Han Dongwook
Department of Physical Therapy, College of Medical and Life Science, Silla University.
J Phys Ther Sci. 2013 Sep;25(9):1063-6. doi: 10.1589/jpts.25.1063. Epub 2013 Oct 20.
[Purpose] This study was performed to discover the possible onset time of diabetic neuropathy by age of diabetic patients, and to provide the knowledge necessary for preventing or managing diabetic neuropathy. [Subjects] The subjects of this study were outpatients who visited D Hospital Department of Neurology with complaints of significant neuropathic symptoms including dullness, numbness and paraesthesia. [Methods] Stimulations of 5 Hz, 250 Hz and 2,000 Hz were generated with a Neurometer CPT (Neurotron Inc., Baltimore, MD, USA) and delivered selectively to C fibers, A-delta fibers and A-beta fibers. The intensity of the stimulations of 5 Hz, 250 Hz and 2,000 Hz was incrementally increased as much as 0.01 mA. [Result] The results of this experiment show that the period of retrogression of nervous fibers was different significantly according to the age of patients with diabetes mellitus. Especially, in the case of individuals in their 50's, Aβ, Aδ, and C fibers in both the right and left lower limbs significantly changed within a period of 2 months. In the case of individuals in their 60's, Aβ and C fibers of the right lower limb meaningfully changed 2 months after the onset of the disease, and Aβ, Aδ, and C fibers of the left lower limb also significantly changed within a period of 2 months. [Conclusion] We discovered that patients suffering from DM especially in their 50's or 60's should be thoroughly followed for their condition, right from the onset of DM, in order to prevent the retrogression of nervous fibers.
[目的] 本研究旨在通过糖尿病患者的年龄来发现糖尿病神经病变可能的发病时间,并提供预防或管理糖尿病神经病变所需的知识。[对象] 本研究的对象是因出现包括迟钝、麻木和感觉异常等明显神经病变症状而前往D医院神经科就诊的门诊患者。[方法] 使用Neurometer CPT(美国马里兰州巴尔的摩市Neurotron公司)产生5Hz、250Hz和2000Hz的刺激,并选择性地传递至C纤维、A-δ纤维和A-β纤维。5Hz、250Hz和2000Hz刺激的强度以0.01mA的幅度递增。[结果] 本实验结果表明,神经纤维退变的时期因糖尿病患者的年龄而有显著差异。特别是,50多岁的个体,双侧下肢的Aβ、Aδ和C纤维在2个月内显著变化。60多岁的个体,发病2个月后右下肢的Aβ和C纤维有明显变化,左下肢的Aβ、Aδ和C纤维在2个月内也显著变化。[结论] 我们发现,尤其是50多岁或60多岁的糖尿病患者,从糖尿病发病起就应密切关注其病情,以防止神经纤维退变。