Abstract
Diabetic neuropathy (DN) is a major complication associated with diabetes mellitus (DM) and results in fatigue. We investigated whether type 2 diabetic patients with or without neuropathy experienced muscle fatigue and determined the most influencing factor on muscle fatigue. Overall, 15 out of 25 patients with type 2 DM were diagnosed with DN using a nerve conduction study in the upper and lower extremities, and the composite score (CS) was calculated. We obtained the duration of DM and body mass index (BMI) from subjects, and they underwent a series of laboratory tests including HbA1c, fasting plasma glucose, triglycerides, and high- and low-density lipoprotein. To qualify muscle fatigue, this study used surface electromyography (sEMG). Anode and cathode electrodes were attached to the medial gastrocnemius. After 100% isometric maximal voluntary contracture of plantarflexion, the root mean square, median frequency (MDF), and mean power frequency (MNF) were obtained. We showed a correlation among laboratory results, duration of DM, BMI, CS, and parameters of muscle fatigue. The duration of DM was related to fatigue of the muscle and CS (p < 0.05). However, CS was not related to fatigue. The MDF and MNF of muscle parameters were positively correlated with HbA1c and fasting plasma glucose (p < 0.05). In conclusion, we suggest that the duration of DM and glycemic control play important roles in muscle fatigue in patients with DN. Additionally, sEMG is useful for diagnosing muscle fatigue in patients with DN.
Highlights
Diabetic neuropathy (DN) is a peripheral nerve dysfunction, and one of the major complications associated with diabetic retinopathy and diabetic nephropathy [1,2]
The aim of this study was to study the correlation among various parameters, including laboratory studies, duration of diabetes mellitus (DM), body mass index (BMI), nerve conduction studies (NCS), and muscle fatigue (RMS, median frequency (MDF), and mean power frequency (MNF))
Patients with suspected or diagnosed psychological factors related to fatigue [15], spine disease, and vascular, neurological, or metabolic conditions unrelated to DM or DN were excluded This study was performed retrospectively and in accordance with the Declaration of Helsinki; the study protocol was approved by the Inha University Hospital Institutional Review
Summary
Diabetic neuropathy (DN) is a peripheral nerve dysfunction, and one of the major complications associated with diabetic retinopathy and diabetic nephropathy [1,2]. DN has a high prevalence among diabetic patients [2,3]. This is more common in patients with type 2 diabetes mellitus (DM) [2]. Fatigue is a common complication and leads to an energy imbalance [6,7], in addition to affecting the quality of life and functional status in people with type 2 DM [8,9]. Muscle fatigue is defined as a decreased maximum capacity to produce force or power output [10]. Due to its non-invasiveness nature, real-time data, and applicability, surface electromyography (sEMG) is a widely used technique to assess muscle fatigue [11,12].
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