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

Epineurial arteriolar wall components in sural nerves of 45 diabetics (39 with and six without neuropathy) were measured and compared with those of 34 healthy subjects. Intimal area and numbers of intimal nuclei were significantly greater in diabetics than in controls. Regression lines relating intimal to medial area in diabetics and controls had a common slope, but the line for diabetics was at a higher intercept. We found no direct association between increase of intima and severity of nerve fiber degeneration. These studies indicate that intima is increased in arterioles in diabetes, due primarily to proliferation of intimal cells. The increased intima, and possible resulting decrease of nerve perfusion, may contribute to development of diabetic polyneuropathy.
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PMID:Intima of epineurial arterioles is increased in diabetic polyneuropathy. 341 3

A total of 2000 patients of different age, suffering from diabetes were studied, giving consideration to clinical, neurophysiological and diabetological parameters. The authors have identified syndromes of damage to somatic and visceral peripheral nerves in such patients. It is suggested that three main variants of damage to the peripheral nerves be differentiated: (1) subclinical disorders; (2) somatovisceral polyneuropathies in type I diabetes; (3) polyneuropathies in type II diabetes. Neural dysfunction in the first variant of the disease may be reversed following normalization of metabolic disturbances. Polyneuropathies in type I diabetes are largely related to axonal involvement whereas in type II diabetes they are characterized by a more complex pathogenesis and are largely due to damage to the myelin membranes of axons.
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PMID:[Clinical and pathogenetic aspects of symmetrical diabetic neuropathy]. 343 63

The relationship between diabetic neuropathy on the one hand and microangiopathy and arteriosclerosis on the other was studied by determining plasma 6-keto-prostaglandin F1 alpha (PGF1 alpha) and plasma thromboxane B2 (TXB2) in diabetics with neuropathy. The subjects were 13 patients with insulin independent diabetes mellitus with polyneuropathy (DN+ group), 9 cases which had no neuropathy (DN- group) and 6 control cases. The patients with severe retinopathy, nephropathy and hypertension were excluded. Plasma 6-keto-PGF1 alpha and plasma TXB2 concentration were determined by radioimmunoassay. The motor neuron conduction velocity (M.C.V.) was measured through the tibial nerve in all diabetics. Plasma 6-keto-PGF1 alpha was 116.3 +/- 4.2 pg/ml (mean +/- SE) in the DN+ group and 139.9 +/- 3.0 in the DN- group, each group showing a significant fall over the control with 150.8 +/- 4.5. Plasma 6-keto-PGF1 alpha in the DN+ group showed a significant decrease in comparison with that in the DN- group. As to plasma TXB2, there was no significant difference among the three groups. The M.C.V. fell off significantly in the DN+ group with 52.9 +/- 3.2 m/sec. Furthermore, a significant positive correlation was observed between M.C.V. and plasma 6-keto-PGF1 alpha. The following is the summary of these results. A decrease in plasma 6-keto-PGF1 alpha was observed in diabetics with polyneuropathy. A decrease in the production of prostacyclin (PGI2) due to impairment of vascular endothelium in the nerve tissue was surmised. The decrease in plasma 6-keto-PGF1 alpha presumably stimulates the activity of platelet agglutination and causes an ischemic change in the nerve tissue.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Evaluation of plasma 6-keto-prostaglandin F1 alpha and thromboxane B2 in diabetic neuropathy]. 355 71

A 58-year-old woman presented with a history of premature onset of menopause, longstanding hepatosplenomegaly, monoclonal gammopathy, lower limb polyneuropathy of recent onset, diabetes mellitus, excessive perspiration and leg edema. Polyneuropathy and excessive perspiration improved following a course of prednisone and melphalan. The clinical and pathophysiological features fit the rare entity known as POEMS syndrome.
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PMID:An unusual case of POEMS syndrome. 357 Jul 37

200 years have gone by since the autonomic disturbance in diabetes mellitus has been described for the first time ever. There is a great deal of information on the close relationship between somatic and visceral symptoms in diabetic polyneuropathy (PNP), so that there should be talked about only of one form of manifestations within the meaning of a distal symmetric somatovisceral PNP. The longer fibres such as the vagal fibres of the viscus, sympathetic fibres of the eye are affected at first and more intensively in the autonomic region same as in the sensory and motor region. Due to the fact that for reasons of fragmentary knowledge pathogenetically substantiated classification of the autonomic disturbances in diabetic PNP is not at hand, such a classification is being made from organotopic and phenomenologic aspects. Frequently, afferent denervation of an organ results in enhancing the effects of an autonomic innervation dysfunction, as for instance in unnoticed hypoglycaemia, in order to modify the symptoms, as for instance in rectal incontinence with unnoticed defecation, or rather to let new symptoms appear, for instance loss of testicular pain. In recent years, appropriate methods of examinations were tested for the clinical routine, permitting to give evidence of autonomic dysfunctions before clinical manifestation. It is still unclear to what extent such subclinical abnormalities are reversible with a more favourable regulation of the metabolic process, for instance with the aid of continuous subcutaneous insulin injections. An impressive symptom of innervation dysfunctions of the cardiovascular system is orthostatic hypertension that may, in exceptional cases, even lead to confinement to bed. The most important pathogenic factor seems to be vascular denervation. A pronounced tachycardia at rest, frequently found in diabetics, is the result of the failure of the vagal autonomic system, and, after additional destruction of the sympathetic fibres, it adjusts itself to a lower level that cannot be changed by reflex mechanisms. Cardialgia absent in the case of myocardial ischemia is a factor of an increased mortality of long-term diabetics. The correlation between vascular denervation and arteriosclerosis or mediasclerosis, respectively, is being under discussion. Denervation on the gastrointestinal tract has an effect on the motility and excretory functions. The innvervation dysfunctions lead to sialadenosis by changing the composition of saliva. In most cases esophageal dysfunction is not perceived by the patient.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:[Autonomic symptoms in diabetic polyneuropathies]. 359 51

