Neurological Complications Of Diabetes Mellitus Research Articles

Associated with hyperglycemia: a rare cause of hyperkinetic movement disorders

Diabetic striopathy, a neurological disorder associated with diabetes mellitus, is characterized by specific changes in basal ganglia structures, particularly the striatum. Although its precise etiology remains elusive, chronic hyperglycemia, microvascular dysfunction, oxidative stress, and inflammation are implicated. Diagnosis relies on clinical assessment and neuroimaging, revealing characteristic basal ganglia abnormalities. Management focuses on optimizing glycemic control and alleviating symptoms. We present an 83-year-old woman with abrupt-onset unilateral chorea-ballismus as a case illustration, showcasing diagnostic and therapeutic approaches. Understanding the underlying mechanisms and refining management strategies are crucial for effectively addressing this complex neurological complication of diabetes mellitus.

Open-label observational study of effectiveness and tolerability of ipidacrine in treatment of patients with diabetic polyneuropathy (DIAMANT study)

Diabetic polyneuropathy (DPN) is one of the most common complications of diabetes mellitus, leading to the development of flaccid paresis, neuropathic pain syndrome, sensitive ataxia, as well as trophic disorders in the distal parts of the lower extremities.The purpose of the randomized, open-label, comparative, prospective study was to evaluate the effectiveness and tolerability of ipidacrine in the complex treatment of patients with DPN.Materials and methods. Patients with DPN (n = 60) were randomized into 2 groups. Both groups received basic therapy (alpha-lipoic acid, B vitamins, gabapentin); in the treatment of patients of the main group (n = 30), in addition, ipidacrine was used (Ipidacrine-SZ, North Star Co., Russia). We have analyzed the intensity of pain syndrome (VAS-P), the average daily dosage of gabapentin, and the results of the neuropathic dysfunctional scale (modified version, NDSm), Pittsburgh Sleep Quality Index, PSQI), Global Rating of Change Scale (GROC), the results of electroneuromyography (ENMG). The total duration of the observation and treatment period was 2 months.Results. After 2 months of therapy in the main group of patients, compared with the control group, there was significantly more complete pain control (VAS-P: 3.0 ± 0.9 vs 3.6 ± 0.8), a decrease in the average daily dosage of gabapentin (390 vs 500 mg/day), reduction in the severity of clinical manifestations of polyneuropathic syndrome (NDSm: 4.4 ± 1.0 vs 4.9 ± 1.0 points) and improvement in sleep quality (PSQI: 6.8 ± 1.3 vs 7.9 ± 1.7). According to ENMG data, patients in the main group showed a significant improvement in the neurophysiological parameters of both motor and sensory fibers, which was significantly more pronounced compared to the control group. A significantly larger proportion of patients in the main group assessed the improvement from the therapy as ‘pronounced’ (GROC: 10/33.3 % vs 6/20.0 %).Conclusions. The use of ipidacrine in complex therapy of patients with DPN can significantly reduce the clinical manifestations of disease and improve the neurophysiological parameters of the peripheral nerves of the lower extremities. Ipidacrine can be considered as a basic drug for the treatment of patients with neurological complications of diabetes mellitus.

FRI634 Diagnostic Delay Of Diabetic Amyotrophy Is Associated With Complicated Disease Leading To Mental, Physical, And Financial Debilitation- A Case Report

