Klinički i elektrofiziološki znaci dijabetične polineuropatije – utjecaj glikemije i trajanja šećerne bolesti

Diabetic polyneuropathy occurs in around 50% of diabetic patients. Its pathophysiological mechanism is not completely clarified and major occurrences boil down to the change in neural phenotype and vasa nervorum. As glucose neurotoxicity has been suggested by plenty of evidence, the aim of the study was to assess the effect of glycemia on the severity of diabetic polyneuropathy. Considering that some practical experiences point to serious complications in patients suffering from diabetes of shorter duration, another aim was to assess the effect of diabetes duration on the severity of related neuropathy. Clinical and electromyoneurographic examinations were performed in 100 patients with diabetic polyneuropathy free from any laboratory signs of renal failure. The effect of HbA1c value and duration of disease on clinical symptoms, signs and electrophysiological indicators of polyneuropathy was analyzed. Study results indicated that 78% of patients with diabetic polyneuropathy did not have well-regulated glycemia. Diabetes duration was associated with a growing number of sensory symptoms, among which the sensation of pain similar to electric shock was present in 63% of patients. In addition, it also had negative impact on the sensory and motor nerve conduction velocity. HbA1c influenced the whole range of electrophysiological indicators of diabetic polyneuropathy.Dijabetična polineuropatija javlja se u oko 50% bolesnika s dijabetesom. Njezin patofiziološki mehanizam nastanka nije u potpunosti razjašnjen, a glavna zbivanja svode se na promjenu neuralnog fenotipa i vasa nervorum. Kako postoje mnogi dokazi o neurotoksičnosti glukoze, cilj studije bio je ispitati utjecaj glikemije na težinu dijabetične polineuropatije. Budući da neka iskustva u praksi upućuju na prisutnost teških komplikacija u bolesnika koji imaju dijabetes kraćeg trajanja, ispitao se utjecaj dužine trajanja dijabetesa na težinu pridružene neuropatije. Klinički i elektromioneurografski je ispitano 100 bolesnika s dijabetičnom polineuropatijom. Uvjet je bio da bolesnici nemaju laboratorijske znakove bubrežnog oštećenja, a analizirao se utjecaj vrijednosti HbA1c i trajanja bolesti na kliničke simptome, znakove i elektrofiziološke pokazatelje polineuropatije. Rezultati su pokazali da 78% bolesnika s dijabetičnom polineuropatijom nema dobro reguliranu glikemiju. Trajanje dijabetesa utječe na pojavu većeg broja senzornih simptoma, od kojih se osjećaj boli poput udara struje javlja u 63% bolesnika, a utječe i na pogoršanje brzine provodljivosti senzornih i motornih živaca. HbA1c utječe na čitav niz elektrofizioloških pokazatelja dijabetične polineuropatije