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Query: UMLS:C0011849 (diabetes)
 277,896 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Recent studies on axonal transport in experimental neuropathy are reviewed and the following combinations of pathological changes and underlying axonal transport abnormalities are proposed for a classification of polyneuropathies. Alterations of the anterograde transport of slow component a(SCa) leads to changes of the dimensions of the axon calibre without the occurrence either of overt neuropathy or fibre loss. Thus damming of SCa in beta,beta'-iminodiproprionitrile (IDPN) intoxication results in axonal swelling in nerve roots whereas decrease of SCa leads to atrophy distal to the swellings in IDPN intoxication and in streptozotocin induced diabetes as well. Decrease in the amount of material conveyed within the anterograde fast component (aFC) leads to acute axonal degeneration including break down of axons and fibre loss. This state occurs in acute hypoglycaemia and in doxorubicin intoxication. The most frequent type of polyneuropathy, namely distal axonopathy with accumulation of axon organelles leading to distal fibre loss, is associated with decrease in amount of the retrograde fast component (rFC). The transport is impaired before the appearance of symptoms and electrophysiological signs of neuropathy develop in the intoxications induced by parabromophenylacetylurea, acrylamide and 2.5 hexanedione, and the severity of neuropathy is proportional to the rFC impairment.
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PMID:A proposal for a classification of neuropathies according to their axonal transport abnormalities. 242 41

The flare response in skin largely depends on an intact primary sensory fiber, the C-fiber. We measured the flare response to the intradermal injection of substance P, histamine, and capsaicin in control subjects and in diabetic patients with and without clinically obvious polyneuropathy. The neuropathic diabetic patients had a reduced flare response to substance P, histamine, and capsaicin, compared with control and nonneuropathic diabetic subjects. The smaller flare response in the neuropathic diabetics after capsaicin administration suggested a dysfunction of the peripheral component of the C-fiber. Alternatively, dysfunction of the mast cell or vascular reactivity may contribute to the diminished flare. Because C-fibers participate in nociception in addition to the flare response, the findings of this study, by a method that permits a quantifiable measurement of the function of peripheral sensory neurons in diabetic subjects, has potential usefulness in evaluating sensory neuropathy in diabetic patients.
Diabetes 1987 Oct
PMID:Diminished flare response in neuropathic diabetic patients. Comparison of effects of substance P, histamine, and capsaicin. 244 7

Standardised skin biopsies followed by immunohistochemical examination for the presence of terminal nerve fibres reacting for neuropeptides substance P (SP) and calcitonin gene-related peptide (CGRP) were evaluated. Healthy subjects regularly displayed free nerve endings of both fibre types in the papillary and reticular dermis. Both fibre types were present close to blood vessels, while CGRP immunoreactive fibres were more often encountered near sweat gland acini compared to SP fibres. Diabetes mellitus complicated by polyneuropathy was accompanied by marked reduction of SP and CGRP reactive fibres in the dermis layers. Five type I diabetes patients without clinical or neurophysiological evidence of polyneuropathy also had reduced density of both fibre types, being significant for CGRP fibres when compared with controls. Skin biopsy with immunohistochemical staining for neuropeptides may represent a sensitive tool in evaluation of patients with peripheral neuropathies.
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PMID:Nerve fibre studies in skin biopsies in peripheral neuropathies. I. Immunohistochemical analysis of neuropeptides in diabetes mellitus. 248 Apr

We and others have previously described neuroaxonal dystrophic changes as one of the hallmarks of structural diabetic autonomic polyneuropathy involving sympathetic nerves. In the present study, a systemic search for similar changes was undertaken in the mainly sensory symmetric polyneuropathy of the spontaneously diabetic BB-rat. Changes identical to those described in sympathetic nerves in this model were found in sensory ganglion cells, in their proximal extramedullary axons, and in proximal and distal myelinated axons of the spinal dorsal columns. The dystrophic substructures consisted of tubulovesicles, tubular rings, layered membranes, electron-dense membranous bodies, and neurofilamentous changes. Neuroaxonal dystrophic abnormalities increased with increasing duration of diabetes, and exhibited a topographic distribution along the sensory neuroaxonal axis, suggesting metabolic abnormalities as well as abnormalities in the turn-around mechanism of fast axonal transport in the pathogenesis of dystrophic changes in diabetic nerves.
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PMID:Neuroaxonal dystrophy in distal symmetric sensory polyneuropathy of the diabetic BB-rat. 253 12