Abstract Disclosure: A.J. Zaidi: None. W. Staehle: None. Introduction: Delay in diagnosis is a major problem impacting medicine, especially if pathology is not very common, like Diabetic amyotrophy. It typically presents with unilateral proximal muscle weakness and pain affecting thighs, hips and buttocks. It is relatively a rare neurological complication of Diabetes Mellitus and prediabetes, affecting approximately 1 percent of the patients. It is commonly underrecognized leading to long course to diagnosis. Case presentation: A 58 year old female presented to clinic with 5 year history of Lower back and left hip pain, slowly progressive leg weakness, with weight loss 25 pounds. Her past medical history included Type 2 diabetes mellitus with A1C 6.9, controlled by Metformin alone. She had multiple previous presentations to local primary care physicians, with unclear clinical diagnosis. She underwent several tests and imaging, was seen by neurologist, orthopedist and spine physician. Her treatments included pain regimens with N-acetylcysteine, Ibuprofen, gabapentin, tizanidine, lidocaine patch, low dose steroids, physical therapy and chiropractor visits. These provided only partial symptomatic relief. She had no other significant history, She lost her job due to being limited by her pain. Exam revealed discomfort to palpation on lower lumbar, generalized atrophy of left thigh muscles, asymmetric proximal weakness, normal sensation and reflexes. Blood work showed normal ESR, CRP, CPK, ANA, myomarker panel, Vit D levels. CSF evaluation was deferred by the patient. Imaging from previous records included Hip X-ray with mild degenerative disease, Lumbar CT with mild arthropathy on the Left L5- S1. Unremarkable lumbar and Sacral MRI. EMG revealed L4 radiculopathy with denervation of L vastus medialis and tibialis anterior, Irritation in S1 nerve root, without denervation. Based on overall investigations, and lack of evidence of alternative diagnosis, it was determined that the patient had Diabetic Amyotrophy. She refused IVIG, treated with prednisone 5mg PO oral for a month, Duloxetine and gabapentin, with significant improvement in pain and weakness. Patient was also connected with appropriate social services, physical and occupational therapy. Conclusion: Diagnostic delay of diabetic amyotrophy can lead to mental, physical, and financial debilitation. Due to low prevalence and broad differential of proximal muscle wasting, it is a challenging to diagnose and remains the diagnosis of exclusion. EMG studies with polyradiculopathy in proximal leg musculature is suggestive. Physicians should have a high clinical suspicion for diabetic amyotrophy to prevent long clinical course leading to harm to the patient. The emphasis is on creating awareness of the disease, and improving communication among clinicians and with patients, which are relatively minor investments to prevent delayed diagnosis of underrecognized complication. Presentation: Friday, June 16, 2023

A Case Report of Diabetic Striatopathy: Rare Section and Unusual Complication of Hyperglycaemia

Non-Ketotic Hyperglycaemic (NKH) Hemichorea-Hemiballismus Syndrome/Diabetic Striatopathy (DS) is a rare neurological complication of diabetes mellitus. Hemichorea can present as a manifestation of diabetes mellitus or occur in patients with poorly controlled diabetes. This case report highlights the importance of differentiating this syndrome from other intracranial pathologies, as adequate glycaemic control can lead to complete resolution of the symptoms. The authors present a case of a 65-year-old female who presented to the Emergency Department (ED) with a sudden onset of involuntary movements in the left upper and lower limbs for 30 minutes. The patient was conscious and oriented, with a General Random Blood Sugar (GRBS) of 502 mg/dL, and ketone levels of 0.1 mmol/L (normal value: less than 0.6 mmol/L). The Computed Tomography (CT) scan revealed high attenuation in the right basal ganglia, and the Magnetic Resonance Imaging (MRI) of the brain indicated T1 hyperintensity in the right basal ganglia. The patient was managed with insulin infusion and hydration. Involuntary movements completely resolved after blood sugar levels were controlled with insulin. Hyperglycaemia should be considered as a differential diagnosis in patients presenting to the ED with hemichorea.

Lysine demethylase KDM5B down-regulates SIRT3-mediated mitochondrial glucose and lipid metabolism in diabetic neuropathy.

Diabetic peripheral neuropathy (DPN) is a common neurological complication of diabetes mellitus without efficient interventions. Both lysine demethylase 5B (KDM5B) and sirtuin-3 (SIRT3) have been found to regulate islet function and glucose homeostasis. KDM5B was predicted to bind to the SIRT3 promoter by bioinformatics. Here, we investigated whether KDM5B affected DPN development via modulating SIRT3. The db/db mice and high glucose-stimulated Schwann cells (RSC96) were used as in vivo and in vitro models of DPN, respectively. Glucose level, glucose and insulin tolerance of mice were measured. Neurological function was evaluated by motor nerve conduction velocity (MNCV), tactile allodynia assay and thermal sensitivity assay. Adenosine triphosphate level, oxygen consumption rate, extracellular acidification rate, β-oxidation rate, acetyl-CoA level, acetylation levels and activities of long-chain acyl CoA dehydrogenase (LCAD) and pyruvate dehydrogenase (PDH) were detected. Methyl thiazolyl tetrazolium assay was adopted to determine cell viability. Reactive oxygen species (ROS) production was detected by MitoSox staining. Western blotting for measuring target protein levels. Molecular mechanisms were investigated by co-immunoprecipitine (Co-IP), chromatin immunoprecipitation (ChIP) and luciferase reporter assay. KDM5B was up-regulated, while SIRT3 was down-regulated in DPN models. SIRT3 overexpression or AMPK activation ameliorated mitochondrial metabolism dysfunction and ROS overproduction during DPN. KDM5B overexpression triggered mitochondrial metabolism disorder and oxidative stress via directly transcriptional inhibiting SIRT3 expression by demethylating H3K4me3 or indirectly repressing AMPK pathway-regulated SIRT3 expression. KDM5B contributes to DPN via regulating SIRT3-mediated mitochondrial glucose and lipid metabolism. KDM5B inhibition may be an effective intervention for DPN.

