The Effect of Peripheral Vascular Disease on Diabetic Neuropathy

OBJECTIVE: To evaluate the effect of peripheral vascular disease (PVD) on diabetic neuropathy with the use of Doppler ultrasound and electrodiagnostic study. METHOD: One hundred fifty one patients with diabetes mellitus underwent nerve conduction studies. PVD was diagnosed when ankle-brachial index (ABI) was 0.9 and less and also toe-brachial index (TBI) was 0.7 and less. Electrophysiologically normal group was subdivided into non- PVD group (A1) and PVD group (A2). Diabetic neuropathy group was subdivided into non-PVD group (B1) and PVD group (B2). The frequency of diabetic neuropathy and the difference of amplitude, conduction velocity, and F wave latency within A groups and B groups were investigated. RESULTS: Diabetic neuropathy was significantly correlated with PVD (p<0.05). There was no definite difference of electrophysiologic parameters between A1 and A2 groups. B1 group showed significantly reduced amplitude of sensory nerve action potential (SNAP) in sural nerve compared with B2 group (p<0.05). In all patients, the amplitude of SNAP in sural nerve was related with duration of diabetes and TBI by multiple linear regression analysis. CONCLUSION: This study supports the influence of PVD on diabetic neuropathy and suggests vascular abnormality in patients with diabetic neuropathy may result in predominantly axonal injury rather than demyelinating injury.

Hemodynamic Change after Half Body Bathing in Patients with Cardiovascular Risk Factor

OBJECTIVE: Nowadays half body bathing (H-bath) became popular with increasing interests of health and well-being. H-bath is expected to be beneficial and safe as well as conventional whole body bathing (W-bath). However, there has been no formal report on the safety and effectiveness of H-bath. Therefore, this study tried to evaluate and compare the cardiovascular response during H-bath and W-bath in patients with or without cardiovascular disease. METHOD: 17 subjects with at least one cardiovascular risk factor and 15 subjects without any cardiovascular risk factor took H-bath while 22 healthy control group without any cardiovascular risk factor took W-bath. Changes of skin and oral temperature as well as hemodynamic responses (systolic blood pressure, diastolic blood pressure, heart rate) were measured. RESULTS: Increasing of systolic blood pressure and heart rate in H-bath was statistically lowered compared to W-bath as time goes by in bathing (p<0.05). There were no significant difference in patients with and without cardiovascular disease. CONCLUSION: Heart rate, temperature, systolic blood pressure showed a more gradual increase during H-bath than during W-bath. We propose that H-bath could be a more safe and compliant method of cardiac rehabilitation in patients with cardiovascular disease.