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

Neurological complications in the light of their clinical and topographical pattern are discussed with regard to the literature and 40 personal cases. Peripheral neuropathy is the most common (average frequency 26%). The main clinical, anatomical, histological and pathogenetic features of polyneuritis in diabetes are illustrated. Diabetic amyotrophy is a true clinical entity, though its site (neural or muscular) and pathogenesis are still the subject of discussion. Cranial nerve damage (oculomotor paralysis in particular) has the typical clinical, anatomical and histological picture of peripheral forms. Myelopathy leads to three distinct anatomical and clinical patterns: pseudo-tabes caused by degeneration of the roots and posterior cords; chronic anterior poliomyelitis due to degeneration of the cells of the anterior cornua; myelosis attributable to combined degeneration of the posterior and anterolateral cords. The main features of encephalopathy and the relation between epilepsy and diabetes are also examined.
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PMID:[Neurologic complications of diabetes mellitus]. 64 15

A 16-year-old boy with insulin-dependent diabetes mellitus since age five years was admitted with severe ketoacidosis, and suffered a cardiorespiratory arrest from which he made a full recovery. He subsequently developed the typical clinical picture of diabetic amyotrophy with painful asymmetrical weakness and wasting of proximal lower limb muscles. Cerebrospinal fluid protein was elevated, and electromyography showed typical changes. Diabetic amyotrophy has not previously been reported in this age group.
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PMID:Adolescent diabetic amyotrophy. 320 32

We prospectively determined the prevalence of morbidity from the various forms of diabetic neuropathy over one year in a population of 800 patients with diabetes mellitus (336 type 1, 464 type 2 DM). Symptoms documented were: pain/paraesthesia in the feet, loss of feeling and the restless legs syndrome. We also documented the prevalence of: neuropathic ulcers, amyotrophy, foot drop, and oculomotor palsy. Autonomic symptoms documented were: impotence, postural hypotension and diarrhoea. The only symptoms reported by 100 non-diabetic control subjects were: loss of feeling in 2% and restless legs syndrome in 7%. In the diabetics; pain/paraesthesia was present in 13%, feeling loss in 7% and neuropathic ulcers in 2%. The prevalence of Diabetic amyotrophy (proximal femoral neuropathy) was 0.8%, oculomotor palsy 0.1% and peroneal nerve palsy 0.1%. Erectile impotence was present in 20%, symptomatic postural hypotension in 1% and diabetic diarrhoea in 1%. Overall; 22.9% of the population was afflicted by one or more problems resulting from neuropathy. Neuropathy was associated with older age (p < 0.001), and serious retinopathy (p < 0.001) in both groups of diabetics and with duration of diabetes, proteinuria (p < 0.02), hypertension (p < 0.01) and ischaemic heart disease (p < 0.02) in type 1 diabetics.
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PMID:Prevalence and forms of neuropathic morbidity in 800 diabetics. 820 Jul 77

Diabetic neuropathy (DN) refers to symptoms and signs of neuropathy in a patient with diabetes in whom other causes of neuropathy have been excluded. Distal symmetrical neuropathy is the commonest accounting for 75% DN. Asymmetrical neuropathies may involve cranial nerves, thoracic or limb nerves; are of acute onset resulting from ischaemic infarction of vasa nervosa. Asymmetric neuropathies in diabetic patients should be investigated for entrapment neuropathy. Diabetic amyotrophy, initially considered to result from metabolic changes, and later ischaemia, is now attributed to immunological changes. For diagnosis of DN, symptoms, signs, quantitative sensory testing, nerve conduction study, and autonomic testing are used; and two of these five are recommended for clinical diagnosis. Management of DN includes control of hyperglycaemia, other cardiovascular risk factors; alpha lipoic acid and L carnitine. For neuropathic pain, analgesics, non-steroidal anti-inflammatory drugs, antidepressants, and anticonvulsants are recommended. The treatment of autonomic neuropathy is symptomatic.
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PMID:Diabetic neuropathy. 1646 71