Diabetic neuropathy in combination with deficiency state

Diabetic polyneuropathy (DPN) is the most common neurological complication of diabetes mellitus. The most common type of DPN is distal symmetric, predominantly sensory, polyneuropathy. Chronic hyperglycemia plays a key role in DPN pathogenesis. It leads to accumulation of advanced glycation end products in tissues, including vasa nevrorum that supply peripheral nerves with oxygen. Thorough diagnostic approach to DPN is crucial for early detection of this condition. Early diagnosis and treatment slow DPN progression rates and leads to symptom reduction. Long-lasting metformin therapy may cause vitamin B deficiency. This article describes a comprehensive approach to the treatment of patient with type 2 diabetes and symptomatic diabetic and vitamin deficiency neuropathy. Apart from DM therapy, the patient received pathogenesis-based therapy of DPN with alpha-lipoic acid and a combination of vitamins B1, B6 and B12. Such pathogenesis-based approach has shown to decrease severity of DPN symptoms and reduce sensory ataxia.

Ipidacrine efficacy in diabetic polyneuropathy complex treatment: A review

Diabetic polyneuropathy (DPN) is a common neurological complication of diabetes mellitus. The most common DPN type is distal symmetric, predominantly sensory, polyneuropathy (DSPN), often accompanied by pain syndrome. This article is aimed to evaluate of ipidacrine (Ipigrix) efficacy in complex DSPN therapy. The dynamics of clinical and neurophysiological manifestations of DPN in the form of the appearance of previously absent tendon reflexes, a decrease in the area and severity of sensory disturbances, the intensity of neuropathic pain, an increase in the amplitude of motor and sensory responses in response to stimulation of peripheral nerves indicates the activation of reinnervation processes against the background of therapy using ipidacrine. Assessing the positive effect on the restoration of the structure and function of peripheral nerves, good tolerability and safety of ipidacrine (Ipigrix), it is possible to recommend the drug in patients with DSPN.

PRECLINICAL MARKERS OF NEUROPATHIC DAMAGE IN TYPE 1 DIABETES MELLITUS

Background and Aims: Diabetic neuropathy (DN) is the most common neurological complication of diabetes mellitus (DM). Although DN has been related to long-lasting disease, early signs might be appreciable after a few years from DM onset. Our study aimed to detect with clinical and multimodal neurophysiological tests the presence of DN in a group of patients with DM type 1.

Management of patients with painful diabetic neuropathy: clinical case report

Diabetic polyneuropathy is the most common neurological complication of diabetes mellitus (DM) and may affect about half of all patients with diabetes. Timely diagnosis and treatment of DPN can prevent such serious complications as limb numbness, severe pain during the day and night, foot ulceration and suppuration, amputation of the foot or toes, disability and even death. The combined approach to the treatment of DPN is the most effective and includes glycemic control, diet, optimal hypoglycemic therapy, management of cardiovascular diseases, educational conversations with patients, psychological support in the form of consultations with a psychologist or psychotherapy, and sufficient pathogenetic and symptomatic drug therapy of DPN. A clinical case of managing a patient with T2DM, DPN and cardiovascular diseases is described in detail. The interdisciplinary approach was used to treat the patient, which included the use of drug and non-drug therapies. The drug therapy of diabetes was adjusted, and medications to treat cardiovascular diseases were prescribed. Pathogenetic therapy of DPN remains a highly controversial issue. Among the drugs that affect the pathogenetic mechanisms of DPN, careful consideration was given to B vitamins and alpha lipoic acid. In the presented clinical case report, the patient was prescribed a combination drug containing vitamins B1, B6 and B12 as a pathogenetic therapy of DPN. A high priority in the treatment of DM and DPN is placed on raising awareness among patients about the causes and prognosis of the disease. Most patients with diabetes and DPN have psychological problems, symptoms of anxiety and depression about the disease, catastrophization of existing symptoms, poor adherence to medication due to feelings of despair and thoughts of the disease as incurable. In view of above factors, psychological methods appear as effective in the treatment of patients with diabetes and DPN. The cognitive behavioural therapy was used in the described clinical case as a psychological method. The use of CBT improved the patient’s emotional state, increased his adherence to medications and lifestyle recommendations. A positive effect in the form of decreased severity of neuropathic and autonomic symptoms of DPN was observed in as little as 10 days after treatment. At follow-up Week 12, the patient’s condition continued to improve and his work capacity increased.