We evaluated the prevalence of peripheral neuropathy by clinical and electrophysiological criteria and the prevalence of autonomic parasympathetic nerve dysfunction by heart-rate variation during deep breathing (expiration-to-inspiration ratio [E:1]) in 132 newly diagnosed non-insulin-dependent diabetic (NIDDM) subjects aged 45-64 yr and 142 randomly selected nondiabetic control subjects. The relationship of nerve dysfunction to the degree of hyperglycemia and insulin-secretion capacity were also investigated. Single and scattered symptoms and signs of peripheral neuropathy were found in both diabetic and control subjects. Symptomatic polyneuropathy was found in 1.5% of diabetic subjects but none of the control subjects. Polyneuropathy defined by clinical signs was found in 2.3% of the diabetic subjects and 1.4% of the control subjects. No subjects with both symptoms and signs were seen. Nerve conduction velocities (NCVs) were significantly slower in diabetic than control subjects. Polyneuropathy according to electrophysiological criteria was found in 15.2% of diabetic subjects but was not found in any control subjects. Electromyographic abnormalities were more common in diabetic than control women, but not significant differences were found in men. The resting heart rate was higher in diabetic than control women, but no significant difference was found in men. The mean E:I was significantly lower in diabetic men and women than control men and women. An abnormally low E:I was found in 9.2% of the diabetic men, 3.3% of the control men, 3.3% of the diabetic women, and none of the control women. NCV parameters, but not E:I, were inversely correlated with fasting blood glucose and glycosylated hemoglobin levels. A positive correlation between NCV and fasting and postglucose serum insulin levels was found in both groups.(ABSTRACT TRUNCATED AT 250 WORDS)
Diabetes 1989 Oct
PMID:Prevalence of neuropathy in newly diagnosed NIDDM and nondiabetic control subjects. 255 61

The binding capacity of ouabain to erythrocyte Na,K-ATPase was determined to analyze alterations in this enzyme activity in non-insulin-dependent diabetic patients. A significant (p less than 0.001) reduction of the binding capacity of ouabain was found in erythrocytes obtained from the diabetic patients with polyneuropathy (0.51 +/- 0.02 pmol/10(9) erythrocytes, m +/- SE, n = 14) as compared with the patients without neuropathy (0.67 +/- 0.02, n = 14) or age-matched control subjects (0.71 +/- 0.04, n = 11). Accordingly, the effect of an aldose reductase inhibitor (ARI; Ponalrestat) on erythrocyte Na,K-ATPase activity was studied following two or three months oral administration in seven of the diabetic patients with polyneuropathy. After treatment with Ponalrestat the mean binding capacity of ouabain was significantly increased from 0.53 +/- 0.04 to 0.57 +/- 0.03 (p less than 0.05 by paired t-test). Furthermore, enzyme kinetics showed that in normal subjects the apparent Km and Vmax of erythrocyte membrane Na,K-ATPase were 0.51 +/- 0.07 mM (n = 5, m +/- SE) and 7.19 +/- 0.27 nmol Pi/mg protein/min (n = 5, m +/- SE), respectively. The Vmax with 3 mM ATP was significantly (p less than 0.05) decreased in the diabetic patients with polyneuropathy as compared with age-matched control subjects. However, the apparent Km did not change. Finally, the in vitro effect of Ponalrestat was examined in erythrocyte membrane fractions from the diabetic patients with polyneuropathy. The activity of erythrocyte membrane Na,K-ATPase was found to be directly stimulated about 1.2 fold by the addition of pharmacological doses of Ponalrestat (10(-10), 10(-8), 10(-6) M).(ABSTRACT TRUNCATED AT 250 WORDS)
Diabetes Res 1989 Nov
PMID:Effect of aldose reductase inhibitor (Ponalrestat) on erythrocyte Na,K-ATPase activity in non-insulin-dependent diabetic patients with polyneuropathy. 256 96

