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المصدر: Clinical Neurophysiology. 141:S115
مصطلحات موضوعية: Neurology, Physiology (medical), Neurology (clinical), Sensory Systems
الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_________::6164c1e4e3298999e4cdf67fabf36df3Test
https://doi.org/10.1016/j.clinph.2022.07.302Test -
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المؤلفون: Sandra Elise Olsen, Kristian Bernhard Nilsen, Marit R. Bjørgaas, Øystein Dunker, Bjørn Olav Åsvold, Trond Sand
المصدر: Muscle and Nerve
مصطلحات موضوعية: medicine.medical_specialty, Physiology, Neural Conduction, Sensory system, Polyneuropathies, Cellular and Molecular Neuroscience, Physical medicine and rehabilitation, Diabetic Neuropathies, Sural Nerve, Physiology (medical), Diabetes mellitus, Medial plantar nerve, Diabetes Mellitus, Humans, Medicine, Neurologic Examination, medicine.diagnostic_test, business.industry, Magnetic resonance neurography, Peroneal Nerve, Middle Aged, medicine.disease, Nerve conduction study, Research studies, Neurology (clinical), Tibial Nerve, Abnormality, business, Polyneuropathy
الوصف: INTRODUCTION/AIMS: Nerve conduction studies (NCS) are widely used in diagnosing diabetic polyneuropathy. Combining the Z-scores of several measures (Z-compounds) may improve diagnostics by grading abnormality. We aimed to determine which combination of nerves and measures are best suited for studies of diabetic polyneuropathy. METHODS: Sixty-eight patients with type-1 diabetes and 35 controls were included. NCS measurements were taken from commonly investigated nerves in one arm and both legs. Different Z-compounds were calculated and compared to reference material to assess abnormality. A sensitivity-proxy, accuracy-index (AI) and Cohen's d were calculated. RESULTS: Z-compounds with the highest AI consisted of the tibial- and peroneal motor-, and the sural-, superficial peroneal- and tibial medial plantar sensory nerves in one or two legs. All Z-compounds were able to discriminate between diabetic subjects and non-diabetic controls (mean Cohen's d = 1.42 (range 1.03-1.63)). The association between AI and number of measures was best explained logarithmically (R2 = 0.401), with diminishing returns above approximately 14-15 measures. F-wave inclusion may increase the AI of the Z-compounds. Although often clinically useful among the non-elderly, the additional inclusion of medial plantar NCS into Z-compounds in general did not improve AI. DISCUSSION: Performing unilateral NCS in several motor- and sensory lower extremity nerves is suited for the evaluation of polyneuropathy in diabetic patients. The use of Z-compounds may improve diagnostic accuracy in diabetic polyneuropathy and may be particularly useful for follow-up research studies, as single summary-measures of NCS abnormality-development over time. This article is protected by copyright. All rights reserved.
وصف الملف: application/pdf
الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::2725f8cc1ab6abaa3f3de5396bcd04f4Test
https://hdl.handle.net/11250/2982333Test -
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المؤلفون: Tor Ivar Hansen, Trond Sand, Elise Cd Haferstrom, Marit R. Bjørgaas, Sandra Elise Olsen, Brian M. Frier, Asta Håberg
المصدر: Diabetologia
مصطلحات موضوعية: Adult, Male, Pattern separation, endocrine system diseases, Endocrinology, Diabetes and Metabolism, 030209 endocrinology & metabolism, Article, Impaired awareness of hypoglycaemia, 03 medical and health sciences, 0302 clinical medicine, Cognition, Memory, Surveys and Questionnaires, Internal Medicine, Medicine, Humans, Insulin, Prospective Studies, Association (psychology), Type 1 diabetes, business.industry, nutritional and metabolic diseases, Human physiology, Middle Aged, medicine.disease, Hypoglycemia, Cognitive test, Diabetes Mellitus, Type 1, Female, Cognitive function, business, Hypoglycaemia, Cognition Disorders, hormones, hormone substitutes, and hormone antagonists, 030217 neurology & neurosurgery, Clinical psychology
