Symptoms In Diabetic Patients Research Articles

Obsessive-compulsive disorder, insulin signaling and diabetes – A novel form of physical health comorbidity: The sweet compulsive brain

BackgroundWhile a growing body of research highlights a bi-directional link between diabetes and mood disorders, little is known about the relationship between diabetes and obsessive-compulsive disorder (OCD). The aim of the present review is to investigate current evidence linking OCD, insulin-signaling and diabetes. MethodsA PubMed search was conducted to review all the available studies assessing diabetes, glucose metabolism and insulin-signaling in OCD patients and vice versa. ResultsSome clinical and epidemiological studies show a higher prevalence of diabetes in OCD and vice versa compared to the general population. Animal and genetic studies suggest a possible role of insulin-signaling in the pathophysiology of OCD. Deep brain stimulation (DBS) studies suggest that abnormal dopaminergic transmission in the striatum may contribute to impaired insulin sensitivity in OCD. While DBS seems to increase insulin sensitivity, a possible protective role of serotonin reuptake-inhibitors on diabetic risk needs further studies. ConclusionDespite their preliminary nature, these data highlight the importance of further investigations aimed at assessing metabolic features in OCD patients and OCD symptoms in diabetes patients to understand the impact of each condition on the pathophysiology and course of the other. Understanding the role of insulin in the obsessive-compulsive brain could open new treatment pathways for OCD.

COVID-19 Risk Prediction for Diabetic Patients Using Fuzzy Inference System and Machine Learning Approaches.

Individuals with pre-existing diabetes seem to be vulnerable to the COVID-19 due to changes in blood sugar levels and diabetes complications. As observed globally, around 20–50% of individuals affected by coronavirus had diabetes. However, there is no recent finding that diabetic patients are more prone to contract COVID-19 than nondiabetic patients. However, a few recent findings have observed that it could be at least twice as likely to die from complications of diabetes. Considering the multifold mortality rate of COVID-19 in diabetic patients, this study proposes a COVID-19 risk prediction model for diabetic patients using a fuzzy inference system and machine learning approaches. This study aimed to estimate the risk level of COVID-19 in diabetic patients without a medical practitioner's advice for timely action and overcoming the multifold mortality rate of COVID-19 in diabetic patients. The proposed model takes eight input parameters, which were found as the most influential symptoms in diabetic patients. With the help of the various state-of-the-art machine learning techniques, fifteen models were built over the rule base. CatBoost classifier gives the best accuracy, recall, precision, F1 score, and kappa score. After hyper-parameter optimization, CatBoost classifier showed 76% accuracy and improvements in the recall, precision, F1 score, and kappa score, followed by logistic regression and XGBoost with 75.1% and 74.7% accuracy. Stratified k-fold cross-validation is used for validation purposes.

Diabetes and Depression: A Bidirectional Phenomenon

Diabetes mellitus is a strong molecular etiological upstream event that leads to different pathological problems like Cardio-vascular disease, nephropathy, neuropathy, retinopathy, hearing loss, and immunological disturbances, the most common of which is depression. Diabetes and depression relationship is thought to be bidirectional, meaning that depression can lead to diabetes and diabetes can assist the onset of depression. Depression is one of the most overlooked symptoms in diabetes patients, and it is strongly related to a decline in quality of life. Several pathological links are discussed in this review, including dysregulation of the hypothalamic pituitary-adrenal (HPA) axis and neurotransmitter systems, particularly the monoaminergic system, the role of oxidative stress, neuroinflammation, and cell death, impaired neurogenesis and BDNF synthesis, particularly in the hippocampus and prefrontal cortex, brain areas that regulate emotional behaviour, and finally, epigenetic factors.

