Clinical characteristics of dry eye in patients with type 2 diabetic peripheral neuropathy / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To investigate the clinical features of dry eye in patients with type 2 diabetes mellitus complicated with peripheral neuropathy.METHOD: Prospective cohort study. A total of 192 patients with type 2 diabetes were enrolled in the Department of Endocrinology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine from July 2021 to March 2022. The right eyes of all patients were selected as the observation eye, among which 122 patients were diagnosed with diabetic peripheral neuropathy(DPN)and 70 patients were diagnosed with non-diabetic peripheral neuropathy(NDPN). The score of ocular surface disease index(OSDI), tear meniscus height, tear meniscus width, corneal epithelial thickness, corneal endothelial cell density, tear secretion test(Schirmer Ⅰ test, SⅠt), corneal sensitivity, meibomian gland function status score, tear film breakup time(BUT), corneal fluorescein sodium staining score and Toronto clinical scoring system(TCSS)score were compared between two groups. The correlation between OSDI score and TCSS score in type 2 diabetes patients was analyzed as well.RESULTS: The morbidity of dry eye in the DPN group(55 eyes, 45.1%)was significantly higher than that of NDPN group(20 eyes, 28.6%; χ2=5.094, P=0.024), BUT and corneal sensitivity score of DPN were lower than NDPN group(P<0.001), meanwhile, corneal staining score and meibomian gland function score were higher than NDPN group(P<0.001). OSDI scores of all subjects were negatively correlated with TCSS scores(rs=-0.233, P=0.002), and OSDI scores of DPN group were negatively correlated with TCSS scores(rs=-0.511, P<0.001), but there was no significant correlation between the two scores of NDPN patients(rs=0.007, P=0.957).CONCLUSIONS: DPN patients are more likely to develop dry eye than NDPN patients. OSDI score is not an accurate evaluation index for type 2 diabetes patients, especially for DPN patients.

Effect of resistance exercise on peripheral neuropathy in Type 2 diabetes mellitus / 中南大学学报(医学版)

OBJECTIVES@#To explore the improvement of neurological symptoms in patients with Type 2 diabetic peripheral neuropathy via resistance exercise.@*METHODS@#A total of 100 patients with Type 2 diabetic peripheral neuropathy were selected as the research objects, and they were randomly divided into an observation group who performed resistance exercise (@*RESULTS@#Compared with the control group, there was statistically difference in the TCSS scores in the observation group at 3 months (@*CONCLUSIONS@#After the intervention of resistance exercise, the blood glucose and DPN can be improved in a certain extent, and which can be popularized in Type 2 diabetes patients.

Correlation between plasma homocysteine level and impaired glucose tolerance in patients with peripheral neuropathy / 国际生物医学工程杂志

Objective To investigate the correlation between plasma homocysteine level and impaired glucose tolerance(IGT) patients in peripheral neuropathy.Methods 80 patients with IGT were selected according to the results of routine nerve conduction test,including 40 patients associated with peripheral neuropathy (IGT-PN),and 40 patients without peripheral neuropathy (IGT-NPN).Besides,40 healthy subjects were selected as control.Plasma homocysteine levels were measured in the three groups by enzyme rate method.The severity of neuropathy was scored and graded by the Toronto Clinical Scoring System (TCSS).Results Plasma homocysteine levels were significantly higher in the all IGT groups than those in the control group.The plasma homocysteine level in the IGT-PN group (14.2±2.7) μmol/L was significantly higher than that in the IGT-NPN group (12.3±2.6) μmol/L (P＜0.05).Regression analysis showed that plasma homocysteine level had independent effects on IGT with peripheral neuropathy.Plasma homocysteine level was positively correlated with TCSS score.Conclusions Plasma homocysteine may play an important role in the pathogenesis of peripheral neuropathy in patients with IGT,and their level may be associated with the severity of peripheral neuropathy.

The relationship between ultrasonic feature of lower limb peripheral nerve and Toronto clinical scoring ;system in type 2 diabetes mellitus / 实用医学杂志

Objective To evaluate the morphological changes of the small nerves in lower extremity with high-resolution ultrasonography in type 2 diabetes mellitus (T2DM). Methods 84 cases of T2DM patients were divided into four different groups according to TCSS score [group Ⅰ (0-5 point), group Ⅱ (6-8 point), groupⅢ (9-11 point), group Ⅳ (12-19 point)]. The ultrasonic feature of posterior tibial nerve, sural nerve and saphenous nerve were observed to observe the relationship between ultrasound findings and scoring. Results Abnormality rate admitted from ultrasound findings are as follows. In group Ⅳ, nerve abnormality rate was the highest, followed by group Ⅲ, group Ⅱ and group Ⅰ (P 0.05). The saphenous nerve epineurium abnormality increased in group Ⅱ and Ⅲ compared with group Ⅰ and Ⅳ(P <0.05). Abnormality rate of 3 neural ultrasound decreased in line with sural nerve, posterior tibial nerve and saphenous nerve. Conclusions Certain correlation was observed between TCSS and never ultrasonic feature in T2DM patients. The higher TCSS scores is, the greater chance of presence of abnormal sonographic features of nerves will be. The sural nerve abnormality was higher than others.