Demographic and Clinical Factors Associated with Depression in 140 Hospitalized Diabetic Patients with Distal Symmetric Polyneuropathy Evaluated Using Beck Depression Inventory and 6-Item Neuropathy Total Symptom Score Questionnaire.

BACKGROUND Diabetic distal symmetric polyneuropathy (DSPN) is one of the most common and costliest long-term complications. The pain and function limitations may lead to depression. This study aimed to assess the influence of demographic and clinical factors on the prevalence of depression among diabetic patients with distal symmetric polyneuropathy (DSPN). MATERIAL AND METHODS A total of 140 patients with diabetic DSPN completed the 21-item Beck Depression Inventory (BDI) measuring characteristic attitudes and symptoms of depression. The intensity of neuropathic complaints was assessed using the Neuropathy Total Symptom Score- 6 items (NTSS-6). Testing for peripheral neuropathy was performed. All patients completed questionnaires, which included anthropometric measures, social parameters, and medical aspects. Statistical analyses were done using STATISTICA 8 PL software. RESULTS Statistically significant relationships were found between the depression symptoms in diabetic patients and the intensity of subjective neuropathy symptoms evaluated by NTSS-6, body mass index (BMI), and education level. On average, each 1-point increase in NTSS-6 predicted a 16% increase in the risk of depression. Each 1 kg/m² increase in the BMI was associated with a 10% increase of depression risk. CONCLUSIONS The study showed the positive quantitative relationship between diabetic DSPN and depression symptoms. The BMI, severity of neuropathy symptoms, and lower level of education had a statistically significant association with the level of depression and may be useful in evaluating the risk of depression among DSPN patients.

The 8-Week Efficacy of Frequency Rhythmic Electrical Modulated System (FREMS) as an Add-on Therapy in the Treatment of Symptomatic Diabetic Peripheral Polyneuropathy.

BACKGROUND: Frequency Rhythmic Electrical Modulated System (FREMS) is a method of transcutaneous treatment based on frequency-modulated electromagnetic neural stimulation. Its efficacy in neuropathic pain in diabetes mellitus still lacks enough research. METHODS: A randomized, single-blind, sham-controlled trial in individuals with symmetric distal polyneuropathy (SDPN) as an add-on therapy compared to standard therapy with alpha-lipoic acid. Participants were randomized to FREMS and standard of care (SOC) versus SOC only. The primary outcome was a change from baseline in perceived pain assessed by visual analogue scale (VAS) after 5 days of treatment and after 8 weeks of follow-up between treatment groups. RESULTS: After 5 days of treatment, patients in both groups felt significant reduction in pain as measured by VAS, although only FREMS treatment lasted for 8 weeks and induced a significant improvement in quality of life measured by EuroQol 5-Dimension 5-Level (EQ-5D-5L) and Clinical Global Impression of Change (CGI-C) questionnaires. There were non-significant differences observed in the instrument pain assessment. No relevant side effects were recorded during the study. CONCLUSIONS: FREMS as an addition to alpha-lipoic acid therapy occurred to be a beneficial method of treatment in individuals with SDPN and was associated with improvements in pain severity, quality of life and clinical global improvement.

Is It Possible to Prevent Sars-Cov-2 Infection in a Non-Infectious Diseases Ward during the Pandemic on the Example of a Diabetes Clinic Institute of Rural Health, Lublin, Poland?

Diabetes is considered an epidemic of the 21st century. On 11 March 2020, two months after the outbreak of COVID-19 (coronavirus disease of 2019) epidemic in China, the World Health Organization announced COVID-19 to be a pandemic. From that time, many hospitals and wards have started to function as both infectious and non-infectious ones; so did the Diabetes Clinic Institute of Rural Health in South-Eastern Poland. Considering the global importance of diabetes and its prevalence worldwide, it seemed important to investigate how the Diabetes Clinic passed through the individual phases of the pandemic, and the possibility of protecting hospitalized patients against future pandemic infection. We present detailed characteristics of the situation in a ward which used to treat non-infectious patients with diabetes only and, nowadays, has been obliged to take into account the risk of spreading SARS-Cov-2 (severe acute respiratory syndrome coronavirus-2) infection also. Moreover, we suggest solutions to avoid cases of infectious diseases in non-infectious wards in the future.

Association between rs7901695 and rs7903146 polymorphisms of the TCF7L2 gene and gestational diabetes in the population of Southern Poland.

OBJECTIVES: The etiology of gestational diabetes mellitus (GDM) remains to be fully elucidated. Elevated risk for type 2 diabetes in patients with history of GDM and for GDM in women with familial history of diabetes may suggest that GDM and type 2 diabetes share a common genetic and environmental background. The TCF7L2 (Transcription Factor 7 Like 2) gene is one of the most important genetic factors of the established correlation with type 2 diabetes, and it may also play a role in the pathophysiology of GDM. The aim of the study was to assess the influence of two polymorphisms of the TCF7L2 gene (rs7901695 and rs7903146), which are associated with the development of type 2 diabetes, in women with GDM. MATERIAL AND METHODS: The study included 50 women with glucose tolerance disorders diagnosed for the first time during the current pregnancy. Single nucleotide polymorphisms (SNPs) were genotyped using allelic discrimination. The results were confirmed using the sequencing method. Selected clinical parameters were also analyzed. RESULTS: No correlation between the studied polymorphisms of the TCF7L2 gene and GDM was observed. Glycemic control with diet or diet and insulin was associated with better control of the weight gain during pregnancy. CONCLUSIONS: No correlation between rs7903146 and rs7901695 polymorphisms of the TCF7L2 gene and GDM was found. Glycemic control with diet or diet and insulin is associated with better control of the weight gain during pregnancy.