Inflammatory biomarkers as a part of diagnosis in diabetic peripheral neuropathy.

Diabetic peripheral neuropathy (DPN), a chronic neurological complication of diabetes mellitus, remains scantily addressed area of research. Many lacunae in the temporal sequence between cause and effect of DPN still remain unfilled and therefore treatment of DPN remains unsatisfactory. This is largely due to the conventional glucocentric focus to resolve the problem. This focus over hyperglycemia should be shifted to consider, chronic low grade inflammation as the major determinant in DPN. Rapidly emerging evidences from recent studies suggest that chronic low grade inflammation leads to the activation of innate immune system response, loss of insulin signaling and insulin resistance, endoplasmic reticulum stress, mitochondrial stress, leading to production of kinases like protein kinase C, mitogen activated protein kinase and jun-N-terminal kinase, pro-inflammatory cytokines and inter leukins-1b, 2, 6 and 8, tumour necrosis factor-alpha and other chemokines, leading to DPN. These biomarkers can be early predictors of DPN and therefore should be the focus of work testing their clinical utility to identify high-risk individuals as well as perhaps to target interventions. In this paper, we would like to review all the aspects of DPN, laying greater emphasis on inflammatory biomarkers as a tool for early diagnosis of DPN and the possible research approaches to address it satisfactorily.

Management of patients with neurological complications of diabetes mellitus

The article presents a clinical case of an elderly patient who had consulted a neurologist due to rapidly developed various complications of diabetes in the form of damage to the peripheral and central nervous systems. The debut of diabetic amyotrophy two years ago in our patient was mistakenly considered as a manifestation of osteochondrosis of the lumbosacral spine. The recommended drug therapy did not reduce symptoms and caused gastrointestinal disorders, which led to the independent withdrawal of all drugs. Polypharmacy reduced the patient’s adherence to therapy and reduced the frequency of regular visits to the doctor. The article deals with the pathogenesis of the main neurological complications of diabetes (diabetic neuropathy and cognitive disorders) in elderly people with arterial hypertension. The possibility of their therapeutic correction to reduce the number of medications taken by patients is discussed. Tactics of polymorbid patients taking into account concomitant chronic diseases should include normalization of glucose levels, correction of vascular risk factors, non-pharmacological methods of treatment - lifestyle changes, diet therapy, regular moderate physical activity. The use of alpha-lipoic (thioctic) acid (Berlithion) as a lipophilic antioxidant will help to slow down the development of complications.

Cognitive impairment and distal polyneuropathy in a patient with diabetes mellitus in neurological outpatient practice

Cognitive impairment (CI) and distal polyneuropathy are the most common neurological complications of diabetes mellitus (DM) and depend not only on the severity and duration of hyperglycemia, but also on the presence of concomitant diseases. Patients with DM have one or more concomitant diseases that deteriorate the course of each other, and their joint correction improves the patient's status and quality of life. Management of DM patients requires a multidisciplinary approach at the time of diagnosis in order to prevent and identify major complications, to optimize drug therapy, and to use non-pharmacological treatments.

African Plants with Antidiabetic Potentials: Beyond Glycaemic Control to Central Nervous System Benefits.

For centuries, humans have used medicinal plants in the management of both acute and chronic diseases. Currently, the practice of using medicinal plants to manage diseases is becoming increasingly-common; especially in medium to low-income economies where the cost of, or ease of access to orthodox medications are limitations to their effective and sustained use. Diabetes mellitus is a chronic disease whose prevalence continues to increase worldwide. An aspect of diabetes mellitus that causes significant morbidity is its neurological complications, which are known to be associated with an enormous economic burden and reduction in quality of life. While research continues to demonstrate that a wide range of plants that are indigenous to Africa have significant antihyperglycaemic properties, scientific information on the neurobehavioural and/or neuromorphological effects of these plants appear to be lacking. Also, their possible benefits in the prevention or amelioration of the neurological complications of diabetes mellitus remain generally unexamined. In this narrative review, we the examine available scientific literature dealing with the neurobehavioural and/or neuromorphological profiles of selected African plants with substantiated antihyperglycaemic properties; aiming to highlight their potential applications in the prevention and management of the neurological complications of diabetes mellitus. This review demonstrates that a number of the African plants with antidiabetic properties also exhibit central nervous system effects. While the neurobehavioural and neuromorphological effects of some of these plants had been investigated in animal models of DM; their possible roles in the prevention or amelioration of the neurological complications of DM are yet to be established.

