslipidemia. This study presents some interesting and novel ndings which may be very important in the care and management of patients with type-2 diabetes.


2021 ◽  
pp. 29-30
Author(s):  
Murugesan Thinakaran ◽  
Thangadurai Chitra

Background And Objectives: Previous studies have shown that hematological alterations are a common nding in patients with diabetes. To aim of our study was to explore the hematological indices in type 2 diabetic patients compared with non-diabetic individual. Establish the role of haematological parameters as an early prevention strategy. Materialand Method: Two hundred and forty-six subjects were recruited for this study, one hundred and fourteen with type 2 diabetes and One hundred and thirty-two non-diabetes, were evaluated for haematological parameters using hematologic analyzer. All the information's about the disease was collected with the knowledge of the patients form the concern hospital and laboratory. Results And Conclusions: Results were compared with the same measurements in 132 subjects without diabetes mellitus. The haematological prole associated with Type2 diabetic patients signicantly reduced Hb, RBCs, PCV and MCV than Non diabetes. Increased MCHC and WBCs were noted in Type2 diabetes. Our ndings suggest the need of screening for routine hematological tests in type 2 diabetes mellitus


2014 ◽  
Vol 21 (2) ◽  
pp. 89-95
Author(s):  
Olivia Georgescu ◽  
Cătălin Nica ◽  
Silvia Crăciun ◽  
Cristina Toader ◽  
Sorin Ioacără ◽  
...  

Abstract Background and aims: Cardio-Ankle Vascular Index (CAVI) was developed as an index of arterial stiffness independently of blood pressure and other markers of early atherosclerosis. The aim of the study was to assess the correlations between CAVI and renal disease in type 2 diabetic patients compared with those without diabetes. Material and methods: We evaluated anthropometric, biochemical and vascular parameters (through CAVI) in 133 patients with and 80 without type 2 diabetes mellitus (T2DM) mean aged 59.34 ± 11.94 years. Results: We found that 52.04 % of subjects with T2DM and 22.22 % of patients without T2DM had pathological arterial stiffness. Mean CAVI value was significantly higher in T2DM (p = 0.04), positively correlated with age and negatively with glomerular filtration rate. The prevalence of chronic kidney disease in patients with pathological vascular stiffness was 5.28 times higher in T2DM compared with the control group. Conclusion: The prevalence of pathological vascular stiffness, mean CAVI and prevalence of chronic kidney disease (CKD) were also higher in patients with T2DM than in the control group. Arterial stiffness plays an important role in renal impairment both in normoglycemic subjects and patients with T2DM, so preventive measures to optimize lifestyle and treatment must target the decrease of CAVI


2018 ◽  
Vol 46 (1) ◽  
pp. 51-57 ◽  
Author(s):  
V. Thiruvenkatarajan ◽  
J. Jeyadoss ◽  
V. Rao Kadam ◽  
L. Y. Du ◽  
W.-M. Liu ◽  
...  

The ‘torsadogenic’ property of a drug is linked to its ability to increase the transmural dispersion of repolarisation, represented by the interval between the peak of, and the end of, the T-wave (Tp-e interval) in an electrocardiogram. Reports have consistently shown that sevoflurane does not increase the Tp-e interval. Type 2 diabetes is a risk factor for increased QTc (rate-corrected QT interval), QTcd (rate-corrected QTc dispersion: difference between the maximum and the minimum QTc interval), and Tp-e, as well as the rate-corrected Tp-e (Tp-e/QTc ratio). The study aimed to ascertain whether sevoflurane increased the Tp-e interval and Tp-e/QTc ratio in patients with diabetes, thereby increasing their risk of torsades. We enrolled 35 female patients; 17 with type 2 diabetes and 18 controls undergoing non-laparoscopic surgery under sevoflurane anaesthesia. The Tp-e interval, Tp-e/QTc ratio, QTc and QTcd were recorded after intubation, 5, 10, 30 and 60 minutes into the anaesthetic, and were compared between the groups. No significant increase in the Tp-e interval or Tp-e/QTc was observed between or within the groups (a 13 ms increase was considered significant). In the control group, the QTc was significantly increased from baseline immediately after intubation (449 versus 414 ms, P <0.001); at 5 minutes (434 versus 414 ms, P=0.01); at 10 minutes (444 versus 414 ms, P=0.002); at 30 minutes (439 versus 414 ms, P=0.001) and at 60 minutes (442 versus 414 ms; P <0.001) (a 20 ms increase was considered significant). No significant increase in QTc was observed in the diabetic group. There were no between or within group differences observed for QTcd. Our findings suggest that sevoflurane does not have a significant predictable pro-arrhythmic effect in type 2 diabetic patients in the absence of other factors affecting ventricular repolarisation.