The BENAR RELAXATION THERAPY (BRT) DECREASING PSYCHOLOGIC SYMPTOMS IN DIABETES TYPE II IN CANDIBINANGUN DISTRIC

Diabetes prevalence in Yogyakarta is the second highest in Indonesia, and Diabetes sufferers are prone to experiencing physical and psychological disorders. Psychological disorders such as depression, stress, and anxiety are more at risk in Diabetes patients. This condition will be worsen the prognosis and outcome, so managing psychological disorders in Diabetes patients is essential. One of the efforts to manage mental disorders in Diabetes patients is non-pharmacological therapy such as Benar Relaxation Therapy (BRT). It combining between aromatherapy and Benson relaxation techniques which is effective for mild and moderate anxiety therapy. In this study, the BRT try to test the effectivity stress, anxiety, until depression. This therapy using three sickles of therapy and the dose of the aromatherapy was three drops in 20 ml of sterile water which formulated by the researcher. The aim study is evaluate the effect of Benar Relaxation Therapy (BRT) in reducing psychological symptoms in diabetes patients. This study did Quasi-experimental research with a pre-posttest without control group design. 14 adults Diabetes patients who ADL independently and have cellphones with video features in Candibinangun district purposively taken to this study. For three consecutive days, patients received therapy for 15 minutes. Their psychological symptoms were measured using the DASS 21 and PSQI questionnaires. Meanwhile, the measurement of physiological symptoms is to measure blood pressure, pulse, and blood glucose. The data processed using the T-test and Wilcoxon test according to the results of data normality. The results showed that Benar Relaxation Therapy effectively reduced psychological symptoms in the form of depression (p = 0.038) and improved sleep quality (p = 0.042). Physiologically, this therapy was also effective in lowering blood pressure (p = 0.00). However, this therapy is not significant in reducing psychological and physiological symptoms in stress, anxiety, pulse, and blood glucose levels. The conclusions is the Benar Relaxation Therapy in this study was effective in lowering depression scores and blood pressure. This therapy also improves the quality of sleep in type 2 Diabetes patients. However, this therapy significantly increases the patient's stress and anxiety and has no significant effect on pulse and blood glucose levels.
 Keywords: Benar Relaxation Therapy; Psychologic Symptoms

415-P: Prevalence of Gastroparesis Symptoms in Diabetic Patients in the Western Region of Saudi Arabia, 2019

Gastroparesis is a well-established diabetes complication with conflicting data regarding its prevalence. Gastroparesis impacts quality of life, increases direct health-care costs and is associated with morbidity and mortality. Other possible consequences include erratic glycemic control, alteration in drug absorption and hypoglycemia. Objectives: To estimate the prevalence of diabetic gastroparesis symptoms in T2DM patients attending PHC centers and to determine the associated factors Methods: A cross sectional study which included a representative sample of patients attending PHC centers of the Ministry of National Guards Health Affairs, Western Region-Saudi Arabia. Simple random sampling technique was adopted to select the study population. Patient interviewing technique was adopted to fill the Arabic version of GSCI. Information on demographics and personal characteristics, diabetes duration, type of treatment and other variables were obtained. Results: The study involved 365 participants, 66.3% were females, 52.9% aged 40-59 years and 31.8% with disease duration 10-20 years. A GCSI with a score of ≥ 1.9 was used to diagnose gastroparesis symptoms. Prevalence of gastroparesis symptoms was 7.9%. The most frequent symptoms were bloating (34.8%) then stomach fullness (26.6%) and the least frequent was vomiting (4.1%). The most frequently used agent was metformin (84.9%). 47.1% of participants had HbA1C between (7-9%) and 37.9% of them have gastroparesis symptoms (p 0.318). 69% of participants with gastroparesis symptoms were using metformin (p 0.012). 10.3% of participants with gastroparesis symptoms were not using any diabetes medications (p 0.037). 25% of participants with CHD had gastroparesis symptoms (p 0.001). Conclusion: Up to our knowledge, this is the 1st local multi-city and primary care-based study. The prevalence of gastroparesis symptoms was 7.9%. Gastroparesis symptoms were significantly associated with the use of metformin, CHD and participants not on any medication. Disclosure A. A. Bukhari: None. M. M. Alsayari: None.

Prevalence and Risk Factors of Sensory Symptoms in Diabetes Patients in Taiwan.

