Subject(s)
Adamantane/analogs & derivatives , Donohue Syndrome/drug therapy , Hypoglycemic Agents/therapeutic use , Nitriles/therapeutic use , Pyrrolidines/therapeutic use , Thiazolidinediones/therapeutic use , Adamantane/therapeutic use , Adolescent , Diabetes Mellitus, Type 2/complications , Diabetes Mellitus, Type 2/drug therapy , Humans , Male , Pioglitazone , VildagliptinABSTRACT
The objective of the present study was to establish the frequency of psychiatric comorbidity in a sample of diabetic patients with symmetric distal polyneuropathy (SDPN). Sixty-five patients with type 2 diabetes mellitus were selected consecutively to participate in the study at Instituto Estadual de Diabetes e Endocrinologia. All patients were submitted to a complete clinical and psychiatric evaluation, including the Portuguese version of the structured clinical interview for DSM-IV, the Beck Depression Inventory, the Neuropathy Symptom Score, and Neuropathy Disability Score. SDPN was identified in 22 subjects (33.8%). Patients with and without SDPN did not differ significantly regarding sociodemographic characteristics. However, a trend toward a worse glycemic control was found in patients with SDPN in comparison to patients without SDPN (HbA1c = 8.43 +/- 1.97 vs 7.48 +/- 1.95; P = 0.08). Patients with SDPN exhibited axis I psychiatric disorders significantly more often than those without SDPN (especially anxiety disorders, in general (81.8 vs 60.0%; P = 0.01), and major depression--current episode, in particular (18.2 vs 7.7%; P = 0.04)). The severity of the depressive symptoms correlated positively with the severity of SDPN symptoms (r = 0.38; P = 0.006), but not with the severity of SDPN signs (r = 0.07; P = 0.56). In conclusion, the presence of SDPN seems to be associated with a trend toward glycemic control. The diagnosis of SDPN in diabetic subjects seems also to be associated with relevant psychiatric comorbidity, including anxiety and current mood disorders.
Subject(s)
Diabetes Mellitus, Type 2/psychology , Diabetic Neuropathies/psychology , Mental Disorders/epidemiology , Polyneuropathies/psychology , Ambulatory Care/statistics & numerical data , Comorbidity , Diagnostic and Statistical Manual of Mental Disorders , Female , Humans , Male , Mental Disorders/diagnosis , Mental Disorders/etiology , Middle Aged , Psychiatric Status Rating Scales/statistics & numerical data , Severity of Illness Index , Socioeconomic FactorsABSTRACT
The objective of the present study was to establish the frequency of psychiatric comorbidity in a sample of diabetic patients with symmetric distal polyneuropathy (SDPN). Sixty-five patients with type 2 diabetes mellitus were selected consecutively to participate in the study at Instituto Estadual de Diabetes e Endocrinologia. All patients were submitted to a complete clinical and psychiatric evaluation, including the Portuguese version of the structured clinical interview for DSM-IV, the Beck Depression Inventory, the Neuropathy Symptom Score, and Neuropathy Disability Score. SDPN was identified in 22 subjects (33.8 percent). Patients with and without SDPN did not differ significantly regarding sociodemographic characteristics. However, a trend toward a worse glycemic control was found in patients with SDPN in comparison to patients without SDPN (HbA1c = 8.43 ± 1.97 vs 7.48 ± 1.95; P = 0.08). Patients with SDPN exhibited axis I psychiatric disorders significantly more often than those without SDPN (especially anxiety disorders, in general (81.8 vs 60.0 percent; P = 0.01), and major depression - current episode, in particular (18.2 vs 7.7 percent; P = 0.04)). The severity of the depressive symptoms correlated positively with the severity of SDPN symptoms (r = 0.38; P = 0.006), but not with the severity of SDPN signs (r = 0.07; P = 0.56). In conclusion, the presence of SDPN seems to be associated with a trend toward glycemic control. The diagnosis of SDPN in diabetic subjects seems also to be associated with relevant psychiatric comorbidity, including anxiety and current mood disorders.
Subject(s)
Humans , Male , Female , Middle Aged , /psychology , Diabetic Neuropathies/psychology , Mental Disorders/epidemiology , Polyneuropathies/psychology , Ambulatory Care/statistics & numerical data , Comorbidity , Diagnostic and Statistical Manual of Mental Disorders , Mental Disorders/diagnosis , Mental Disorders/etiology , Psychiatric Status Rating Scales/statistics & numerical data , Severity of Illness Index , Socioeconomic FactorsABSTRACT
OBJECTIVES: To evaluate the use of Optical Coherence Tomography (OCT) in the diagnosis of macular edema (ME) in diabetic patients in comparison to indirect ophthalmoscopy (IO) and, in addition, to study the characteristics of these patients. METHODS: 165 patients were randomly selected to join the study in 1998. Ophthalmological, clinical and laboratory examinations were performed for all these patients. RESULTS: Diabetic retinopathy was identified in 143 eyes (44.7%) and ME in 58 (18.3% of the total and 40.5% of the patients with retinopathy). 82.7% (48) of the eyes with ME could be diagnosed with OCT, against 62.0% (36) with IO. Haemoglobin A1c was the only variable that showed a significant association with ME, when compared to control (p < 0.05). Retinopathy was associated with the presence of nephropathy (p = 0.01) and neuropathy (p = 0.001), but ME was not (NS for both). 68% of patients without ME had a visual acuity of more than 50%. CONCLUSIONS: OCT is a new method that can help the evaluation of ME in diabetic patients. It can be used not only to diagnose the lesion, but also to follow up the patients during treatment. High levels of haemoglobin A1c might be associated with the presence of ME. Diabetic complications (nephropathy and neuropathy) are associated with retinopathy but not with macular edema.
