Facteurs associes a la neuropathie diabetique a l'hopital national de Lamorde (Niamey-Niger)

OBJECTIFS. Identifier les facteurs associes a la neuropathie chez les patients diabetiques suivis a l'Hopital National de Lamorde. MeTHODES. Il s'agit d'une etude transversale; prospective sur une duree de 6 mois (Avril a Octobre 2014). Ont ete inclus les patients diabetiques vus en consultation durant la periode d'etude. Le score de Michigan neuropathy screening instrument(MNSI) a permis d'etablir le diagnostic de neuropathie peripherique et la douleur neuropathique a ete diagnostiquee sur la base du score DN4. ReSULTATS. Sur 200 patients inclus; 46% avaient une neuropathie peripherique dont 24% une douleur neuropathique. La survenue de la neuropathie peripherique est significativement correlee au diabete de type 2; a l'age des patients; au sexe masculin; a l'anciennete du diabete et a un bas niveau socio-economique. Une association au desequilibre glycemique a ete observe chez 46;2 % des cas mais non significative (p=0;055). La neuropathie etait egalement associee a la nephropathie; a une retinopathie diabetique et a la dysfonction erectile chez hommes.CONCLUSION. La neuropathie diabetique est frequente au Niger. Sa survenue denote de la presence d'autres facteurs

Correlation between Retinopathy; Nephropathy and Peripheral Neuropathy among Adult Sudanese Diabetic Patients

Diabetes Mellitus is a worldwide common metabolic disorder. Increasing prevalence of diabetes; lack of proper education about the nature and course of the disease and necessary control are the main factors for an early onset of micro vascular complications. Objective: To correlate between retinopathy; nephropathy and neuropathy; among adult Sudanese diabetic patients at Elshaab Teaching hospital; Ahmed Gasim Teaching hospital and Gabber Abu Eleaz centre; from December 2006 to September 2008. were included. Result: Male to female ratio was1.4:1.Common age group affected was 60-69 (32.4).Common duration of diabetes mellitus was 20-24 years (23.9).All patients who had diabetes for 25 years or more had developed complications (19.7).The commonest long term microvascular complication was found to be retinopathy (71.2); followed by neuropathy (69) and nephropathy (50.7).It was found that (47.6) of our patients had the three complications. Conclusion: Long-term micro vascular complications affect male more than female; with average age of onset 60-69 years. All patients who had diabetes for 25 years or more had developed complications. Retinopathy is the most common micro vascular complication; followed by neuropathy. There is a significant correlation between retinopathy; nephropathy and neuropathy in association with the duration and control of blood glucose level

Relationship between duration of diagnosis and neuromusculoskeletal complications of middle-aged type 2 diabetes patients

Abstract. BACKGROUND: Patients with Type 2 Diabetes (T2D) often present with complications involving the neuromusculoskeletal system which creep in as the condition advances in years. Hence there is a need to further understand how the duration of diagnosis of diabetes (DD) relates to the neuromusculoskeletal complications in order to design timely preventive programmes. OBJECTIVE: To investigate the relationship between the duration of diabetes and neuromusculoskeletal complications in type 2 diabetes. METHODS: This was a cross-sectional survey involving 139 consenting T2D patients and 139 age and sex-matched nondiabetic individuals. The participants were assessed for the DD and selected neuromusculoskeletal complications including muscle weakness, ranges of motion (ROM), pain and foot ulceration. RESULTS: The mean DD was 7.82 ± 2.41 years. There were significant differences (p < 0.01) between the clinical variables of both groups. In the diabetic participants, significant inverse relationships (P<0.05) were obtained between the DDD and each of muscle strength {elbow flexors (r = -0.57), knee extensors (r = -0.63), handgrip (r = ­0.82)}; ROM {wrist extension (r = -0.64) and ankle planterflexion (r = -0.63)}. Significant and direct relationships were obtained between the DDD and each of pain (r = 0.62) and ulcerative grading (r = 0.81). CONCLUSIONS: Type 2 Diabetes patients have poorer neuromusculoskeletal variables and longer duration of diabetes is associated with reduced muscle strength, diminished ROM, gradual ulceration of skin of the feet and higher level of foot pain. Immediate therapeutic exercises against these complications soon after diagnosis of diabetes may help to decelerate their progression