In 1987-1988 the authors subjected to comprehensive neurological examination 79 type I diabetics. The group comprised subjects under 60 years and patients with other possible neurotoxic influences were eliminated. After a detailed clinical examination in 75.9% diabetics clinical signs of affection of the peripheral nervous system were revealed, incl. 45.6% clinical diabetic neuropathies were detected. In all instances it was symmetrical distal sensory or sensomotor polyneuropathy and in four instances moreover the carpal tunnel syndrome was detected. The most frequent neurological disorder was panhypaesthesia on the acra of the lower extremities. The most frequent subjective complaint were paraesthesias of the feet and subsequent cramps. The authors investigated moreover parameters of the long-term compensation of diabetes, the duration of diabetes and the biological age of diabetics. They assessed the statistical significance of these parameters for the development of diabetic neuropathy which was proved only for the parameter of the duration of the disease and the biological age of type I diabetics (p less than 0.05).
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PMID:[Incidence and developmental interdependence of peripheral nerve disorders in type 1 diabetics]. 259 48

Porphyrin metabolism was investigated in a 63-year-old male patient who developed a subacute onset polyneuropathy with predominance of motor signs in the upper limb. The screening for lead, cadmium, mercury, aluminum and thallium was negative. The study of porphyrin metabolism showed remarkable abnormalities, particularly a very high level of plasmatic 5-aminolaevulinic acid contrasting with a normal level of porphobilinogen and a nearly complete loss of activity of aminolaevulinic acid dehydratase with no regenerative response to dithiothreitol or zinc ions. The other causes of aminolaevulinic acid dehydratase deficiency (tyrosinaemia, alcoholism, smoking, cirrhosis, renal insufficiency, diabetes mellitus) were ruled out. The diagnosis of primary aminolaevulinic acid dehydratase deficiency was proposed and confirmed by the familial study, which revealed the existence of several heterozygous members in this family.
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PMID:Biochemical diagnosis of an hereditary aminolaevulinate dehydratase deficiency in a 63-year-old man. 260 May 50

The authors present the results of clinicoroentgenological and immunological investigations of the state of lower limb soft tissues in 117 patients with diabetes mellitus. Vascular wall calcification and soft tissue edema were noted practically in all the patients with a period of disease over 1 year. X-ray investigation permitted the detection of vascular lesion at early stages of complication development, in most of the patients even at the preclinical stage. A degree of lower limb vascular lesion is not related to a type of diabetes mellitus and the patients' age. There is direct correlation between the affection of the walls of medium size vessels and vessels of the fundus of the eye. The frequency and severity of lower limb vascular lesion, polyneuropathy and nephropathy grow significantly with an increase in a period of disease. A parallel decrease of immunoglobulins is noted. The affection of osseous tissue does not depend on a period of disease and shows insignificant correlation with a degree of vascular lesion.
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PMID:[The clinical x-ray characteristics of the soft tissues of the lower extremities in diabetics]. 262 81

The reproducibility of three standard neurophysiological techniques (motor and sensory nerve conduction velocities, vibration perception threshold and mean expiratory: inspiratory electrocardiographic R-R ratio) was determined from duplicate measurements approximately four weeks apart in 50 patients with chronic symptomatic diabetic polyneuropathy. There was no change in average glycaemic control (mean +/- SD) between the measurements (HbA1 10.7 +/- 2.0 vs. 10.4 +/- 2.1% at zero and four weeks respectively). While there were no significant differences in the mean values at zero and four weeks for any technique considerable intra-individual variability was observed in several measurements. Mean coefficients of variation (CV) for motor nerve conduction velocity ranged from 9.8% (ulnar nerve) to 10.7% (median) to 12.2% (peroneal nerve). Variability in sensory nerve conduction velocities (CVs 8.6, 8.7 and 14.7% for radial, ulnar and sural nerves respectively) was complicated by a high proportion of unrecordable action potentials. Duplicate action potentials were recordable from the sural nerve in only 15 (30%) patients. The highest intra-individual variability was observed in measurements of vibration perception threshold with CVs of 21.0% (thumb) and 18.0% (hallux). The apparently satisfactory CV of 3.6% for the cardiac E:I ratio test may represent an artefactually low degree of variability. Neurophysiological techniques in current use are characterized by technical limitations and intra-individual variability in patients with established diabetic neuropathy.
Diabetes Res 1989 Nov
PMID:Variability of three standard neurophysiological techniques in established symptomatic diabetic polyneuropathy. 263 95


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