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Query: UMLS:C0011860 (type 2 diabetes)
 57,723 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A case of Werner's syndrome has been reported. The patient presented with insulin resistance, non insulin dependent diabetes mellitus and muscular atrophy.
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PMID:[Insulin resistance and non-insulin dependent diabetes in the course of Werner's syndrome. Case report]. 899 37

Patients with diabetic amyotrophy may have an inflammatory vasculopathy and may obtain reversal of neurological deficits with immunosuppression. We present a patient with NIDDM, subacute onset of painful asymmetric polyradiculopathy, and unilateral enhancement of lumbar nerve roots on MRI. Clinical improvement and resolution of nerve root enhancement occurred with immunosuppression. We suggest, therefore, that nerve biopsy and gadolinum-enhanced lumbosacral MRI be performed in all patients presenting with diabetic amyotrophy. If nerve root enhancement is present or if nerve biopsy shows perivascular infiltrates, we recommend a trial of immunosuppression.
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PMID:Treatable lumbosacral polyradiculitis masquerading as diabetic amyotrophy. 934 80

Diabetic neuropathies are universally recognised and cause significant morbidity. At present improving glycaemic control is the only recognised treatment. A man with type 2 diabetes presented with disabling asymmetric lower limb proximal neuropathy. Rapid clinical, functional, and electrical improvement followed treatment with intravenous immunoglobulin. The aetiology of diabetic amyotrophy remains controversial but there is evidence for an immune mediated process and this case suggests a role for immunoglobulin in the management of this debilitating condition.
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PMID:Human immunoglobulin for diabetic amyotrophy--a promising prospect? 1132 Feb 77

A 48-year-old man with a 14-year history of type 2 diabetes with proliferative diabetic retinopathy and distal symmetrical diabetic polyneuropathy visited our hospital. Eight months later, he subacutely developed difficulty in both shoulder movement and trouble standing up from a squatting position. This was accompanied by severe bilateral shoulder and thigh pain. Magnetic resonance imaging of the brain, cervical and lumbar spine, computed tomography of the shoulder and X-ray films of the cervical spine and shoulder revealed no abnormality. Cerebrospinal fluid showed a mild elevation of protein (0.93 g/l) without cell infiltration. Antiganglioside antibodies and point mutation of mitochondrial DNA at position 3243 were not found. Neuropathology of the sural nerve showed a moderate myelinated fiber loss, active axonal degeneration, but onion-bulb formation, endoneurial or epineurial vasculitis were not observed. Electromyography revealed neurogenic changes in the proximal upper limb muscles. Nerve conduction studies revealed mild bilateral slowing in nerve conduction velocity in both of the upper and lower limbs. The diagnosis of this patients was suspected to be a proximal diabetic neuropathy (diabetic amyotrophy). The pain and muscle weakness had persisted more severely in the shoulder than in the thigh throughout the clinical course. His unbearable symptoms could be partially alleviated by an administration of a selective serotonin reuptake inhibitor, fluvoxamine maleate. Proximal diabetic neuropathy is a rare disabling type of neuropathy, which is characterized with subacute bilateral muscle weakness and wasting in the proximal part of the lower limbs. The involvement of the scapulohumeral region observed in this case is very unusual in proximal diabetic neuropathy.
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PMID:A suspected case of proximal diabetic neuropathy predominantly presenting with scapulohumeral muscle weakness and deep aching pain. 1153 31

Diabetic lumbosacral radiculoplexus neuropathy (DLRPN) (also called diabetic amyotrophy) is a well-recognized subacute, painful, asymmetric lower-limb neuropathy that is associated with weight loss and type II diabetes mellitus. Nondiabetic lumbosacral radiculoplexus neuropathy (LRPN) has received less attention. Comparison of large cohorts with DLRPN and LRPN demonstrated that age at onset, course, type and distribution of symptoms and impairments, laboratory findings, and outcomes are similar. Both conditions are lumbosacral radiculoplexus neuropathies that are associated with weight loss and begin focally with pain but that evolve into widespread, bilateral paralytic disorders. Although both are monophasic illnesses, patients have prolonged morbidity from pain and weakness, and many patients become wheelchair-dependent. Although motor-predominant, there is unequivocal evidence that autonomic and sensory nerves are also involved. Cutaneous nerves from patients with DLRPN and LRPN show pathological evidence of ischemic injury (multifocal fiber loss, perineurial thickening and degeneration, neovascularization, microfasciculation, and swollen axons with accumulated organelles) and microvasculitis (mural and perivascular inflammation, separation and fragmentation of mural smooth muscle layers of microvessels and hemosiderin-laden macrophages). Controlled trials with immune-modulating therapies in DLRPN are in progress, and preliminary data suggest that such therapy may be beneficial in LRPN. It is likely that DLRPN and LRPN are immune-mediated neuropathies that should be separated from chronic inflammatory demyelinating polyneuropathy and from systemic necrotizing vasculitis.
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PMID:Diabetic and nondiabetic lumbosacral radiculoplexus neuropathies: new insights into pathophysiology and treatment. 1193 65

