Electrophysiological Patterns of Diabetic Polyneuropathy: Experience from a Tertiary Care Hospital of Bangladesh

Islam, Rashedul; Rahman, Tahminur; Habib, Rumana; Irfan, SM Rezaul; Rahman, Aminur; Bhowmik, Nirmalendu Bikash; Haque, Ahteshamul

doi:10.3329/birdem.v7i2.32448

Cited by 4 publications

(3 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Most of the lower limb nerves showed axonal involvement with some showing mixed pattern while the upper limb nerves predominantly showed demyelinating changes. A similar electrophysiological pattern of involvement of the nerves was also reported in a previous study 15 . Among the patients with abnormal NCS (69.1%), the majority (28.26%) had polyneuropathy (PN), 21.74% cases had carpal tunnel syndrome (CTS), 7.61% had both PN and CTS.…”

Section: Discussionsupporting

confidence: 89%

The pattern of Electrophysiological Abnormality in Long-Standing Type-2 Diabetes Mellitus Patients: Experience at Referral Neurology Hospital in Bangladesh

Debnath

Hussain

Khan

et al. 2021

J. Natl Inst. Neurosci Bangladesh

View full text Add to dashboard Cite

Background: Nerve conduction studies (NCS) are the most objective measure of nerve function, and their use is recommended in the clinical and epidemiological evaluation of diabetic polyneuropathy. Objective: This study was conducted to describe the pattern of electrophysiological abnormality in long-standing type-2 Diabetes Mellitus patients. Methodology: This cross-sectional study was conducted in the Department of Neurophysiology at the National Institute of Neurosciences & Hospital, Dhaka, Bangladesh from July 2017 to June 2019. Among the one hundred and eight consecutive patients of type 2 diabetes with a duration of more than 10 years attending the Neurophysiology laboratory, patients were selected for the study based on the inclusion and exclusion criteria. NCS study of the right upper limb (median and ulnar nerves) and left lower limbs (tibial, peroneal, and sural nerves) were done. NCS of other nerves were also done when indicated. Result: A total number of 92 patients were recruited for this study. NCS was abnormal in 56 (60.9%) patients. 43.5% (n=40) patients were male and 56.5% (n=52) patient were female. Among the 56 (60.9%) patients with abnormal NCS, most [35 (38%)] had mixed types (both sensory and motor) of neuropathy. In 28 (30.4%) patients, both demyelination and axonal involvement were present. The median nerve (46.7%) was the commonest nerve to be involved followed by the Sural nerve. In patients with elevated HbA1C, the axonal loss was more pronounced in the lower limbs’ nerves. Polyneuropathy (28.26%) was more than mononeuropathy (21.74%). Conclusion: Most of the patients of type 2 long-standing DM developed a mixed type of polyneuropathy and elevated HbA1C was significantly associated with the axonal involvement predominantly in lower limbs’ nerves. Journal of National Institute of Neurosciences Bangladesh, January 2021, Vol. 7, No. 1, pp. 10-13

show abstract

Section: Discussionsupporting

confidence: 89%

The pattern of Electrophysiological Abnormality in Long-Standing Type-2 Diabetes Mellitus Patients: Experience at Referral Neurology Hospital in Bangladesh

Debnath

Hussain

Khan

et al. 2021

J. Natl Inst. Neurosci Bangladesh

View full text Add to dashboard Cite

show abstract

“… 134 Oxidative stress, inflammation, damage to small blood vessels supplying nerves (vasa nervorum), and neuronal injury and damage due to metabolic disturbance are the possible cause of pathogenesis of diabetic neuropathy. 129 , 135–137 In diabetic peripheral neuropathy, there is neuropathic pain burning, shooting, tingling, or lancinating in nature, occurring along with paresthesia worsening during the night. There may be an exaggerated response to stimuli of pain and pain upon contact with, for example, footwear and bedclothes.…”

