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

Type II (noninsulin-dependent) diabetes (NIDDM) can be preceded by a relatively long period of disturbed glucose metabolism. Therefore, the prevalence of neuropathy and its possible relationship to metabolic abnormalities were investigated in 95 newly diagnosed type II diabetics (upper age limit was set at 55 years) with a mean age of 49.7 years (men/women ratio 1:1). The study program was as follows: Detailed history, clinical investigation of peripheral nerves, sensory assessment to touch and pain (pinprick), vibration sensation using established techniques, and motor nerve conduction velocities (MNCV) of the fibular (peroneal) and ulnar nerves. Three cardiovascular autonomic function tests were performed: the Valsalva maneuver, standing (ratio between RR-intervalmax: RR-intervalmin), and deep breathing (maximum/minimum heart rate). Vascular diseases were diagnosed using a conventional 12-lead resting electrocardiogram (ECG) and impedance measurement of the lower extremities. The results were as follows: abnormal vibration sensation in 80.0%, abnormalities of MNCV in 15.7%, abnormal sensations to touch or pinprick in 14.7%, and loss of reflexes in 13.6%. If peripheral neuropathy was defined as having at least three of the four abnormalities plus neuropathic symptoms, the prevalence was 6.3% (6 of 95 patients). Abnormalities of the three cardiovascular autonomic function tests were much less prevalent in type II diabetic patients (2.1-7.3%). In conclusion, the study showed that peripheral and autonomic neuropathy is not common at diagnosis in middle-aged type II diabetic patients without signs of microvascular or macrovascular complications.
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PMID:Prevalence of peripheral and autonomic neuropathy in newly diagnosed type II (noninsulin-dependent) diabetes. 183 Mar 12

We examined cognitive functions and central conduction velocities in 20 patients, over 63-year old, with NIDDM compared with 20 normal, age-matched controls. Mean conduction velocity of median nerve, was significantly lower in diabetics than in controls, but absolute values were within normal range. Neurological examination showed clinical signs of lower limbs neuroperipheral involvement. Only one cognitive subtest performance was abnormal whereas there was no impairment in central conduction velocities. In our study population, although median nerve conduction velocity values may introduce a bias of low peripheral neuropathy incidence, there was no evidence of a massive or progressive specific central nervous system involvement caused by NIDDM.
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PMID:Central nervous system involvement in elderly patients with non-insulin-dependent diabetes mellitus. 208 35

Urinary excretion patterns of various endogenously produced alcohols, such as ethanol, propanol, isobutanol, butanol, and isopentanol, were evaluated in 17 type 1 (IDDM) and 15 type 2 (NIDDM) diabetic patients, and in two different groups of healthy control subjects (n = 12, n = 8, respectively) matched for sex, age and weight. In addition to the urinary alcohol excretion determined by gas-chromatography and mass-spectrometry, four cardiovascular reflex tests were performed, and the motor and sensory conduction velocities of three different peripheral nerves were measured. In the type 1 diabetic patients, urinary excretions of ethanol and propanol were significantly higher than in the control subjects (P less than 0.0001, P less than 0.00001, respectively), whereas the control subjects exhibited significantly higher urinary excretion rates of the other three alcohols (P less than 0.007, P less than 0.02 and P less than 0.002, respectively) compared with the type 1 diabetic patients. In the type 2 diabetic patients, only the urinary excretion of propanol was significantly elevated (P less than 0.002) compared with the control subjects, while the urinary excretion rates of butanol and isopentanol were significantly lower (P less than 0.02, P less than 0.05, respectively) than in the controls. Urinary alcohol excretions were not related to diabetic peripheral neuropathy in both groups studied. The clinical meaning of the urinary excretion patterns of different endogenously produced alcohols in diabetes mellitus has to be further evaluated.
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PMID:Urinary excretion patterns of endogenously produced alcohols in type 1 (IDDM) and type 2 (NIDDM) diabetes mellitus compared with healthy control subjects. 226 52

To assess the prevalence of autonomic neuropathy (AN) in non-insulin dependent diabetes mellitus (NIDDM) and its relationships with other diabetic complications, duration of diabetes, and obesity, we evaluated 51 NIDDM patients (age 41-59 years, mean 49 years, duration of diabetes 0-15 years, mean 6.9 years). AN tests included a deep breathing test (E/I ratio) and an orthostatic tilt table test (acceleration and brake (25 of 51, 49%) and the most frequent disturbance was an impaired E/I ratio (18 of 25; 72%). There were no obvious correlations between AN indices and the duration of diabetes, symptoms of AN, peripheral neuropathy or retinopathy. However, an influence of obesity on AN was suggested. Patients with AN showed a significantly higher BMI than patients without AN (31.0 +/- 0.9 vs. 27.5 +/- 0.8; P less than 0.01).
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PMID:Autonomic neuropathy in non-insulin dependent (type II) diabetes mellitus. Possible influence of obesity. 240 80