Amitriptyline and Sertraline in Diabetic Neuropathy: a Comparative View

Purpose: To investigate the effect of amitriptyline (Ami) and sertraline (Sert) in diabetes neuropathy. Methods: Diabetes was induced in 3 groups of rats (n=6) with streptozotocin (STZ; 55mg/kg; i.p.). Two of the groups of diabetic rats received amitriptyline (15 mg/kg; p.o) and sertraline (30 mg/kg; p.o.) while another 2 groups (n=6) received the same drug treatment without prior administration of STZ. A normal group (n=6) of rats and STZ-induced group (n=6) of diabetic rats served as controls.The blood glucose; glycosylated hemoglobin (GHb); pain sensitivity and neuromuscular strength in all the rats were determined. Results: Ami (15mg/kg; p.o.) produced severe hyperglycemia (p 0.01) whereas Sert (30mg/kg; p.o.) produced significant hypoglycaemia in the diabetic rats. Ami significantly increased the GHblevel while Sert had no significant effect. Both Ami and Sert raised the grip strength that was significantly reduced by STZ. When administered for 3 weeks; Ami and Sert increased the STZ induced reduction of the grip strength in the diabetic rats (p 0.01). STZ (55mg/kg; i.p) increased the pain sensitivity. Pain sensitivity was significantly reduced by Ami (15 mg/kg; p.o; administered for 3 weeks) in the diabetic rats but marginally reduced in the normal group. However 3-week administration of Sert (30 mg/kg; p.o.) significantly reduced the pain sensitivity in both the diabetic and normal rats (p 0.01) when compared with STZ treated group. Conclusion: Sertraline could offer a good choice in the treatment of diabetic neuropathy particularly in patients with depression being treated with amitriptyline

Cystopathie chez le diabétique ivoirien : étude transversale des facteurs de risque à Abidjan

Contexte : Le diabète sucré, notamment le type 2 est responsable de complications dégénératives en particulier la neuropathie. L'atteinte vésicale neuropathique qui est la cystopathie est l'objet de notre travail. Objectif : Décrire les facteurs de risque pouvant influencer l'apparition de la cystopathie. Matériel et méthodes : Il s'agissait d'une étude transversale prospective à visée descriptive qui s'est déroutée du 19 juin au 19 juillet 2005 au centre antidiabétique d'Abidjan (CADA). Elle a porté sur une population de 74 diabétiques régulièrement suivis au CADA. Résultats : Il en ressort une prédominance du diabète de type 2 avec 89,2%, un âge moyen de 50 ans et prédominance du sexe masculin avec un sex-ratio de 2,7. Les données cliniques sont caractérisées par une prévalence des troubles urinaires estimée à 20,3%, une prédominance de la dysurie soit 66,7% par rapport à l'ensemble des troubles urinaires. Les facteurs de risque cardio-vasculaires existent dans cette population de diabétique, avec 31% d'hypertension artérielle, 24,3% de dyslipidémie et 17,6% d'obésité. Nos patients ont un mauvais équilibre glycémique avec une valeur moyenne de l'hémoglobine glyquée à 8,3% .La glycémie joue un rôle essentiel dans l'apparition de la cystopathie. Conclusion : Les facteurs cardiovasculaire (hypertension, dyslipidémie et obésité) existent dans notre série mais n'influencent pas l'apparition de la cystopathie. C'est le mauvais équilibre glycémique qui joue un rôle essentiel. La réalisation d'une échographie suspubienne à travers la mesure des volumes pré et post mictionnel est d'un apport utile au diagnostic

Neuropathie diabetique: physiopathologie et traitement

A partir de 58 patients (diabetiques) presentant des symptomes de neuropathie; l'auteur passe en revue les mecanismes physiopathologiques de la neuropathie (diabetique) et les possibilites therapeutiques