Skip to main content

Advertisement

Log in

Clinical and nerve conduction studies in female patients with diabetic dermopathy

  • Original Article
  • Published:
Acta Diabetologica Aims and scope Submit manuscript

Abstract

This study aims to assess the clinical and electrophysiological characteristics of diabetic polyneuropathy (PNP) in female patients. We investigated clinical and electrophysiological features in 175 female patients with diabetes mellitus to compare those with PNP only, diabetic dermopathy (DD), or diabetic foot (DF). Among clinical features, the loss of deep tendon reflexes, the presence of negative sensory symptoms, superficial sensory loss, and the loss of vibration sense were more common in DD patients than PNP patients. As compared with DD patients, the presence of skin atrophy, superficial and positive sensory symptoms were more common in DF patients. Neuropathic symptom and disability scores were significantly higher in DD and DF patients than PNP patients. In the electrophysiological studies, the only significant difference was observed in the mean distal latencies for ulnar nerves, which were longer in DD patients as compared with PNP patients, but similar between DD and DF patients. All other parameters failed to show significant difference among patients, though values for DD patients lied in between PNP and DF patients. Carpal tunnel syndrome was present in 45% of PNP patients, 63.8% of DD patients, and 50% of DF patients (P = 0.031). Our results suggest that female patients with diabetic dermopathy might have a more severe sensorial neuropathy than patients without these skin lesions.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Vinik A (1999) Diabetic neuropathy: pathogenesis and therapy. Am J Med 107:17S–26S

    Article  PubMed  CAS  Google Scholar 

  2. Braunwald E, Fauci AS, Kasper DL (2001) Harrison principles of internal medicine. 15th edn. McGraw-Hill, New York

    Google Scholar 

  3. Dyck PJ, Thomas PK (1999) Diabetic neuropathy. 2nd edn

  4. Thomas PK, Tomlinson DR (1993) Diabetic and hypoglycemic neuropathy. In: Dyck PJ, Thomas PK (eds) Peripheral neuropathy. Saunders, Philadelphia, pp 1219–1250

    Google Scholar 

  5. Vinik AI, Mitchell BD, Leichter SB, Wagner AL, O’Brian JT, Georges LP (1995) Epidemiology of the complications of diabetes. In: Leslie RDG, Robbins DC (eds) Diabetes: clinical science in practice. Cambridge University Press, Cambridge, pp 221–287

    Google Scholar 

  6. Luo DZ, Calcutt NA, Sosenko JM, Harati Y (2003) Symposium: painful diabetic neuropathy: from basic mechanisms to clinical management. Program and abstracts of the 63rd Scientific Sessions of the American Diabetes Association. New Orleans

  7. Booya F, Bandarian F, Larijani B, Pajouhi M, Nooraei M, Lotfi J (2005) Potential risk factors for diabetic neuropathy: a case control study. BMC Neurol 5:24

    Article  PubMed  Google Scholar 

  8. The DCCT Research Group (1988) Factors in the development of diabetic neuropathy in feasibility phase of diabetes control and complications trial (DCCT). Diabetes 37:476–481

    Article  Google Scholar 

  9. Vondrova H, Bartos V, Skibova J (1990) Factors affecting the incidence and severity of polyneuropathy in type I diabetes mellitus. Casopis Lekaru Ceskych 129:1004–1008

    PubMed  CAS  Google Scholar 

  10. Christen WG, Manson JE, Bubes V, Glynn RJ (1999) Risk factors for progression of distal symmetric polyneuropathy in type 1 diabetes mellitus. Sorbinil Retinopathy Trial Research Group. Am J Epidemiol 150:1142–1151

    PubMed  CAS  Google Scholar 

  11. Oge A, Demir S, Gemalmaz A, Ak F (2004) Relationship between carpal tunnel syndrome and polyneuropathy in diabetics: is the polyneuropathy a risk factor or not? Turk J Endocrinol Metab 1:43–47

    Google Scholar 

  12. Fraser DM, Campbell IW, Ewing DJ, Clarke BF (1979) Mononeuropathy in diabetes mellitus. Diabetes 28:96–101

    Article  PubMed  CAS  Google Scholar 

  13. Bahou YG (2002) Carpal tunnel syndrome: a series observed at Jordan University Hospital (JUH), June 1999–December 2000. Clin Neurol Neurosurg 104:49–53

    Article  PubMed  Google Scholar 

  14. Schady W, Abuaisha B, Boulton AJM (1998) Observation on severe ulnar neuropathy in diabetes. J Diabetes Complications 12:128–132

    Article  PubMed  CAS  Google Scholar 

  15. Katz JS, Saperstein DS, Wolfe G, Nations SP, Alkhersam H, Amato AA, Barohn RJ (2001) Cervicobrachial involvement in diabetic radiculoplexopathy. Muscle Nerve 24:794–798

    Article  PubMed  CAS  Google Scholar 

  16. Cavanagh PR, Derr JA, Ulbrecht JS, Maser RE, Orchard TJ (1992) Problems with gait and posture in neuropathic patients with insulin-dependent diabetes mellitus. Diabet Med 9:469–474

    PubMed  CAS  Google Scholar 

  17. Feldman EL, Russell JW, Sullivan KA, Golovoy D (1999) New insights into the pathogenesis of diabetic neuropathy. Curr Opin Neurol 12:553–563