Vibratory and cooling detection thresholds (VDT and CDT) were determined at both the palmar aspect of the distal phalanx of the right index finger (upper limb) and the plantar aspect of the distal phalanx of the right great toe (lower limb) in 53 consecutive patients with diabetes mellitus (NIDDM), in order to analyze the frequency of the abnormality of each threshold and the relationship between each threshold and the clinical or laboratory findings. VDT in the lower limb was statistically correlated with age, duration of diabetes mellitus, and blood urea nitrogen value of each patient, but not with fasting blood glucose and hemoglobin A1C levels. VDT in the lower limb was significantly greater in the groups of patients with each of the subjective sensory disturbances, peripheral neuropathy (based on our criteria), retinopathy, and proteinuria. Forty-seven per cent of the patients showed clinically peripheral neuropathy, and the frequencies of the abnormality of VDT, CDT and VDT or CDT were 34, 26 and 45%, respectively. VDT and CDT reflect the abnormality of different populations of the peripheral nerve fibers and seem to be affected separately. The determination of both VDT and CDT is useful for the evaluation of the neuropathic state of diabetic patients.
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PMID:[Vibratory and cooling detection thresholds in diabetes mellitus]. 238 92

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)
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PMID:Prevalence of neuropathy in newly diagnosed NIDDM and nondiabetic control subjects. 255 61

Vibratory detection threshold (VDT) was determined on the plantar side of the distal phalanx of the right great toe of 22 diabetic (NIDDM) patients. In addition, a neurological examination and a sural nerve conduction study were performed. Peripheral neuropathy, based on our criteria, was found in 41% of the patients. VDT was abnormally high in 23% of the patients. The combined frequency of the abnormality of the amplitude of the action potential of the sural nerve or the conduction velocity or both was 73%. The nerve conduction study showed the highest sensitivity in detecting the abnormality of the peripheral nerve in this study; this is in agreement with the result shown in the literature. Seven patients showed no response to electrical stimulation of the sural nerve, although VDT was obtained in these patients. Among the 6 patients that underwent the normal sural nerve conduction study, no one showed abnormally high VDT. The determination of VDT seems to be a useful examination for the follow-up study of diabetic neuropathy, although it is less sensitive than the sural nerve conduction study.
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PMID:[Correlation between vibratory detection threshold and conduction study of sural nerve in diabetic patients]. 260 39

Both early onset and late onset type II diabetes were present in one family of nine siblings. The three early onset type II diabetic siblings showed severe microvascular complications: proliferative retinopathy, diabetic nephropathy, and peripheral neuropathy. Early onset type II diabetes was not associated with any particular HLA haplotype. Early onset type II diabetes could be considered a clinical and genetic disease entity different from MODY type diabetes.
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PMID:Severe microvascular disease in type II diabetes of early onset. A family study. 275 Apr 46

Electrophysiological evaluation of peripheral neuropathy was done in 16 patients with tropical pancreatic diabetes (TPD) and the data compared with those of a matched group of 16 NIDDM patients. Peripheral neuropathy was present in 6 TPD and 5 NIDDM patients. Abnormal motor conduction velocity in the lateral popliteal nerve was seen in 9 TPD patients and in 8 NIDDM patients and biothesiometry was abnormal in 7 patients in each group. One TPD patient had an abnormal F wave in the lower limb. An abnormal sensory potential was recorded in the sural nerve in 6 TPD and 8 NIDDM patients. The study showed that occurrence of peripheral neuropathy in TPD was similar to that in NIDDM. Subclinical neuropathy could be detected by electromyographic recording in both groups of patients.
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PMID:Peripheral neuropathy in tropical pancreatic diabetes. 375 48

Heart rate variability (HRV) during deep breathing was studied with a neonatal heart monitor in 143 control subjects and 218 patients with diabetes (102 with IDDM and 116 with NIDDM). In the control group HRV decreased after age 20 by 4-5 beats per decade (from 29.7 +/- 5.8 beats at age 20-29 to 11.8 +/- 5.4 beats at age 60+). In all age groups HRV in IDDM was lower than in the controls, and both age and duration of diabetes played a role in the decrease of HRV (from 21.5 +/- 5.3 beats at age 20-29 to 6.3 +/- 5.4 at age 60+). In NIDDM aging seemed to play a less important role, and the influence of the duration of the disease was not statistically significant. In both groups of patients the frequency of HRV below the 2.5th percentile was 82% in those with symptoms and/or signs of autonomic neuropathy, 64% in patients with peripheral neuropathy only, and 36% in those who had no obvious signs or symptoms of neuropathy. Interindividual variability was pronounced, and age and duration of the disease together accounted for only 36% of the observed differences between IDDM and the controls. Determination of HRV with a standard neonatal heart monitor presents an easy, simple, and nonstressful test of cardiac autonomic neuropathy. The norms of the test are age related.
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PMID:Heart rate variability in diabetes: relationship to age and duration of the disease. 397 50


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