Cardiac diabetic autonomic neuropathy

The prevalence of diabetes mellitus (DM) is steadily increasing and represents a significant public health problem. At the same time, the incidence of neurological complications of diabetes mellitus, especially diabetic polyneuropathy, is increasing. Cardiac autonomic neuropathy, a form of diabetic polyneuropathy, is the most serious complication of diabetes mellitus, as it is an independent risk factor for cardiovascular complications in patients with diabetes mellitus and is associated with increased mortality. Due to prolonged asymptomatic flow, cardiac autonomic neuropathy is often diagnosed at a late stage when treatment is not very effective. A targeted search for clinical symptoms of the disease and especially the conduct of cardiovascular tests, which make it possible to diagnose the pathology at an early stage, is essential. Clinical manifestations of cardiac autonomic neuropathy, methods of clinical and instrumental diagnostics, treatment of the disease are considered in detail in the article. The clinical case of a patient with type 2 diabetes mellitus and cardiac autonomic neuropathy, represented by orthostatic hypotension, which is the most disabling symptom, is considered. On the example of a clinical case the medicamentous and non-medicamentous approaches to treatment are discussed, as well as the role of antioxidant therapy, in particular, the preparation of alpha-lipoic acid («Berlithion») in the treatment of cardiac autonomic neuropathy.

Proteasome Modulator 9 Gene rs14259 Polymorphism in Patients with Diabetic Polyneuropathy.

Introduction:Diabetic polyneuropathy (DPN) is a major chronic neurological complication of diabetes mellitus (DM) and typically presents as diabetic sensory polyneuropathy (DSPN). Whereas some patients with similar risk factors develop polyneuropathy, others don’t, which suggests that genetics plays an important role in the progression of disease. The proteasome modulator 9 gene (PSMD9) is a transcriptional regulator of the insulin gene and its variants cause beta-cell dysfunction that devastates insulin transcription. The aim of this study was to determine the correlation between PSMD9 rs14259 polymorphism and the risk of DSPN in Turkish DM patients with DPN.Methods:The study included 31 DM patients with DSPN and 29 healthy controls. All participants underwent electrophysiological investigation. In addition, DNA was isolated from peripheral blood samples for the genotyping of PSMD9 rs14259 polymorphism.Results:Mean age in the DSPN and control groups was 58.03±9.59 years and 57.62±12.32 years, respectively. There were significant differences between the DSPN and controls groups in the frequencies of the genotype for AA (n=9 and n=12, respectively), AG (n=10 and n=15, respectively), and GG (n=12 and n=2, respectively). According to the distribution of PSMD9 rs14259 polymorphism, 45.2% (n=28) of the patients and 67.2% (n=39) of the controls had the A allele, and 54.8% (n=34) of the patients and 32.8% (n=19) of the controls had the G allele, whereas the frequency of the G allele of rs14259 was significantly higher in the DSPN group (X2=1.059, P=0.015) than in the control group (OR: 2.49; 95% CI: 1.18–5.23).Conclusion:The present findings show that the GG genotype and G allele of PSMD9 rs14259 polymorphism may be associated with an increased risk of DSPN in Turkish DM patients.

DN4 QUESTIONNAIRE IN FAMILY PRACTICE FOR EVALUATION OF CLINICAL MANIFESTATIONS OF NEUROPATHIC PAIN IN TYPE 2 DIABETES PATIENTS TREATED BY LIGHT THERAPY