BackgroundDiabetic sensory neuropathy has rarely been studied in the Asian populations. This study investigated the prevalence and risk factors of sensory symptoms (SS) in the Taiwanese diabetes patients.MethodsA total of 1,400 diabetes patients received a health examination together with a structured questionnaire interview for three categories of abnormal sensation of numbness or tingling pain, electric shock, and skin thickness sensation on seven anatomical sites on upper limbs and six sites on lower limbs. Prevalence of SS was defined using nine different criteria, with the least stringent criterion of “any positive symptom on at least 1 site” and the most stringent criterion of “any positive symptom on at least bilateral and symmetrical 2 sites involving the lower limb.” Logistic regression was used to estimate the odds ratios and their 95% confidence interval for SS by the different definitions. Fasting plasma glucose and hemoglobin A1c were entered in separate models to avoid hypercollinearity.ResultsThe prevalence of SS was 14.4 and 54.0% when using the most stringent and least stringent criterion, respectively. Women consistently had a significantly higher prevalence than men did. Among the three categories of symptoms, numbness or tingling pain was the most common, and fingers and toes were the most commonly involved anatomical sites. For any symptoms, 37.1% of the patients had any symptoms on the upper limbs and 41.7% had any symptoms on the lower limbs. Female sex, diabetes duration, hemoglobin A1c, and hypertension were associated with SS in all models.ConclusionsTaiwanese diabetes patients may have a high prevalence of SS if a structured questionnaire is used for screening. Female sex, diabetes duration, hemoglobin A1c, and hypertension are associated with SS.

Association between BDNF Polymorphism and Depressive Symptoms in Patients Newly Diagnosed with Type 2 Diabetes Mellitus.

PurposeLittle is known about the relationship between brain-derived neurotrophic factor (BDNF) gene polymorphisms and psychiatric symptoms in diabetes patients. We investigated the effects of BDNF Val/66/Met polymorphism, glucose status, psychological susceptibility, and resilience on anxiety and depression symptoms in patients newly diagnosed with type 2 diabetes mellitus (T2DM).Materials and MethodsWe examined biochemical factors and BDNF polymorphism in 89 patients who were newly diagnosed with T2DM. Psychiatric symptoms were investigated with the Hospital Anxiety and Depression Scale (HADS), and the Connor-Davidson Resilience Scale (CD-RISC) and Impact of Event Scale (IES) were used to assess psychological resilience and susceptibility to psychological distress, respectively. Logistic regression analyses were conducted to investigate factors associated with psychiatric symptoms.ResultsWe determined that 62 patients (70%) were Met-carriers. No significant differences were found between the Val/Val homozygous and Met-carrier groups regarding age, sex, body mass index, and clinical factors related to glycemic control and lipid profiles. HADS-anxiety and HADS-depression scores and IES factor scores were higher in the Met-carrier than the Val/Val homozygous group. Hemoglobin A1c (HbA1c) level was significantly inversely correlated with the severity of depressive symptoms. Resilience factors showed significant inverse correlations, and IES factors showed positive correlations with depressive symptom severity. In the logistic regression analysis model, depressive symptoms were significantly associated with HbA1c and BDNF polymorphism, whereas only the hyperarousal factor of the IES scale was associated with anxiety.ConclusionDepressive symptoms are associated with the presence of the Met-carriers and lower HbA1c in patients newly diagnosed with T2DM.

The increase of neuropathic symptoms in diabetic patients is related with osteopenia.

To investigate the relationship between the intensity of neuropathic pain and the severity of osteopenia in type 2 diabetic patients with painful diabetic peripheral neuropathy (painful DPN). In 220 patients with type 2 diabetes included in the screening, the presence of neuropathic pain was evaluated using the Douleur Neuropathique 4 Questions (DN4) scoring system. One hundred forty-five patients with painful DPN were identified and included in the study. Socio-demographic and laboratory evaluations were made and bone mineral density (BMD) of these patients was evaluated by the dual-energy x-ray absorptiometry (DEXA) method. There was a significant correlation between the neuropathic pain score and the total T scores of the lumbar spine and femur in patients with painful DPN. According to the regression analysis (standard coefficients), the DN4 score (0.498); the level of vitamin D (- 0.246) and the female sex (0.236) for the lumbar spine region; age (0.387); DN4 score (0.261); and vitamin D level (- 0.155) for the femur region were independently influencing factors on the development of osteoporosis. When osteoporosis (T score ≤ - 2.5) of the lumbar spine was analyzed by binary logistic regression, the risk of osteoporosis in women was 4.4 times higher, and the risk increased with increasing DN4 score. The increase of neuropathic symptoms in patients with DPN is an effective and important factor in the development of diabetic osteopenia.

