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Biomedical subjects

I Cicmir

Publications and source records attributed to I Cicmir.

8 recordsLinked to original sources
PubMed1988

The natural course of peripheral and autonomic neural function during the first two years after diagnosis of type 1 diabetes.

Motor and sensory nerve conduction velocities (MNCV, SNCV), beat-to-beat variation (BBV) at rest, speed of pupillary dilation (SPD), and pupillary latency time (PLT) were measured in 32 patients aged 12-36 years after 19 +/- 2 (mean +/- SEM) days and again after 3, 12, and 24 months of insulin treatment. Moreover, BBV under deep respiration was determined after 12 and 24 months, and thermal discrimination thresholds (TDT) as well as pain and vibration perception thresholds (PPT; VPT) were evaluated after 24 months. Mean HbA1 levels during months 3-24 within the normal range (7.2 +/- 0.2%; mean +/- SEM) were observed in 20 patients (group 1), while in 12 patients (group 2) mean HbA1 of months 3-24 was elevated (10.1 +/- 0.4%). There were no significant differences between both groups with regard to the nerve function tests at baseline and after 3 months. After 12 months mean median MNCV and median, ulnar, and sural SNCV were significantly lower in group 2 than in group 1 (p less than 0.05). After 24 months mean median MNCV, peroneal MNCV, median SNCV, and sural SNCV as well as both BBV tests and PLT were significantly impaired in group 2 as compared to group 1 (p less than 0.05). In addition, mean malleolar VPT and PPT to heat and cold stimuli on the thenar and the foot were significantly elevated in group 2 as compared to group 1 (p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1988

Faecal incontinence in diabetes mellitus: is it correlated to diabetic autonomic or peripheral neuropathy?

Faecal incontinence is a frequent manifestation of diabetic enteropathy. The purpose of this study was to determine whether faecal incontinence in diabetes mellitus correlates with manifestations of diabetic autonomic or peripheral neuropathy at other organ sites. In 12 incontinent and 15 continent diabetics stool frequency and stool continence, basal and squeeze anal sphincter pressures, and continence to rectally infused isotonic saline solution (1500 ml) were prospectively evaluated. These data were correlated to quantitative measures of autonomic neuropathy as assessed by heart rate variation and pupillary reflex response to light, and to quantitative measures of peripheral neuropathy as assessed by nerve conduction velocity and sensitivity to vibration. Incontinent diabetics exhibited decreased basal and squeeze anal sphincter pressures, and reduced continence for fluid compared to their continent controls. The degree of incontinence correlated well with the maximal volume of retained rectally infused saline solution, but neither with basal and squeeze anal sphincter pressures, nor with the severity of autonomic or peripheral neuropathy at other organ sites. It is concluded that a generalized dysfunction of the autonomic or peripheral nervous system does not play a major role in the pathogenesis of faecal incontinence in diabetes mellitus. The great overlap of basal and squeeze anal sphincter pressures in incontinent and continent diabetics raise evidence for disturbances of additional extrasphincteric factors as part of the pathomechanism of faecal incontinence in diabetes mellitus.

Adolescent↗
PubMed1988

Somatic and autonomic nerve function during the first year after diagnosis of type 1 (insulin-dependent) diabetes.

Somatic and autonomic nerve function was assessed by motor and sensory nerve conduction velocities (MNCV; SNCV), beat-to-beat variation at rest, speed of pupillary dilation, and pupillary latency time in 35 newly diagnosed type 1 diabetic patients aged 12-36 years. The nerve function tests were performed 18 +/- 2 (mean +/- SEM) days after the correction of initial ketosis and hyperglycaemia and again after 3 and 12 months of insulin therapy. Mean HbA1 levels of months 3 and 12 within the normal range less than 8.6% (mean: 7.2 +/- 0.2%) were observed in 24 patients (group 1) and greater than or equal to 8.6% (mean: 10.1 +/- 0.6%) in 11 patients (group 2). Group 1 showed no significant changes from baseline in the mean nerve conduction and autonomic functions after 3 and 12 months. In group 2 there was no change until three months, however, at 12 months there was a significant decrease in mean MNCV in the median, ulnar and peroneal nerves (p less than 0.05) and in mean SNCV in the median (p less than 0.05) and sural nerves (p less than 0.01), when compared to the baseline values. The autonomic function tests remained unchanged. No patient had symptoms of neuropathy during the period studied. These findings suggest that the deterioration of motor and sensory nerve conduction precedes that of cardiac and pupillary autonomic function in poorly controlled asymptomatic type 1 diabetic patients during the first year of the disease. Effective glycaemic control prevented progression of subclinical neuropathy, but did not reverse abnormalities which were present at diagnosis.

Adolescent↗
PubMed1987

Peripheral and autonomic nerve function in long-term insulin-dependent diabetes.

In a cross sectional study, motor nerve conduction velocity (MNCV) and sensory nerve conduction velocity (SNCV), beat-to-beat variation (BBV) at rest and speed of pupillary dilatation (SPD) have been investigated in 127 nonketonuric long-term insulin-dependent diabetics aged 19-72 yr and in age-matched control subjects. 84% of the patients had electrophysiologic abnormalities, 58% had symptomatic peripheral neuropathy, 35% had abnormal cardiac parasympathetic tests and 26% had abnormal pupillary tests. The most frequent pathologic feature was a decreased sural SNCV (66%). Among the patients without symptomatic peripheral neuropathy, 71% showed electrophysiologic abnormalities. MNCV and SNCV in median, peroneal and sural nerves correlated with BBV (p less than 0.005), but only peroneal MNCV was related to SPD (p less than 0.005). There was also a relationship between BBV and SPD (p less than 0.05). Glycosylated hemoglobin (HbA1) levels correlated inversely with median MNCV (p less than 0.001), and SNCV (p less than 0.03), peroneal MNCV (p less than 0.05) and sural SNCV (p less than 0.05). Patients with abnormal peripheral or autonomic nerve function tests or symptomatic peripheral neuropathy had significantly higher HbA1 levels than those with normal tests (p less than 0.04) or asymptomatic patients (p less than 0.01). Median MNCV and SNCV, sural SNCV and BBV deteriorated with age (p less than 0.05) and median SNCV and peroneal MNCV deteriorated with the duration of diabetes (p less than 0.001). Our findings show an association between peripheral and autonomic nerve dysfunction in long-term insulin-dependent diabetics.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1980

[The influence of clofibrate on elevated serum lactate levels in diabetic patients treated with biguanides (author's transl)].

The increments in serum lactate and ketone bodies induced by biguanides in 11 diabetics were decreased by a combined treatment with clofibrate and phenformin. Lactate concentration was nearly the same on a placebo or on the combined drug treatment. While-body weight reduction in subjects was without influence on the clofibrate-induced lowering of lactate it inhibited a decrease of ketone bodies. The effect of clofibrate on lactate was directly correlated to its serum triglyceride lowering effect. The decrease in lactate points to an improved lactate utilization. A combined clofibrate-biguanide treatment is only indicated in selected patients, predominantly in diabetics with endogenous hypertriglyceridemia, however, contraindications of both drugs have to be observed.

Adult↗