Exercise improves insulin resistance and has beneficial effects in preventing and treating type 2 diabetes. However, aerobic exercise is hindered in many type 2 diabetic patients because of advancing age, obesity, and other comorbid conditions. Weight lifting or progressive resistance training (PRT) offers a safe and effective exercise alternative for these people. PRT promotes favorable energy balance and reduced visceral fat deposition through enhanced basal metabolism and activity levels while counteracting age- and disease-related muscle wasting. PRT improves insulin sensitivity and glycemic control; increases muscle mass, strength, and endurance; and has positive effects on bone density, osteoarthritic symptoms, mobility impairment, self-efficacy, hypertension, and lipid profiles. PRT also alleviates symptoms of anxiety, depression, and insomnia in individuals with clinical depression and improves exercise tolerance in individuals with cardiac ischemic disease and congestive heart failure; all of these aspects are relevant to the care of diabetic elders. Moreover, PRT is safe and well accepted in many complex patient populations, including very frail elderly individuals and those with cardiovascular disease. The greater feasibility of using PRT over aerobic exercise in elderly obese type 2 diabetic individuals because of concomitant cardiovascular, arthritic, and other disease provides a solid rationale for investigating the global benefits of PRT in the management of diabetes.
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PMID:Battling insulin resistance in elderly obese people with type 2 diabetes: bring on the heavy weights. 1271 22

Four patients with type 2 diabetes mellitus developed mononeuritis multiplex subacutely. Sural nerve biopsies showed multifocal axonal loss in all patients, with epineurial perivascular inflammation affecting small calibre vessels in three. Three patients improved with immunotherapy. These observations suggest that mononeuritis multiplex in diabetes may be caused by an immune mediated vasculopathy and that it is pathogenetically akin to the more common and better recognised diabetic amyotrophy.
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PMID:Mononeuritis multiplex in diabetes mellitus: evidence for underlying immune pathogenesis. 1275 58

Diabetic amyotrophy is a distinctive form of diabetic neuropathy usually characterized by the abrupt onset of pain and asymmetric proximal leg weakness and wasting. Involvement of the upper limbs is unusual, and prognosis is said to be good. We describe two patients, each with type II diabetes mellitus, who presented with diabetic amyotrophy progressing to severe quadriparesis. One patient remains severely disabled. The clinical spectrum of diabetic amyotrophy includes progression to severe quadriparesis.
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PMID:Diabetic amyotrophy progressing to severe quadriparesis. 1537 38

Bruns in 1890 was the first to recognize the main clinical features of 'diabetic amyotrophy'. The term itself was coined by Hugh Garland in 1955 when he reported 12 elderly patients with type 2 diabetes. The aetiology is controversial, and both ischaemic and metabolic hypotheses have been proposed. The current evidence, however, points to a vasculitic aetiology of ischaemia followed by axonal degeneration and demyelination. The main features of diabetic amyotrophy are weakness, wasting and pain, most commonly in the quadriceps muscle. Though the weakness starts on one side, it almost always spreads to the other side in an asymmetrical manner. Patients also complain of sensory symptoms in the thigh such as severe pain, dysaesthesiae and paraesthesiae. On examination, there is weakness in the involved muscles. Tendon jerks, especially the patellar, are absent. Extensor plantar responses may be elicited in some patients. The course of the disease is variable but good functional improvement can be expected in most patients though weakness, sensory symptoms and absent tendon jerks may persist. Some patients experience multiple episodes of the condition commencing mostly on the opposite side. Conservative treatment constitutes optimizing diabetic control along with active physiotherapy and analgesia. Recently, intravenous immunoglobulins have been found to produce dramatic improvement in both clinical and electrophysiological parameters in patients with diabetic polyradiculopathy.
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PMID:Diabetic amyotrophy: a brief review. 1537 63

We report the case of a 13-year-old boy with poorly controlled type 2 diabetes mellitus who developed severe diabetic amyotrophy, which progressed over a few months but demonstrated rapid recovery after administration of intravenous immunoglobulin. This report highlights the importance of monitoring adolescents for even the rare neurologic complications of diabetes mellitus most commonly encountered in adults, and supports the need for well-designed trials using immunomodulatory therapies in diabetic amyotrophy.
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PMID:Diabetic amyotrophy in an adolescent responsive to intravenous immunoglobulin. 1599 Dec 52


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