الوصف: Aims/hypothesis The aim of this study was to compare cognitive function in adults with type 1 diabetes who have impaired awareness of hypoglycaemia with those who have normal awareness of hypoglycaemia. A putative association was sought between cognitive test scores and a history of severe hypoglycaemia. Methods A total of 68 adults with type 1 diabetes were included: 33 had impaired and 35 had normal awareness of hypoglycaemia, as confirmed by formal testing. The groups were matched for age, sex and diabetes duration. Cognitive tests of verbal memory, object-location memory, pattern separation, executive function, working memory and processing speed were administered. Results Participants with impaired awareness of hypoglycaemia scored significantly lower on the verbal and object-location memory tests and on the pattern separation test (Cohen’s d −0.86 to −0.55 [95% CI −1.39, −0.05]). Participants with impaired awareness of hypoglycaemia had reduced planning ability task scores, although the difference was not statistically significant (Cohen’s d 0.57 [95% CI 0, 1.14]). Frequency of exposure to severe hypoglycaemia correlated with the number of cognitive tests that had not been performed according to instructions. Conclusions/interpretation Impaired awareness of hypoglycaemia was associated with diminished learning, memory and pattern separation. These cognitive tasks all depend on the hippocampus, which is vulnerable to neuroglycopenia. The findings suggest that hypoglycaemia contributes to the observed correlation between impaired awareness of hypoglycaemia and impaired cognition. © The Author(s) 2017. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0Test/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::d39bdda7b8abbbf249463ca8282b4834Test
http://europepmc.org/articles/PMC5423963Test -
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المؤلفون: Trond Sand, Kristian Bernhard Nilsen, Marit R. Bjørgaas, Brian M. Frier, Sandra Elise Olsen, Bjørn Olav Åsvold, Marit Stjern
المصدر: Diabetes Care. 39:426-433
مصطلحات موضوعية: Adult, Male, Research design, medicine.medical_specialty, Cross-sectional study, Endocrinology, Diabetes and Metabolism, 030209 endocrinology & metabolism, Hypoglycemia, 03 medical and health sciences, 0302 clinical medicine, Diabetic Neuropathies, Risk Factors, Interquartile range, Internal medicine, Diabetes mellitus, Internal Medicine, medicine, Humans, Risk factor, Advanced and Specialized Nursing, Type 1 diabetes, business.industry, Peripheral Nervous System Diseases, Awareness, Middle Aged, medicine.disease, Surgery, Cross-Sectional Studies, Diabetes Mellitus, Type 1, Peripheral neuropathy, Autonomic Nervous System Diseases, Female, business, 030217 neurology & neurosurgery
الوصف: OBJECTIVE Impaired awareness of hypoglycemia (IAH) is a risk factor for severe hypoglycemia in people with insulin-treated diabetes; autonomic neuropathy has been suggested to underlie its development. The aim was to evaluate a putative association between IAH and autonomic dysfunction using novel and sensitive measures of autonomic neural function. RESEARCH DESIGN AND METHODS Sixty-six adults with type 1 diabetes were studied, 33 with IAH and 33 with normal awareness of hypoglycemia (NAH), confirmed by formal testing. Participants were matched for age, sex, and diabetes duration. Clinical and laboratory evaluations included extensive autonomic function testing, peripheral nerve conduction studies, and quantitative sensory testing. Composite abnormality Z scores were used for group comparisons. RESULTS The IAH and NAH group had similar median (interquartile range) age of 48 (14.5) vs. 47 (14.5) years, diabetes duration of 30 (13.5) vs. 31 (13.5) years, and mean ± SD HbA1c 7.8 ± 2.2% vs. 8.1 ± 1.9%, respectively. The autonomic composite Z score did not differ between the two groups (mean difference −0.15, 95% CI −0.46, 0.16; P = 0.33), nor did the thermal detection (mean difference 0.15, 95% CI −0.31, 0.61; P = 0.51) or nerve conduction scores (mean difference 0.03, 95% CI −0.43, 0.49; P = 0.89). CONCLUSIONS In adults with type 1 diabetes, IAH was not associated with autonomic dysfunction or peripheral neuropathy.
الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::782f29b4b95c817ef1be4b1a397ae415Test
https://doi.org/10.2337/dc15-1469Test -
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المصدر: Diabetes Research and Clinical Practice
مصطلحات موضوعية: Adult, Male, Pediatrics, medicine.medical_specialty, endocrine system diseases, Endocrinology, Diabetes and Metabolism, media_common.quotation_subject, 030209 endocrinology & metabolism, Young Adult, 03 medical and health sciences, 0302 clinical medicine, Endocrinology, Surveys and Questionnaires, Diabetes mellitus, Internal Medicine, medicine, Humans, 030212 general & internal medicine, Symptom intensity, media_common, Type 1 diabetes, Multivariable linear regression, business.industry, nutritional and metabolic diseases, Fear, General Medicine, Awareness, Middle Aged, medicine.disease, Hypoglycemia, Cross-Sectional Studies, Diabetes Mellitus, Type 1, Female, Hypoglycaemia awareness, Worry, business, Symptom score, hormones, hormone substitutes, and hormone antagonists
الوصف: Aims To investigate fear of hypoglycaemia (FoH) in relation to hypoglycaemia awareness, history of severe hypoglycaemia (SH) and hypoglycaemia symptoms in adults with Type 1 diabetes. Methods Questionnaire-based cross-sectional survey. We assessed FoH with the Hypoglycaemia Fear Survey-II Worry subscale, hypoglycaemia awareness status with the Gold score, and used the Edinburgh Hypoglycaemia Scale to grade the presence and intensity of hypoglycaemia symptoms. All these measures have previously been validated for research application. We used multivariable linear regression to examine associations between FoH and hypoglycaemia awareness status, history of SH and hypoglycaemia symptom score. Results Of 636 invitees, 445 (70%) responded, with 435 responses eligible for analyses. Seventy-four persons had IAH (17%). Among those, 47 (64%) reported ≥ 1 SH during the preceding year, in contrast to this being reported by 113 (31%) of persons with normal awareness. The mean (SD) FoH worry score was 1.33 (0.78). This score was 0.64 (95% CI, 0.45–0.83) higher among people with impaired vs. normal hypoglycaemia awareness and 0.53 (95% CI, 0.33–0.73) higher among people with ≥ 3 episodes of SH the preceding year vs. people with no such episode. A higher number and intensity of hypoglycaemia symptoms was associated with higher FoH, as demonstrated by an increase in mean FoH worry score of 0.30 (95% CI, 0.23–0.36) per point increase in mean Edinburgh hypoglycaemia score. Conclusions Impaired awareness of hypoglycaemia, history of SH and higher Edinburgh hypoglycaemia scores were all associated with increased FoH in adults with Type 1 diabetes. © 2018. This is the authors’ accepted and refereed manuscript to the article. This manuscript version is made available under the CC-BY-NC-ND 4.0 license http://creativecommons.org/licenses/by-nc-nd/4.0Test/
الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::fec9e2ac6571e4252b6354eeb6322e5bTest
http://hdl.handle.net/11250/2587387Test -
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المؤلفون: Bjørn Olav Åsvold, Sandra Elise Olsen, Brian M. Frier, Marit R. Bjørgaas, S. E. Aune, L. I. Hansen
المصدر: Diabetic Medicine. 31:1210-1217
مصطلحات موضوعية: Adult, Male, medicine.medical_specialty, Pediatrics, Adolescent, Cross-sectional study, Endocrinology, Diabetes and Metabolism, Severity of Illness Index, Cohort Studies, Young Adult, Endocrinology, Internal medicine, Diabetes mellitus, Severity of illness, Internal Medicine, Humans, Hypoglycemic Agents, Insulin, Medicine, Autonomic Pathways, Young adult, Aged, Feedback, Physiological, Type 1 diabetes, business.industry, nutritional and metabolic diseases, Middle Aged, medicine.disease, Hypoglycemia, Self Care, Cross-Sectional Studies, Diabetes Mellitus, Type 1, Cohort, Disease Progression, Female, business, Attitude to Health, Cohort study, Patient education
الوصف: Aims To examine the association between diabetes duration and hypoglycaemia symptom profiles and the presence of impaired awareness of hypoglycaemia. Methods A cross-sectional study was performed, using validated methods for recording hypoglycaemia symptoms and assessing hypoglycaemia awareness. The associations between symptom intensity, hypoglycaemia awareness and diabetes duration were examined, and the prevalence of impaired awareness was ascertained for Type 1 diabetes of differing durations. Results Questionnaires were mailed to 636 adults with Type 1 diabetes, of whom 445 (70%) returned them. A total of 440 completed questionnaires were suitable for analysis. Longer diabetes duration was associated with lower intensity of autonomic symptoms (P for trend
الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::5fe01eba7163f9f539bc0fd0586ffe9fTest
https://doi.org/10.1111/dme.12496Test -
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المؤلفون: Marit R. Bjørgaas, Sandra Elise Olsen, Ellen Gjerløw, Bjørn Olav Åsvold, Erik Waage Nielsen
المصدر: Nursing research. 63(2)
مصطلحات موضوعية: Adult, Male, medicine.medical_specialty, Adolescent, Cross-sectional study, media_common.quotation_subject, Health Status, Hypoglycemia, Cohort Studies, Young Adult, Sex Factors, Diabetes mellitus, Surveys and Questionnaires, medicine, Outpatient clinic, Humans, Psychiatry, General Nursing, media_common, Aged, Response rate (survey), Type 1 diabetes, business.industry, Norway, Fear, Middle Aged, medicine.disease, Cross-Sectional Studies, Diabetes Mellitus, Type 1, Female, Worry, business, Clinical psychology, Cohort study
الوصف: Background: Severe hypoglycemia is a serious complication of type1 diabetes feared by many who have the disease. Objectives: The aim of this study was to investigate specific fears related to hypoglycemia in adults with type 1 diabetes and to investigate how aspects of fear of hypoglycemia may differ between genders. Methods: A cross-sectional study with questionnaires sent to 636 patients with type 1 diabetes, aged 18–75 years, who attended the outpatient clinic at St. Olavs Hospital, Trondheim, Norway. Fears related to hypoglycemia were assessed using the Hypoglycemia Fear Survey II Worry subscale (HFS-II-Worry). Results: The response rate was 70% (N = 445, 216 women and 229 men). The mean HFS-II-Worry score was higher in women than in men (2.46 [SD = 0.80] vs. 2.22 [SD = 0.74], respectively; p < .001). Women scored higher than men in all items in the HFS-II-Worry, and women’s average scores were statistically significantly higher in 5 of the 18 items after correction for multiple comparisons. The largest gender differences in mean scores occurred in the items “low blood glucose interfering with important things,” “becoming upset and difficult,” “difficulty thinking clearly,” and “feeling lightheaded or dizzy.” In both women and men, the highest mean scores appeared in the worry items “become hypoglycemic while sleeping” and “not having food available.” Discussion: In this sample of Norwegian adults with type 1 diabetes, women expressed more concerns about hypoglycemia than men. The highest HFS-II-Worry scores occurred in the same items in women and men, but the largest gender differences in mean scores appeared across a variety of other items, some of which were related to social esteem.
الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::764ced4927b284202bd1e694a37b6638Test
https://pubmed.ncbi.nlm.nih.gov/24589650Test -
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المصدر: Clinical Neurophysiology. 127:e106
مصطلحات موضوعية: medicine.medical_specialty, Diabetic neuropathy, business.industry, Type i diabetes mellitus, Healthy subjects, Standard score, medicine.disease, Gastroenterology, Sensory Systems, Surgery, Neurology, Diabetic polyneuropathy, Physiology (medical), Internal medicine, medicine, Neurology (clinical), Abnormality, Nerve conduction, business, Polyneuropathy
الوصف: Objectives Nerve conduction studies (NCS) are widely used to confirm clinical polyneuropathy. We wanted to find the best subset of nerve conduction parameters to be used in a compound Z-score value to be used for grading of abnormality and evaluation of progression in studies of diabetic neuropathy. Methods Standard NCS (9 nerves) were performed on 66 patients with type I diabetes mellitus and compared to reference data (366 healthy subjects). Compound scores were calculated as average Z scores of included variables. The compound scores that best distinguished between a separate set of 28 healthy controls and diabetic subjects were identified using t -tests and abnormality rates. Results Twenty compound scores were calculated. Sensitivity for polyneuropathy varied between 46% and 72%, with median prevalence of 69%. All compound scores differentiated patients from controls (5.1 t Conclusion Prevalence of diabetic polyneuropathy varies depending on selection of variables in nerve conduction studies. Key message Compound Z scores may be ideal for longitudinal studies of polyneuropathy.
الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_________::0228d7a92d1714a00b614b47c24a317fTest
https://doi.org/10.1016/j.clinph.2015.11.356Test