2014 ◽  
Vol 21 (4) ◽  
pp. 285-290
Author(s):  
Marius Cristian Neamţu ◽  
Ştefania Crăiţoiu ◽  
Rucsandra Dănciulescu Miulescu ◽  
Denisa Margină

AbstractBackground and Aims. Previous studies have shown that hypochromia is a common finding in patients with chronic diseases. The aim of our study was to estimate the anthropometric and metabolic characteristics of patients with type 2 diabetes mellitus (T2DM) and hypochromia. Material and Methods. 30 patients with T2DM were recruited for this study. Patient demographics, relevant concomitant illnesses and medical history were recorded. Anthropometric, biochemical parameters (fasting plasma glucose - FPG, glycated hemoglobin -HbA1c, glomerular filtration rate - GFR) and morphology of blood smear were assessed. Patients diagnosed with diabetes and hypochromia constituted the study group and patients with type T2DM but without hypochromia constituted the control group. Results. The study showed no statistically significant differences on anthropometric and metabolic characteristics of patients with diabetes and hypochromia, compared with controls. Conclusions. We observed a high prevalence of hypochromia in diabetic patients (46.66%). Our findings suggest the need of screening for routine hematological tests in patients with T2DM.


2009 ◽  
Vol 8 (3) ◽  
pp. 74-78
Author(s):  
A. M. Efendiyev ◽  
G. I. Azizova ◽  
G. R. Huseynova

We evaluated some biochemical and immune parameters, such as IgA, IgM, IgG, CIC, phagocytic index, T-lymphocytes, as well as avidity of antibodies in type 2 diabetic patients.Avidity, high- and low-avid antibody ratio was determined by test-systems for express-diagnostics of clinical and preclinical forms of immunologic deficiency. All patients (n = 47), depending on the level of glycemia and disease duration were divided into 3 groups: in the stage of compensation, subcompensation and decompensation. Control group included 17 healthy subjects.Value of high-avid antibodies in diabetes mellitus patients decreased in 75, 57 and 26% respectively, whereas in healthy subjects it is 89%. Conversely, increased amount of low-avid antibodies was observed, respectively 25, 43, and 74% (11% in control).These parameters prove antibody-folding disorders in diabetes mellitus and show that, change of metabolic parameters affects antibody avidity: G class high-avid antibody level decreases and shows weak protective function. This indicates functional disorders in B-system immunity.


2018 ◽  
Vol 15 (2) ◽  
pp. 189-191
Author(s):  
Baghdad Science Journal

This study is an attempt to find whether arginine metabolism dysregulation by arginase activity is related to hyperglycemia, followed by changes in nitric oxide (NO) generation in type 2 diabetic patients. This study includes 42 control subjects (Group I), and 92 Iraqi patients with type 2 diabetes mellitus (T2DM). The patient group was subdivided into two groups: Group II (54) with T2DM only and Group III (38) with T2DM and dyslipidemia (who were treating with atorvastatin along with diabetes treatment). The samples were obtained to measure arginase activity and NO levels. Serum arginase activity increased significantly in patients(groupII and groupIII) compared to control group. While serum NO level was significantly lower in diabetic patients as compared to control group, three significant correlations appeared in this study between glucose and arginase activity, glucose and NO levels, and between arginase activity and NO levels. The results also show that treatment with atorvastatin affects arginase activity and NO levels. Increasing in levels of arginase activity can be considered as an indicator of diabetic status. Endothelial dysfunctions accompanied with diabetes mellitus reverses correlation between arginase and NO in diabetic


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