Patients with diabetes mellitus may encounter various musculoskeletal complications. Typical manifestations can be seen in the hand, such as limited joint mobility, flexor tendon synovitis, Dupuytren's contracture and carpal tunnel syndrome. Humeral periarthropathy is also more frequent. The most serious complications can occur in the form of diabetic foot, which may lead to severe deformities and disability. Diabetic amyotrophy and muscle infarction are more rare complications. While osteopenia has a well recognized association with type I diabetes mellitus, this probably is not true for type II. Similarly, the association between diabetes mellitus and osteoarthritis has not been proven.
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PMID:[Rheumatologic manifestations in diabetes]. 1677 Oct 95

The musculoskeletal system can be affected by diabetes in a number of ways. The shoulder is one of the frequently affected sites. One of the rheumatic conditions caused by diabetes is frozen shoulder (adhesive capsulitis), which is characterized by pain and severe limited active and passive range of motion of the glenohumeral joint, particularly external rotation. This disorder has a clinical diagnosis and the treatment is based on physiotherapy, non-steroidal anti-inflammatory drugs (NSAIDs), corticosteroid injections and, in refractory cases, surgical resolution. As with adhesive capsulitis, calcific periarthritis of the shoulder causes pain and limited joint mobility, although usually it has a better prognosis than frozen shoulder. Reflex sympathetic dystrophy, also known as shoulder-hand syndrome, is a painful syndrome associated with vasomotor and sudomotor changes in the affected member. Diabetic amyotrophy usually affects the peripheral nerves of lower limbs. However, when symptoms involve the shoulder girdle, it must be considered in the differential diagnosis of shoulder painful conditions. Osteoarthritis is the most common rheumatic condition. There are many risk factors for shoulder osteoarthritis including age, genetics, sex, weight, joint infection, history of shoulder dislocation, and previous injury, in older age patients, diabetes is a risk factor for shoulder OA. Treatment options include acetaminophen, NSAIDs, short term opiate, glucosamine and chondroitin. Corticosteroid injections and/or injections of hyaluronans could also be considered. Patients with continued disabling pain that is not responsive to conservative measures may require surgical referral. The present review will focus on practice points of view about shoulder manifestations in patients with diabetes.
Curr Diabetes Rev 2010 Sep
PMID:Shoulder manifestations of diabetes mellitus. 2070 86

Diabetic amyotrophy or lombosacral radiculoplexus neuropathy is a rare complication associated with early-stage diabetes. Thigh pain, quadricipital amyotrophy, proximal weakness of lower limbs and weight loss are the main symptoms of the disease. As neurological damage is related to inflammatory microvasculitis, corticosteroid therapy may be considered as the first line therapy. We report a 54-year-old patient with type 2 diabetes affected with severe diabetic amyotrophy. Following intravenous corticosteroid therapy, the patient reported a rapid pain relief and gained muscle strength.
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PMID:[Diabetic amyotrophy: favorable outcome following corticosteroid therapy?]. 2128 93

Diabetic amyotrophy is a rare condition in which patients develop severe aching or burning pain in hips and thighs. This is followed by weakness and wasting of the muscles of proximal lower extremities, which often occur asymmetrically. Diabetic neuropathic cachexia is a different type of diabetic neuropathies. It leads to intense pain in affected extremities accompained by anorexia, weight loss as well as mood and sleep disturbances. A 42-year-old type 2 diabetic woman with a known poor glycemic control presented with loss of appetite, and weight (approximately 15 kg), severe burning sensation over her lower limbs, depression and sleep disturbances for 3 months. Symmetric wasting was noted in her proximal lower extremities with bilateral muscle weakness. Her patella and Achilles reflexes were absent with decrease in her upper extremity reflexes. We evaluated the patient as diabetic amyotrophy associated with diabetic neuropathic cachexia based on clinical signs, electrophysiological and radiological examination findings. Physicians should take into consideration these rare complications of diabetes mellitus showing characteristics different from other types of neuropathies.
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PMID:Concomitance of diabetic neuropathic amyotrophy and cachexia: a case report with review of the literature. 2805 61