Impact of Diabetic Polyneuropathy on Ventilatory Function and Respiratory Muscle Endurance
DOI:
https://doi.org/10.61841/f5nfz288Keywords:
iabetic polyneuropathy, Pulmonary function, Respiratory muscle endurance, Spirometry, Type II diabetes.Abstract
Diabetic polyneuropathy is one of the most common complications associated with diabetes mellitus. Respiratory neuromuscular function may be affected in diabetic polyneuropathy in type II diabetes. To determine impact of diabetic polyneuropathy on ventilatory function and respiratory muscle endurance. A cross sectional study was performed on ninety type II diabetic patients and thirty matched normal subjects from both genders. Their age ranged from 40 to 60 years. The duration of illness was at least five years. The subjects were assigned into two groups; normal subjects (control group (G1) and diabetic patients (study group (G2). The study group was subdivided into three equal subgroups; (G2a) represented diabetic patients without neuropathy; (G2b) included diabetic patients with clinically diagnosed neuropathy and (G2c) included diabetic patients with confirmed neuropathy diagnosed by nerve conduction studies (NCS). Severity of diabetic polyneuropathy was assessed and rated according to Toronto Clinical Neuropathy Scoring System (TCNS) and confirmed by NCS. Ventilatory function (forced vital capacity, forced expiratory volume in one second and forced expiratory volume in one second / forced vital capacity ratio (FEVI/FVC) and respiratory muscle strength (peak expiratory flow) and endurance (maximal voluntary ventilation) were assessed by Jaeger Vyntus IOS spirometer. revealed significant decrease in all measured variables in both (G2b) and (G2c) comparing with (G1) and (G2a) except FEVI/FVC ratio which is similar in four groups. A negative correlation was observed between the scores of TCNS and all measures of respiratory functions and between the age and MVV. Diabetic polyneuropathy in type II diabetes has a negative effect on pulmonary function.
Downloads
References
1. Saeedi P, Petersohn I, Salpea P, Malanda B, Karuranga S, Unwin N, et al. Global and regional diabetes prevalence estimates for 2019 and projections for 2030 and 2045: Results from the International Diabetes Federation Diabetes Atlas. Diabetes research and clinical practice. 2019;157:107843.
2. Bansal V, Kalita J, Misra UK. Diabetic neuropathy. Postgraduate medical journal 2006;82:95-100.
3. Tesfaye S, Selvarajah D. Advances in the epidemiology, pathogenesis and management of diabetic peripheral neuropathy. Diabetes /metabolism research and reviews 2012;28:8-14.
4. Ang L, Jaiswal M, Martin C, Pop-Busui R. Glucose control and diabetic neuropathy: lessons from recent large clinical trials. Current diabetes reports 2014;14:528.
5. Pop-Busui R, Lu J, Brooks MM, Albert S, Althouse AD, Escobedo J, et al. Impact of glycemic control strategies on the progression of diabetic peripheral neuropathy in the Bypass Angioplasty Revascularization Investigation 2 Diabetes (BARI 2D) Cohort. Diabetes Care 2013;36:3208-15.
6. Pop-Busui R, Boulton AJ, Feldman EL, Bril V, Freeman R, Malik RA, et al. Diabetic neuropathy: a position statement by the American Diabetes Association. Diabetes care 2017;40:136-54.
7. Dyck PJ, Albers JW, Andersen H, Arezzo JC, Biessels GJ, Bril V, et al. Diabetic polyneuropathies: update on research definition, diagnostic criteria and estimation of severity. Diabetes/metabolism research and reviews 2011, 27:620-8.
8. Kabitz HJ, Sonntag F, Walker D, Schwoerer A, Walterspacher S, Kaufmann S, et al. Diabetic polyneuropathy is associated with respiratory muscle impairment in type 2 diabetes. Diabetologia 2008;51:191-7.
9. Van Eetvelde BL, Cambier D, Vanden Wyngaert K, Celie B, Calders P. The Influence of Clinically Diagnosed Neuropathy on Respiratory Muscle Strength in Type 2 Diabetes Mellitus. Journal of diabetes research 2018;2018.
10. Klein OL, Krishnan JA, Glick S, Smith LJ. Systematic review of the association between lung function and Type 2 diabetes mellitus. Diabetic medicine 2010;27:977-87.
11. American Diabetes Association. Diagnosis and classification of diabetes mellitus. Diabetes care 2014;37Suppl 1: S81-90.
12. Perkins BA, Olaleye D, Zinman B, Bril V. Simple screening tests for peripheral neuropathy in the diabetes clinic. Diabetes care 2001;24:250-6.
13. Bril V, Perkins BA. Validation of the Toronto Clinical Scoring System for diabetic polyneuropathy. Diabetes Care 2002;25:2048-52.
14. Bril V, Tomioka S, Buchanan RA, Perkins BA, mTCNS Study Group. Reliability and validity of the modified Toronto Clinical Neuropathy Score in diabetic sensorimotor polyneuropathy. Diabetic Medicine 2009;26:240-6.