Low brain-derived neurotrophic factor protein levels and single-nucleotide polymorphism Val66Met are associated with peripheral neuropathy in type II diabetic patients.

Studies by our group demonstrated brain-derived neurotrophic factor (BDNF) levels in blood and BDNF-Val66met-SNP as potential biomarkers in chemotherapy-induced peripheral neuropathy. Here, we evaluate symptoms of peripheral neuropathy (PN) and depression in patients with type II diabetes mellitus in search of an association with serum BDNF levels and the Val66Met-SNP. In total, 90 patients enrolled in the study; 23 (25.6%) had known PN, as determined by nerve conduction studies (NCS-PN), and 67 (74.4%) were not diagnosed with PN (U-PN). PN symptoms were assessed and graded in these groups using the total neuropathy score (TNSr) and DN4 scales. Small nerve fiber testing of sensitivity thresholds to cold, warm and hot pain signals was performed using the Q-sense device. Depression was assessed using the PHQ9 questionnaire. BDNF protein levels and Val66Met-SNP were determined with ELISA and Sanger sequencing, respectively. NCS-PN patients showed lower serum BDNF levels alongside significantly higher TNSr, DN4 and PHQ9 scores and lower hot pain sensitivity thresholds as compared to U-PN patients. Patients with Met-BDNF-SNP showed increased TNSr scores and lower hot pain sensitivity thresholds as compared to patients with Val-BDNF-SNP. Depression showed a weaker correlation with sensitivity thresholds to hot pain signals as compared to TNSr and DN4 scores. Diminished peripheral BDNF resources and Met-BDNF-SNP genotype are associated with augmented symptoms of PN in patients with type II diabetes mellitus. Sensitivity thresholds to hot pain signals may be less influenced by depression and possibly more accurately detect PN symptoms in diabetic patients.

Prevalence of Depressive Symptoms in Patients with Type 1 and 2 Diabetes Mellitus.

PurposePatients with diabetes are at increased risk of developing depression. The aim of the study was to determine the occurrence of depressive symptoms in patients with type 1 (T1DM) and type 2 diabetes (T2DM), including the association with different independent sociodemographic and clinical variables.Patients and MethodsThe studies were carried out on 618 people, including 115 patients with T1DM and 215 patients with T2DM and 288 people without diabetes constituting two control groups. Subjects were characterized in terms of sociodemographic, clinical and biochemical aspects, and the occurrence of depressive symptoms using Beck Depression Inventory (BDI) was determined. In the logistic regression analysis, the correlations between BDI score and with independent variables such as sex, age, body mass index, duration of diabetes, HbA1c level, diabetic complications and mean arterial pressure were examined.ResultsThe mean BDI score was significantly higher in women and men with T1DM and T2DM compared to controls. In diabetic patients, depressive symptoms occurred more often in women than in men. Among patients with T1DM, the incidence of depressive symptoms was 17.5% of the women and 8.6% of the men and in patients with T2DM, the incidence of depressive symptoms was revealed in 28.9% of the women and in 19.8% of the men. In patients with T1DM and T2DM, the occurrence of depressive symptoms increases with age, HbA1c level and complications, and the risk of depressive symptoms turned out to be almost three times higher in women than in men with T2DM.ConclusionThe prevalence of depressive symptoms in diabetic patients is higher than in non-diabetics. Depressive symptoms account for 13% of the patients with T1DM and 24.7% of the patients with T2DM. The risk of depressive symptoms in T1DM and T2DM increases with age, HbA1c level and the presence of complications, and it is gender-related in T2DM only.

Exocrine pancreatic insufficiency and causes of abdominal symptoms in diabetes patients.

