RESUMEN
Background: Diabetes mellitus (DM) is one of the most common chronic diseases globally. Diabetic neuropathy is the most common & troublesome complication. But exact pathogenesis is not yet known. Comparatively there are few studies showing relation between glycemic status & diabetic neuropathy. Hence present study was conducted, which was aimed to assess the same in lower limbs in type 2 DM. Methods: 60 type 2 diabetes mellitus male patients were selected from diabetic OPD. 30 were having glycated hemoglobin (HbA1c) 6%-9% (group B), 30 were having HbA1c > 9% (group C). They were compared with age and sex matched 30 normal healthy controls (group A). Conduction velocity and amplitude of bilateral sural sensory nerve action potential (SNAP) and peroneal compound muscle action potential (CMAP) were recorded. Glycated hemoglobin was measured using ion exchange resin method. Results: Group B and group C had significantly lesser means of conduction velocity and amplitude of sural SNAP (p<0.001) and peroneal CMAP (p<0.05) as compared to group A. Hb A1c had statistically significant negative correlation with conduction velocity and amplitude of sural SNAP (p<0.001) as well as peroneal CMAP (p<0.001). Conclusions: This study shows that diabetic patients with higher blood glucose levels are at increased risk of diabetic neuropathy. Diabetic neuropathy in lower limbs worsens with increasing blood glucose levels. Hence stringent action has to be taken at an early stage to control blood glucose levels. Also, patients should be encouraged for regular follow up and strict glycemic control.
RESUMEN
Background: The complications associated with type 2 Diabetes Mellitus (DM) may cause functional impairment in older people. Recently it has been proved that motor dysfunction in the form of skeletal muscle dysfunction does occur in type II DM. However very few studies have assessed the upper limb skeletal muscle dysfunction. Objectives: The study was aimed to assess the hand grip strength, endurance in type 2 DM patients and compare the same with age matched healthy controls. We also correlated glycosylated Hb and duration of illness with the hand grip strength and endurance in the patients. Materials and Methods: Hand grip dynamometer was used to measure the hand grip strength and endurance in sixty diagnosed patients of type II DM. Similar tests were performed in age matched healthy controls. Blood samples were collected for blood glucose fasting, postprandial levels and Hb1AC in both the groups. Comparisons between patients and controls, and correlations were done by applying suitable tests. Results: The hand grip muscle strength and endurance in type II DM patients were significantly lower as compared to the normal controls (P < 0.05, P < 0.001). There was no correlation between the hand grip muscle strength and endurance with HbA1c and the duration of the disease in the patients of type II DM (P > 0.05). Conclusions: The present study shows that type II DM patients suffer from skeletal muscle dysfunction in the form of reduced hand grip strength and endurance. Hence the treating Physician should not be ignorant about these disabilities. In addition to the strict measures to control the blood glucose levels, interventions to improve the muscle mass and strength in these patients should be undertaken.