We studied a family in which the father and 7 of 10 children had episodes of Bell's palsy. Five of the eight affected family members also had ocular motor palsies. Facial nerve and blink reflex studies in four affected siblings demonstrated asymmetrically reduced amplitude of evoked responses without delayed conduction. EMG revealed signs of chronic denervation and reinnervation in all four patients; two had synkinesis. Three siblings had diabetes mellitus, but with no clinically evident polyneuropathy.
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PMID:Familial recurrent Bell's palsy with ocular motor palsies. 361 60

Increasingly more tests are being used to detect and characterize diabetic polyneuropathy, but their value in setting minimal criteria for the diagnosis of neuropathy and for staging severity remains inadequately studied. In 180 diabetics, we compared the percentage of patients with test abnormalities and associations among test results, evaluating neuropathic symptoms [neuropathy symptom score (NSS) and neuropathy scale of neuropathy symptom profile (NNSP)], deficits [neurologic disability score (NDS) and vibratory (VDT) and cooling (CDT) detection thresholds], or nerve dysfunction [nerve conduction (NC)]. The percentage of patients that were abnormal varied considerably depending on criteria for abnormality and the tests used. Abnormality (greater than or equal to 3 SD of 1 or more parameters) of NC of one or more of four nerves occurred in 80%, of two or more in 69%, of three or more in 46%, and of four in 21%. Similarly, for other tests, the rate of abnormality decreased with use of increasingly stringent criteria. Setting the criteria for abnormal NC at abnormality of two or more nerves, NSS at greater than or equal to 1, NDS at greater than 6, NNSP at greater than or equal to 97.5th percentile, and at greater than or equal to 95th percentile for the other tests, NC was abnormal in 69%, NSS in 54%, NDS in 48%, NNSP in 47%, VDT in 44%, and CDT in 35%. Abnormality of any two or more of the six tests evaluated occurred in 64% of patients.(ABSTRACT TRUNCATED AT 250 WORDS)
Diabetes Care
PMID:Vibratory and cooling detection thresholds compared with other tests in diagnosing and staging diabetic neuropathy. 362

The progression of subclinical polyneuropathy over 2.5 years has been studied in a representative group of 75 young patients with Type 1 (insulin-dependent) diabetes (initial age 16-19 years). The relationships between changes in nerve function, glycaemic control and concurrently developing microvascular complications (retinopathy, microproteinuria) were investigated. Deterioration of motor, sensory and autonomic nerve function, retinopathy and microproteinuria was related to poor glycaemic control. In addition, there was an association between developing neural and microvascular complications which was not diminished when their common relationship to hyperglycaemia was taken into account. These findings suggest that, although poor glycaemic control is an essential permissive factor in the early development of diabetic polyneuropathy, other influences, shared with microvascular complications, must also be important.
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PMID:Progression of subclinical polyneuropathy in young patients with type 1 (insulin-dependent) diabetes: associations with glycaemic control and microangiopathy (microvascular complications). 369 6

The autonomic innervation of the heart has been studied in 32 young patients with insulin-dependent diabetes mellitus and 28 controls by measuring the intervals PP of electrocardiograms at rest, deep breathing, stimulation of n. vagus according to Ashner method and after suppression of vagus tone by atropine. The orthostatic test was performed. The patients with diabetes were established to have a higher heart rate and less manifested variations of the intervals PP at rest. During deep breathing, the patients with diabetes also showed a poorer variability of the intervals PP as compared with the controls. The reactions, however, in both groups with Ashner test and orthostatic test, were similar. Asymptomatic sinoatrial block was recorded in a patient with diabetes by the method of Ashner. The study revealed that the autonomic innervation of the heart was oft disturbed in case of diabetes. There was a correlation between the severity of that disorder and diabetes duration, diabetic peripheral polyneuropathy established in all cases. The other manifestations of diabetic polyneuropathy are more rare and later observed. The disturbed autonomic innervation of heart activity could be responsible, in some cases, for the sudden cardiac death among the patients with diabetes.
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PMID:[Autonomic innervation of the heart of young patients with insulin-dependent diabetes]. 371 65

The clinicopathological study of a case of relapsing complete bilateral external ophthalmoplegia associated with a sensory-motor polyneuropathy is presented. No other causes apart from diabetes mellitus were ascertained. The sural biopsy demonstrated an axonal as well as demyelinating neuropathy. The physiopathology of the rare cases of diabetic multiple bilateral cranial nerve palsies is discussed.
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PMID:Complete bilateral relapsing ophthalmoplegia in a diabetic patient with a sensory-motor distal polyneuropathy. 372 Aug 4


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