The pancreas has dual functions, endocrine and exocrine, that complement each other and work closely together, contributing to the digestion, absorption, and metabolism of foods. More than a decade ago, it was demonstrated that pancreatic exocrine insufficiency occurs in a significant number of patients with diabetes mellitus. Diabetes mellitus affects virtually every organ system in the body, and the degree of organ involvement depends on the duration and severity of the disease, as well as other co-morbidities. Gastrointestinal side effects include pancreatopathy, small intestinal bacterial overgrowth, oesophageal dysmotility, gastroesophageal reflux disease, gastroparesis, neuropathy, and nonalcoholic fatty liver disease.

Gastrointestinal symptoms in patients with diabetes mellitus and non-diabetic: A cross-sectional study in north of Iran

Background and aimGastrointestinal (GI) symptoms are common in patients with diabetes mellitus (DM), which involved in high cost of health care and low quality of life. The aim of this study to investigate the prevalence of GI symptoms in diabetic patients referred to the Gastrointestinal and Liver Diseases Research Center (GLDRC), Guilan University of Medical Sciences (Rasht, Iran) using a validated questionnaire. MethodsIn this descriptive, cross-sectional study, 255 diabetic patients and 255 non-diabetic subjects were recruited. Participants were randomly selected. The questionnaire recorded GI symptoms among the study population. ResultsGI symptoms were reported in 91.4% of diabetic patients, and 42.1% of them were male. The common GI symptoms in diabetic patients were flatulence (33.0%), followed by retrosternal pain (14.9%), belching (13.7%), postprandial fullness (12.5%), and constipation (11.4%). Retrosternal pain, constipation, flatulence, loss of appetite, and abdominal distention were more prevalent in diabetic women than men. ConclusionsDM is associated with high prevalence rate of upper and lower GI symptoms. This effect may be linked to gender and poor glycemic control in diabetic patients, but not to type and duration of diabetes.

3-Mercapto-5H-1,2,4-Triazino[5,6-b]Indole-5-Acetic Acid (Cemtirestat) Alleviates Symptoms of Peripheral Diabetic Neuropathy in Zucker Diabetic Fatty (ZDF) Rats: A Role of Aldose Reductase.

Peripheral neuropathy is the most prevalent chronic complication of diabetes mellitus. Good glycemic control can delay the appearance of neuropathic symptoms in diabetic patients but it is not sufficient to prevent or cure the disease. Therefore therapeutic approaches should focus on attenuation of pathogenetic mechanisms responsible for the nerve injury. Considering the role of polyol pathway in the etiology of diabetic neuropathy, we evaluated the effect of a novel efficient and selective aldose reductase inhibitor, 3-mercapto-5H-1,2,4-triazino[5,6-b]indole-5-acetic acid (cemtirestat), on symptoms of diabetic peripheral neuropathy in Zucker Diabetic Fatty (ZDF) rats. Since the age of 5months, male ZDF rats were orally administered cemtirestat, 2.5 and 7.5mg/kg/day, for two following months. Thermal hypoalgesia was evaluated by tail flick and hot plate tests. Tactile allodynia was determined by a von Frey flexible filament test. Two-month treatment of ZDF rats with cemtirestat (i) did not affect physical and glycemic status of the animals; (ii) partially inhibited sorbitol accumulation in red blood cells and the sciatic nerve; (iii) markedly decreased plasma levels of thiobarbituric acid reactive substances; (iv) normalized symptoms of peripheral neuropathy with high significance. The presented findings indicate that inhibition of aldose reductase by cemtirestat is not solely responsible for the recorded improvement of the behavioral responses. In future studies, potential effects of cemtirestat on consequences of diabetes that are not exclusively dependent on glucose metabolism via polyol pathway should be taken into consideration.

A prospective, observational study of prevalence of various autonomic dysfunction related symptoms in diabetic patients at a tertiary care hospital in south India

A prospective, observational study of prevalence of various autonomic dysfunction related symptoms in diabetic patients at a tertiary care hospital in south India

Evaluation of health utility values for diabetic complications, treatment regimens, glycemic control and other subjective symptoms in diabetic patients using the EQ-5D-5L.