    Article  PubMed  CAS  Google Scholar 

  18. Young RJ, Zhou YQ, Rodriguez E, Prescot RJ, David JE, Clake F (1986) Variable relationship between peripheral somatic and autonomic neuropathy in patients with different syndromes of diabetic neuropathy. Diabetes 45:1092–1197

    Google Scholar 

  19. Negrin P, Lelli S (1987) The practical value of electromyographic parameters in diabetic neuropathy: our experience in 1276 patients. Electromyogr Clin Neurophysiol 27:283–287

    PubMed  CAS  Google Scholar 

  20. Marston WA (2006) Risk factors associated with healing chronic diabetic foot ulcers: the importance of hyperglycemia. Ostomy Wound Manage 52:26–39

    PubMed  Google Scholar 

  21. Romano G, Moretti G, Di Benedetto A, Giofre C, Di Cesare E, Russo G, Califano L, Cucinotta D (1998) Skin lesions in diabetes mellitus: Prevalence and clinical correlations. Diabetes Res Clin Pract 39:101–106

    Article  PubMed  CAS  Google Scholar 

  22. Kiziltan ME, Benbir G, Akalin MA (2006) Is diabetic dermopathy a sign for severe neuropathy in patients with diabetes mellitus? Nerve conduction studies and symptom analysis. Clin Neurophysiol 117:1862–1869

    Article  PubMed  CAS  Google Scholar 

  23. Kiziltan ME, Benbir G (2008) Clinical and electrophysiological differences in male and female patients with diabetic foot. Diabetes Res Clin Pract 79:e17–18

    Article  PubMed  Google Scholar 

  24. Albers JW, Brown MB, Sima AA, Greene DA (1996) Nerve conduction measures in mild diabetic neuropathy in the early diabetes intervention trial: the effects of age, sex, type of diabetes, disease duration, and anthropometric factors. Tolrestat study group for the early diabetes intervention trial. Neurology 46:85–91

    PubMed  CAS  Google Scholar 

  25. Cornblath DR, Chaudhry V, Carter K, Lee D, Seysedadr M, Miernicki M, Joh T (1999) Total neuropathy score. Validation and reliability study. Neurology 53:1660–1664

    PubMed  CAS  Google Scholar 

  26. Huntley AC (1993) Cutaneous manifestations of diabetes mellitus. Diabetes Metab Rev 9:161–176

    Article  PubMed  CAS  Google Scholar 

  27. Pastore C, Izura V, Geijo-Barrientos E, Dominguez JR (1999) A comparison of electrophysiological tests for the early diagnosis of diabetic neuropathy. Muscle Nerve 22:1667–1673

    Article  PubMed  CAS  Google Scholar 

  28. Shawn JB, Brown MJ (2002) Diabetic neuropathies. In: Katirji B, Kaminsky HJ, Cpreston D, Ruff RL, Shapiro BE (eds) Neuromuscular disorders in clinical practice. Butterman-Heinemann, Boston, pp 598–621

    Google Scholar 

  29. Shun CT, Chang YC, Wu HP, Hsieh SC, Lin WM, Lin YH, Tai TY, Hsieh ST (2004) Skin denervation in type 2 diabetes: correlations with diabetic duration and functional impairments. Brain 127:1593–1605

    Article  PubMed  Google Scholar 

  30. Kelly WF, Nicholas J, Adams J, Mahmood R (1993) Necrobiosis lipoidica diabeticorum: association with background retinopathy, smoking, and proteinuria. A case controlled study. Diabet Med 10:725–728

    PubMed  CAS  Google Scholar 

  31. Boulton AJ, Kubrusly DB, Bowker JH, Gadia MT, Quintero L, Becker DM, Skyler JS, Sosenko JM (1986) Impaired vibratory perception and diabetic foot ulceration. Diabet Med 3:335–337

    PubMed  CAS  Google Scholar 

  32. Chammas M, Bousquet P, Renard E, Poirier JL, Jaffiol C, Allieu Y (1995) Dupuytren’s disease, carpal tunnel syndrome, trigger finger, and diabetes mellitus. J Hand Surg [Am] 20:109–114

    Article  CAS  Google Scholar 

  33. Gamstedt A, Holm-Glad J, Ohlson CG, Sundstrom M (1993) Hand abnormalities are strongly associated with the duration of diabetes mellitus. J Intern Med 234:189–193

    Article  PubMed  CAS  Google Scholar 

  34. Solomon DH, Katz JN, Bohn R, Mogun H, Avorn J (1999) Nonoccupational risk factors for carpal tunnel syndrome. J Gen Intern Med 14:310–314

    Article  PubMed  CAS  Google Scholar 

  35. Haupt WF, Wintzer G, Schop A, Lottgen J, Pawlik G (1993) Long-term results of carpal tunnel decompression. Assessment of 60 cases. J Hand Surg [Br] 18:471–474

    CAS  Google Scholar 

  36. Benotmane A, Mohammedi F, Ayad F, Kadi K, Azzouz A (2000) Diabetic foot lesions: etiologic and prognostic factors. Diabetes Metab 26:113–117

    PubMed  CAS  Google Scholar 

  37. Kane DD, Kerns JM, Lin DL, Damaser MS (2004) Early structural effects of oestrogen on pudendal nerve regeneration in the rat. BJU Int 93:870–878

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to G. Benbir.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Kiziltan, M.E., Benbir, G. Clinical and nerve conduction studies in female patients with diabetic dermopathy. Acta Diabetol 45, 97–105 (2008). https://doi.org/10.1007/s00592-008-0031-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00592-008-0031-1

Keywords

Navigation