Diabetic Neuropathy

Hirson, Cedric; Feinmann, E. L.; Wade, Henry

doi:10.1136/bmj.1.4825.1408

Cited by 19 publications

(7 citation statements)

References 11 publications

(13 reference statements)

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“…These observations are close to those of Jordan. 18 Hirson et al 19 found NP in 57% of diabetics; however, the sample size of their study was much smaller. Type I and Type II diabetic patients with NP were older with a longer duration of diabetes as compared to those without NP in our study.…”

Section: Discussionmentioning

confidence: 94%

Profile of Neurological Problems in Diabetes Mellitus: Retrospective Analysis of Data from 1294 Patients

et al. 1997

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Data from 1294 patients with diabetes mellitus admitted to the Endocrinology Department of the Institute of Medical Sciences, Srinagar, Kashmir, from 1986 to 1994, were analyzed for frequency of various neurological problems. Of 1294 patients, 46.29% had clinical evidence of one or more neurological problems. The frequency of neurological problems was significantly more in patients with type II diabetes mellitus (P<0.001). Predominant neurological problems included peripheral neuropathy (96.66%), stroke (5.51%), Parkinsonism (1.50%), seizure disorder (1.17%) and dementia (1% Diabetes mellitus (DM) constitutes a growing concern to the population of the world, predominantly because of the devastating effects of its chronic complications. So common and so definite are the chances of developing certain complications during the course of this "lifelong" disease that some of them have been regarded as "consequences" rather than complications.1 Major long-term complications of diabetes are neuropathy, retinopathy, nephropathy and angiopathy. Peripheral neuropathy (PNP) is the most common chronic complication of diabetes mellitus and can involve almost any peripheral nerve. It is a major cause of morbidity among these patients. 1,2Estimates of prevalence of diabetic PNP vary widely, between 10% to 100%. [2][3][4][5][6] Compared to complications in the peripheral nervous system, long-term diabetic complications in the central nervous system are relatively subtle and occur more frequently than is believed. Diabetes literature is replete with information on the vascular complications of neuropathy, nephropathy, retinopathy, coronary artery disease and peripheral vascular disease, but little information is available on the cerebrovascular disease in diabetic patients. This is surprising because diabetic patients have a two-to sixfold increased risk of thromboembolic strokes than the nondiabetic population, and strokerelated mortality and morbidity are increasing in the diabetic population. [6][7][8][9][10] In this study, we retrospectively analyzed the data from 1294 patients with DM, for various neurological problems (NP), with particular reference to PNP and strokes. This study was conducted with the particular purpose of finding the pattern of NP in the diabetic population in a developing part of the world, where health care systems are nowhere near optimal. Subjects and MethodsThe medical records of 1294 patients with DM admitted to the endocrine division of the Institute of Medical Science (IMS), Srinagar, Kashmir (India), were screened for NP. Out of these, 167 patients had type I DM, 1087 patients had type II DM, and 40 were documented to have fibrocalculous pancreatic diabetes (FCPD). Patients with gestational diabetes, secondary causes of hyperglycemia (i.e., Cushing's syndrome, acromegaly, drugs, etc.) and those whose records were inadequate or diagnosis was not satisfactorily made, were excluded from the study. The definitions and terms used during the analysis of the patient records are as follows: 1) Admission:...

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Section: Discussionmentioning

confidence: 94%

Profile of Neurological Problems in Diabetes Mellitus: Retrospective Analysis of Data from 1294 Patients

et al. 1997

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“…In a later publication (1955) Garland re-named the syndrome 'diabetic amyotrophy'. Hirson, Feinmann, and Wade (1953) also observed weakness and wasting of the quadriceps femoris muscle in 12 diabetics with neuropathy and commented on this being a most striking feature. Goodman (1954) presented 17 cases with femoral neuropathy, 16 of whom had diabetes mellitus, and suggested that the incidence of involvement of the femoral nerve in diabetes was higher than is generally realized.…”

Section: Bruns (1890) First Drew Attention In Diabetics Tomentioning

confidence: 96%

Femoral nerve conduction in diabetes and chronic occlusive vascular disease.

Js¹,

Hurwitz²

1968

Journal of Neurology, Neurosurgery & Psychiatry

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“…A true symmetrical polyneuritis is rare in diabetes mellitus (Hirson, Feinmann, and Wade, 1953). In the following case a symmetrical polyneuritis developed rapidly in a patient with recently stabilized diabetes.…”

Section: Diabetes Mellitus With Acute Polyneuritismentioning

confidence: 76%

Posterior Dislocation of Shoulder-joint

Bilbey¹

1957

BMJ

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DELAYED-ACTION STAB BRITISH 1345MDA D CICALS JOURNAL mid-axillary line. After overcoming his initial surprise he went along and had two stitches inserted in the wound. Nothing further eventuated.Seven months later, whilst on holiday in Sydney, he developed pains in the left upper abdomen and left chest. They were not particularly severe and allowed of a barium examination, which revealed large bowel in the left thoracic cavity.A left thoracotomy was carried out on October 26, 1955. Transverse colon was found in the chest. It was densely adherent to the lung and margins of the opening in the diaphragm. This opening was not greater than i in. (1.9 cm.) in diameter. The abdominal contents were replaced and the diaphragm was repaired. The patient made a good recovery. CommentThese three cases have certain features in common.(1) The injury was relatively mild. (2) It was situated in the left lower thoracic region. (3) The suspicion of injury to the diaphragm did not arise at the time of the initial incident. (4) The x-ray picture of the chest following the initial injury in Cases 1 and 2 was quite normal. No evidence of pneumothorax or lung damage was to be seen. The history in Case 3 suggests that had an x-ray film of the chest been taken this would likewise have been normal. (5) The latent period. In the three cases, one year, two months, and seven months respectively elapsed between the original injury and the onset of intestinal obstruction. It is assumed that negative intrathoracic pressure and positive intra-abdominal pressure were the factors responsible for the gradual ascent of the bowel. (6) All cases did well following surgery. However, it is easy to imagine such cases having a fatal termination. The opening is small, the amount of bowel that can ascend is large, and irreversible damage to the bowel is quite likely. (7) The medico-legal aspects, combining as they do a minor injury, a latent period, and then a strangulated diaphragmatic hernia, are of obvious importance. It is felt that in each of these cases the opening in the diaphragm was due to trauma. In no case was it felt that the opening was of congenital nature.

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Diabetic Neuropathy

Cited by 19 publications

References 11 publications

Profile of Neurological Problems in Diabetes Mellitus: Retrospective Analysis of Data from 1294 Patients

Profile of Neurological Problems in Diabetes Mellitus: Retrospective Analysis of Data from 1294 Patients

Femoral nerve conduction in diabetes and chronic occlusive vascular disease.

Posterior Dislocation of Shoulder-joint

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