Section: Other Major Complication Of Diabetes Mellitusmentioning

confidence: 99%

Oral Health Messiers: Diabetes Mellitus Relevance

Ahmad¹,

Haque²

2021

DMSO

View full text Add to dashboard Cite

This article aims to narrate the various oral complications in individuals suffering from diabetes mellitus. Google search for “diabetes mellitus and oral complications” was done. The search was also carried out for “diabetes mellitus” and its oral complications individually. Diabetes mellitus is a chronic metabolic disorder that is a global epidemic and a common cause of morbidity and mortality in the world today. Currently, there are about 422 million cases of diabetes mellitus worldwide. Diabetic patients can develop different complications in the body such as retinopathy, neuropathy, nephropathy, cardiovascular disease. Complications in the oral cavity have been observed in individuals suffering from diabetes mellitus. A study noted that more than 90% of diabetic patients suffered from oral complications. Another research has shown a greater prevalence of oral mucosal disorders in patients with diabetes mellitus than non-diabetic population: 45–88% in patients with type 2 diabetes compared to 38.3–45% in non-diabetic subjects and 44.7% in type 1 diabetic individuals compared to 25% in the non-diabetic population. Oral complications in people with diabetes are periodontal disease, dental caries, oral infections, salivary dysfunction, taste dysfunction, delayed wound healing, tongue abnormalities, halitosis, and lichen planus. The high glucose level in saliva, poor neutrophil function, neuropathy, and small vessel damage contribute to oral complications in individuals with uncontrolled diabetes. Good oral health is imperative for healthy living. Oral complications cause deterioration to the quality of life in diabetic patients. Complications like periodontal disease having a bidirectional relationship with diabetes mellitus even contribute to increased blood glucose levels in people with diabetes. This article intends to promote awareness regarding the oral health of diabetics and to stress the importance of maintaining proper oral hygiene, taking preventive measures, early detection, and appropriate management of oral complications of these patients through a multidisciplinary approach.

show abstract

“…The pathogenesis of DPN includes oxidative and inflammatory stress besides metabolic dysfunction causing neuronal injury and damage 20 , 21 . Electrophysiological nerve conduction studies (NCS) can confirm that the diagnosis of DPN and the sural nerve is the most applicable to correlating with the severity of DPN 22 . However, NCS does not generally distinguish early changes of neuronal damage and some DPN patients give negative results in the clinical assessment 23 .…”

Section: Introductionmentioning

confidence: 99%

The relationship between exacerbated diabetic peripheral neuropathy and metformin treatment in type 2 diabetes mellitus

Hashem

Esmael

Nassar

et al. 2021

Sci Rep

View full text Add to dashboard Cite

Metformin-treated diabetics (MTD) showed a decrease in cobalamin, a rise in homocysteine, and methylmalonic acid, leading to accentuated diabetic peripheral neuropathy (DPN). This study aimed to determine whether or not metformin is a risk factor for DPN. We compared MTD to non-metformin-treated diabetics (NMTD) clinically using the Toronto Clinical Scoring System (TCSS), laboratory (methylmalonic acid, cobalamin, and homocysteine), and electrophysiological studies. Median homocysteine and methylmalonic acid levels in MTD vs. NMTD were 15.3 vs. 9.6 µmol/l; P < 0.001 and 0.25 vs. 0.13 µmol/l; P = 0.02, respectively with high statistical significance in MTD. There was a significantly lower plasma level of cobalamin in MTD than NMTD. Spearman’s correlation showed a significant negative correlation between cobalamin and increased dose of metformin and a significant positive correlation between TCSS and increased dose of metformin. Logistic regression analysis showed that MTD had significantly longer metformin use duration, higher metformin dose > 2 g, higher TCSS, lower plasma cobalamin, and significant higher homocysteine. Diabetics treated with metformin for prolonged duration and higher doses were associated with lower cobalamin and more severe DPN.

show abstract

Electrophysiological Patterns of Diabetic Polyneuropathy: Experience from a Tertiary Care Hospital of Bangladesh

Cited by 4 publications

References 10 publications

The pattern of Electrophysiological Abnormality in Long-Standing Type-2 Diabetes Mellitus Patients: Experience at Referral Neurology Hospital in Bangladesh

The pattern of Electrophysiological Abnormality in Long-Standing Type-2 Diabetes Mellitus Patients: Experience at Referral Neurology Hospital in Bangladesh

Oral Health Messiers: Diabetes Mellitus Relevance

The relationship between exacerbated diabetic peripheral neuropathy and metformin treatment in type 2 diabetes mellitus

Contact Info

Product

Resources

About