15. Preston DC, Shapiro BE. Electromyography and neuromuscular disorders: clinical-electrophysiologic correlation. 3rd ed. Elsevier Health Sciences; 2012 p.97-124
16. England JD, Gronseth GS, Franklin G, Miller RG, Asbury AK, Carter GT, et al. Distal symmetric polyneuropathy: a definition for clinical research: report of the American Academy of Neurology, the American Association of Electrodiagnostic Medicine, and the American Academy of Physical Medicine and Rehabilitation. Neurology 2005;64:199-207.
17. Zilliox L, Peltier AC, Wren PA, Anderson A, Smith AG, Singleton JR, et al. Assessing autonomic dysfunction in early diabetic neuropathy: the Survey of Autonomic Symptoms. Neurology 2011;76:1099-105.
18. http://www.carefusion.co.uk, last access; 892019.
19. Ranu H, Wilde M, Madden B. Pulmonary function tests. The Ulster medical journal. 2011;80(2):84..
20. Cotes JE, Chinn DJ, Miller MR. Lung function: physiology, measurement and application in medicine. 6th ed. John Wiley & Sons; 2009.
21. Miller MR, Hankinson JA, Brusasco V, Burgos F, Casaburi R, Coates A, et al. Standardisation of spirometry. European respiratory journal 2005;26:319-38.
22. Tang EW, Jardine DL, Rodins K, Evans J. Respiratory failure secondary to diabetic neuropathy affecting the phrenic nerve. Diabetic medicine 2003;20: 599-601.
23. Yesil Y, Ugur-Altun B, Turgut N, Ozturk ZA, Kuyumcu ME, Yesil NK, et al. Phrenic neuropathy in diabetic and prediabetic patients without neuromuscular complaint. Acta diabetologica 2013;50:673-7.
24. Fisher MA, Leehey DJ, Gandhi V, Ing T. Phrenic nerve palsies and persistent respiratory acidosis in a patient with diabetes mellitus. Muscle & nerve 1997;20:900-2.
25. Rison RA, Beydoun SR. Bilateral phrenic neuropathies in a diabetic patient responsive to intravenous immunoglobulin: a case report. Clinical neurology and neurosurgery 2011;113:788-91.
26. De Carvalho MA, Matias T, Evangelista T, Pinto A, Luís MS. Bilateral phrenic nerve neuropathy in a diabetic patient; TO THE EDITOR. European Journal of Neurology 1996;3:481-2.
27. Rice AL, Ullal J, Vinik AI. Reversal of phrenic nerve palsy with topiramate. Journal of Diabetes and its Complications 2007;21:63-7.
28. Bhuyan AK, Baro A, Sarma D, Choudhury B. A study of cardiac autonomic neuropathy in patients with type 2 diabetes mellitus: A Northeast India experience. Indian journal of endocrinology and metabolism 2019;23:246.
29. Moususianu A, BslaGa R, Voidszan S, Bajko Z. Cardiovascular Autonomic Neuropathy in Context of Other Complications of Type 2 Diabetes Mellitus. BioMed research international 2013.
30. Ďurdík P, Vojtková J, Michnová Z, Turčan T, Šujanská A, Kuchta M, et al. Pulmonary function tests in type 1 diabetes adolescents with diabetic cardiovascular autonomic neuropathy. Journal of Diabetes and its Complications 2016;30:79-84.
31. Kaminski DM, Schaan BD, da Silva AM, Soares PP, Plentz RD, Dall’Ago P. Inspiratory muscle weakness is associated with autonomic cardiovascular dysfunction in patients with type 2 diabetes mellitus. Clinical Autonomic Research 2011;21:29-35.
32. Ryan NA, Zwetsloot KA, Westerkamp LM, Hickner RC, Pofahl WE, Gavin TP. Lower skeletal muscle capillarization and VEGF expression in aged vs. young men. Journal of applied physiology 2006;100:178-85.
33. Groen BB, Hamer HM, Snijders T, Van Kranenburg J, Frijns D, Vink H, et al. Skeletal muscle capillary density and microvascular function are compromised with aging and type 2 diabetes. Journal of applied physiology 2014;116:998-5.
34. Fuso L, Pitocco D, Longobardi A, Zaccardi F, Contu C, Pozzuto C, Basso S, Varone F, Ghirlanda G, Antonelli Incalzi R. Reduced respiratory muscle strength and endurance in type 2 diabetes mellitus. Diabetes/metabolism research and reviews 2012;28:370-5.
Downloads
Published
Issue
Section
License
This work is licensed under a Creative Commons Attribution 4.0 International License.
You are free to:
- Share — copy and redistribute the material in any medium or format for any purpose, even commercially.
- Adapt — remix, transform, and build upon the material for any purpose, even commercially.
- The licensor cannot revoke these freedoms as long as you follow the license terms.
Under the following terms:
- Attribution — You must give appropriate credit , provide a link to the license, and indicate if changes were made . You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.
- No additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.
Notices:
You do not have to comply with the license for elements of the material in the public domain or where your use is permitted by an applicable exception or limitation .
No warranties are given. The license may not give you all of the permissions necessary for your intended use. For example, other rights such as publicity, privacy, or moral rights may limit how you use the material.