This study aimed to reveal health utility values for diabetic complications and treatment regimens with adjustment for glycemic control and other clinical manifestations in a diabetic population. The EuroQol 5-Dimension 5-Level (EQ-5D-5L) health utility values for 4963 Japanese diabetic patients were analyzed using a multivariate regression model including major complications and treatment regiments (minimally adjusted model), and that additionally included glycemic control and other subjective symptoms (musculoskeletal, dental, respiratory, gastrointestinal, urinary, and cutaneous symptoms, and hearing impairment) (further adjusted model). The mean utility value was 0.901 ± 0.137. In the minimally adjusted model, blindness, overt nephropathy, regular dialysis, cardiac symptom, sequelae of stroke, symptomatic peripheral neuropathy, decreased sensation, claudication, foot ulcer/gangrene, major amputation, and complex treatment regimens were significantly associated with lower utility values, whereas proliferative retinopathy without blindness, coronary artery disease without cardiac symptom, sequela-free cerebrovascular disease, asymptomatic peripheral artery disease, and minor amputation were not. Major complications and treatment regimens that showed significant association in the minimally adjusted model still presented significant impact on the utility decrement in the further adjusted model. However, most of their regression coefficients were lower in absolute value compared to those in the minimally adjusted model. The utility decrement related to each diabetic complication varied with its severity and accompanying symptoms. Complex treatment regimens were independently associated with lower utility values. The utility decrement associated with diabetic complication and complex treatment regimens would be overestimated in the analysis without adjustment for glycemic control or other subjective symptoms.

Low-Level Laser Therapy to the Major Salivary Glands Increases Salivary Flow and MUC5B Protein Secretion in Diabetic Patients with Hyposalivation: A Preliminary Study

Background: To investigate the effect of low-level laser therapy to salivary gland function in diabetic patients with hyposalivation. Methods: Twelve diabetic patients were recruited. A 940-nm indium-gallium-arsenide-phosphide low-power semiconductor diode laser was used to stimulate the major salivary glands with an irradiation time of 40 s; this was done three times a week for 2 consecutive weeks. Patients were given questionnaires related to dry mouth symptoms. Salivary flow rates, questionnaire responses as well as MUC7, MUC5B and histatin 5 protein salivary concentrations were assessed at the first and sixth visits after laser therapy as well at the 6-week follow-up visit. Results: The unstimulated salivary flow rate and MUC5B concentration at the follow-up visit significantly increased (p < 0.01). Histatin 5 concentration significantly decreased at the follow-up visit compared with that at the first visit (p < 0.05). The mean dry mouth score revealed a significant decrease in dry mouth symptoms at the sixth visit and follow-up visit compared with those at the first visit (p < 0.001). The positive correlation between dry mouth score and flow rate was the strongest at the sixth visit (rs = 0.549). Conclusions: Low-level laser therapy increased the salivary flow rate and decreased dry mouth symptoms in diabetic patients.

Diabetes-induced colonic slow transit mediated by the up-regulation of PDGFRα+ cells/SK3 in streptozotocin-induced diabetic mice.

A major complication related to gastrointestinal (GI) symptoms in diabetic patients is chronic constipation. Constipation has serious negative impacts on quality of life; however, without a comprehensive understanding of the disease, currently available treatments cannot provide a cure. Platelet-derived growth factor receptor alpha-positive cells (PDGFRα+ cells), which form the SIP syncytium with interstitial cells of Cajal and smooth muscle cells, play important roles in GI motility. In the present study, the contributions of PDGFRα+ cells to diabetes-induced colonic slow transit were investigated in streptozotocin (STZ)-induced diabetic mice. Western blotting, quantitative PCR, contractile experiments, and intracellular recording were used in the present study. The results demonstrated that the colon length was increased in STZ-treated mice. The colonic transit of artificial fecal pellets in vitro was significantly delayed in STZ-treated mice. The mRNA and protein expression of PDGFRα, small-conductance Ca2+ -activated K channels (SK3), and P2Y1 receptors were increased in the colons of STZ-treated mice. In contractile experiments, the colonic smooth muscles were more sensitive to the SK3 agonist and antagonist (CyPPA and apamin) and the P2Y1 agonist and antagonist (MRS2365 and MRS2500) in STZ-treated mice. Intracellular recordings showed the responses of membrane potentials in colonic smooth muscle cells to CyPPA, apamin, MRS2365, and MRS2500 were more sensitive in STZ-treated mice. The electric field stimulation-induced P2Y1/SK3-dependent fast inhibitory junctional potentials (fIJPs) of colonic smooth muscles were more significantly hyperpolarized in STZ-treated mice. These results suggest that the purinergic neurotransmitters/P2Y1/SK3 signaling pathway is up-regulated in the diabetic colons, thereby mediating diabetes-induced colonic slow transit.