Background. Peripheral diabetic polyneuropathy (DPN) is one of the most frequent neurological complications of diabetes mellitus (DM). Despite the large number of pharmacological agents, its treatment is not sufficiently effective, which necessitates the search for new therapies.Objective. The aim of the study was to increase the effectiveness of treatment of neuropathic pain in the patients with diabetic polyneuropathy by incorporating procedures using polarizing polychromatic non-coherent light (Bioptron light therapy) into the complex therapy of this disease.Methods. We examined 67 patients with type 2 diabetes complicated with diabetic polyneuropathy. Patients were divided into two groups: group 1 consisted of 32 patients, who received standard treatment; group 2 comprised 35 patients, who additionally underwent 12 light therapy treatments by means of the Bioptron Physiotherapy Unit. The evaluation of neuropathic pain intensity was performed using a modified questionnaire DN4. Results. A positive clinical effect of treatment was evidenced in both groups in 12 days of treatment. In 3 months, the intensity of complaints was significantly lower (p<0.05) only in the group with additional use of polarizing light. In 6 months, the positive effect of the therapy was leveled in the patients of both groups.Conclusions. The use of the DN4 questionnaire with a modified scale for assessing the parameters of neuropathic pain can optimize its diagnosis. The light therapy procedures together with the standard complex therapy of diabetic polyneuropathy increase the clinical efficacy of neuropathic pain treatment and help to preserve the therapeutic effect within 3 months.

FACTORS INFLUENCING THE SEVERITY OF PAIN IN PATIENTS WITH PERIPHERAL DIABETIC NEUROPATHY

Objective: The principal aim of this study was to identify factors influencing the severity of peripheral diabetic neuropathy pain (PDNP), a symptom of the common neurological complication of diabetes mellitus, and peripheral diabetic neuropathy.Methods: A cross-sectional study was performed using two self-administered questionnaires among subjects recruited from outpatient clinics at Hospital Tengku Ampuan Afzan, Kuantan, Malaysia. The Neuropathic Pain-4 tool was used to evaluate the presence of PDNP, and the Short-Form McGill Pain Questionnaire (MPQ) was used to characterize and determine the severity of PDNP. Sociodemographic and clinical data were collected from the patients.Results: The MPQ indicated that most patients reported experiencing mild pain for all sensory pain descriptors other than throbbing and aching (mostly reported to be moderate) and hot-burning (mostly reported to be no pain). The severity of pain was found to be significantly related to the length of time for which the patients had suffered from diabetes in those patients who had been diagnosed over 10 years previously (p=0.04). Indian patients reported a higher severity of pain overall (p=0.04). No significant relationship was found between pain severity and any of the following factors: Type of diabetes (I or II), gender, smoking status, alcohol consumption, obesity, medication taken, or presence of other diseases.Conclusion: In this study, most patients with PDNP reported the severity of the pain to be “mild.” The pain severity may be influenced by a patient’s ethnicity and the length of time for which they have suffered from diabetes.

Study of neurological complications in relation to diabetes mellitus control and duration

Background: Diabetes mellitus (DM) is a leading cause of morbidity and mortality in all age groups in both developed and developing countries. It is associated with significant morbidity and reduces life complications. Among all complications, neurological complications are the chief destroyer and affect patients in the years of their greatest economical and social productivity. Objectives: To evaluate all neurological complications of DM, to correlate the duration of DM with this neurological complication, and prevalence of the complications on the basis of control of DM. Material and Methods: This study was conducted in a tertiary-care hospital. Fifty patients with DM were studied. Their detailed history, physical examination, and laboratory investigations were noted. Result: In this study, total 50 patients [31 males (62%) and 19 females (38%)] were studied. In this study, 64% patients with neurological complication had DM for more than 10 years. Patients with DM having HbA1c value of >7.1 indicate poor control of DM. Conclusion: Chronic neurological complications are observed more commonly in patients with type 2 DM as compared to those with type 1 DM. Neurological complications are more common with uncontrolled DM, which reflects poor glycemic control that in turn has an impact on neurological complications of DM.

Можливості нейрометаболічної терапії в лікуванні неврологічних ускладнень цукрового діабету

В огляді описується вплив нейрометаболічної терапії з використанням Актовегіну на засвоєння глюкози, а також антиоксидантний, антигіпоксантний та інші механізми дії препарату. Розглядаються можливості нейрометаболічної терапії в лікуванні неврологічних ускладнень цукрового діабету. На підставі аналізу результатів великого числа досліджень зроблено висновок про те, що Актовегін може широко застосовуватися при діабетичній полінейропатії і діабетичній енцефалопатії.

Diyabetes Mellitusta Postür, Denge ve Yürüme Bozuklukları

There are several different complications of diabetes mellitus in many body systems. Diabetic neuropathy is one of the most important neurological complication of diabetes mellitus. Neurological complications of diabetes mellitus are predisposing factors for the development of posture, gait and balance disorders and falls. These issues have been briefly reviewed in this article.