Gastrointestinal symptoms in diabetic patients - diabetic exocrine pancreatopathy or small intestinal bacterial overgrowth?

Gastrointestinal symptoms in diabetic patients - diabetic exocrine pancreatopathy or small intestinal bacterial overgrowth?

Electroacupuncture combined with mosapride alleviates symptoms in diabetic patients with gastroparesis.

The present study compared the clinical effectiveness of electroacupuncture (EA), monotherapy and combination therapy involving the administration of EA and mosapride in diabetic patients with severe or mild symptoms suggestive of gastroparesis. A total of 56 patients with type 2 diabetes who had symptoms suggestive of gastroparesis for >3 months were divided into two groups according to the Gastroparesis Cardinal Symptom Index (GCSI) score, including 33 in the mild group (GCSI score <3.5) and 23 in the severe group (GCSI score ≥3.5). Initially, all patients received EA monotherapy for 14 days. An effective response was defined as a reduction of the overall baseline GCSI score by >25% after treatment. The non-responding patients then received a combination treatment with EA and mosapride. Gastric emptying was assessed by the 13C-octanoic acid breath test at the beginning and end of each treatment session. Two patients in the severe group dropped out of the study during the initial treatment session. The results revealed that 34 early-responding patients (30 from the mild group and 4 from the severe group) treated with EA monotherapy, and 20 non-early-responding patients receiving combination therapy with EA and mosapride showed clinically significant improvements. Analysis of data from the mild subgroup demonstrated that EA treatment specifically improved symptoms of nausea, vomiting, stomach fullness, excessive fullness and bloating. There was no statistically significant difference in the gastric half-emptying time among patients prior to and after EA monotherapy. These preliminary results suggested that EA may be an option for improving mild symptoms in patients with diabetic gastroparesis, whereas combination therapy involving EA and pharmaceutics is required in patients with severe symptoms.

An attempt to identify factors determining the prevalence and intensity of depression in patients with diabetes in Polish population — preliminary report

Introduction. Diabetes is included in the group of metabolic diseases. According to the estimates of the World Health Organization (WHO) the global number of patients suffering from diabetes has increased to 387 million in just 11 years. 5% of Polish society, which is about 2 million, is diagnosed with this particular illness in Poland. Metabolic disorders occur 2 to 3 times more often in patients with mental diseases than in the general population. Often diabetes is accompanied by depression making it a chronic illness. Aim. The aim of the study is to identify factors determining the prevalence and intensification of depression in patients suffering from diabetes. Material and methods. The study included 100 patients with diabetes in the Subcarpathian region, who are being treated in specialist clinics. The study was conducted from 12th to 20th April 2016 using an original questionnaire. Verification of differences was performed by means of chi-square test of independence and U Manna-Whitney test, applying the significance level at p < 0.05. Calculations were performed using SPSS. Results. The average age of the respondents was 41.25 years, SD = 15.38. The prevalence of depression in family history was pointed by 31% of responders and 40.0% of them declared permanent psychiatric consultations. Depression was diagnosed in 25.0% of the diabetic patients. Among the symptoms observed the respondents enumerated fatigue, lack of energy, lack of motivation to make any effort (60.0%). Depression was treated more often among patients treated for diabetes for over 20 years (53.8%). Conclusions. The prevalence of depression symptoms was observed by all of the patients in the study. The most common ones included fatigue, lack of energy and lack of motivation to make any effort. More men than women stated that they were consulting a psychiatrist. The patients who suffered from diabetic complications are more eager to consult a psychiatrist and undergo the treatment for depression. Fluctuations of blood glucose may have an impact on depression symptoms in diabetic patients.