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Neuropathic complications and nutrition in patients with type 2 diabetes
Klauzová, Dagmar ; Prázný, Martin (advisor) ; Karen, Igor (referee)
Introduction: Diabetic neuropathy is a chronic complication of diabetes that decreases the quality of life of diabetic patients, mainly because there is currently no effective treatment for diabetic neuropathy and it increases the risk of developing other complications (e. g. diabetic foot syndrome). The development of late complications of diabetes can be delayed by preventive practices, and therefore, it is necessary to focus on prevention and raise awareness among patients about the possible complications associated with diabetes and how to prevent them. Objectives: The aim of this study was to investigate whether lifestyle and dietary habits differ between patients with type 2 diabetes with diabetic peripheral neuropathy and those without diabetic peripheral neuropathy. Methodology: Data collection was done using a self-administered questionnaire with a weekly dietary record. The questionnaire also included a validated sensorimotor neuropathy questionnaire. The questionnaire was distributed on the social media to a closed group of patients with DM2T and was personally offered to patients from the III. Department of Internal Medicine - Endocrinology and Metabolism of the 1st Faculty of Medicine of the Charles University in Prague, specifically at the VFN Clinic in the ambulance of Obesitology...
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The importance of physiotherepy in diabetic neuropathy
MOTEJLOVÁ, Tereza
The subject of this bachelor's thesis is the mapping of physiotherapeutic posibillities for neuropathy, and creating an exercise unit to improve the stability of autotherapy with individual probands. Diabetic neuropathy is a very common chronic complication of the diabetes mellitus disorder. This disorder affects the peripheral nervous system and its most common symptoms are paresthesia, a feelings of cold feet and stability issues. The theoretical part examines the diabetes mellitus disorder. This disorder is written about in the second chapter, containing the classification, diagnostics, therapy and its complications. A chronic complication of this disorder can be diabetic neuropathy, to which is devoted the third chapter. This chapter is composed of the anatomy of the peripheral nervous system, the forms, neuropathic pain and a treatment. The fourth chapter deals with postural stability. The practical part was based on qualitative research. The research group consisted of three probands diagnosed with diabetic neuropathy. Each proband was kept a casuistry, which contains anamnesis, kinesiological analysis, stability examination including a posturograph, and essential neurological examinations. Based on the initial examination, individual physiotherapeutic procedures were created. The main part of the exercise unit was dedicated to sensomotor skills, the relaxation of joint structures on the leg, and exercising on balance pads with postural stability training. The results of this research proved that physiotherapy in diabetic neuropathy has a positive impact on the health condition of the proband. During the therapy, the probands subjectively expressed mitigation of paresthesia. It was confirmed that the probands could better hold their stability even in more difficult positions.
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Small fiber neuropathy in peripheral and autonomic nervous system in patients with diabetes
Potočková, Veronika ; Mazanec, Radim (advisor) ; Voháňka, Stanislav (referee) ; Kunc, Pavel (referee)
Small fiber neuropathy in peripheral and autonomic nervous system in patients with diabetes Abstract This dissertation thesis wants to draw attention to the relevance of early detection of small nerve fibers damage in the somatic and autonomic nervous systems in patients with type 1 and type 2 diabetes mellitus (T1DM, T2DM). Only early diagnosis can prevent the severe complications that progressive forms of diabetic neuropathy (DN) bring. The main objectives of this work were to evaluate the possibility of using thermal quantitative sensory testing (TQST) to identify patients with diabetes at higher risk of cardiac autonomic neuropathy (CAN) and distal symmetric polyneuropathy (DSPN) with predominant small nerve fibers impairment. Other aims were to assess the impact of CAN on the development of carotid atherosclerosis and to determine the prevalence and risk factors for depression and anxiety in diabetic patients with and without DN. The results show that TQST can be used as a screening tool to identify patients with a higher risk of CAN. We demonstrated a significant effect of CAN presence on carotid intima-media thickness in patients with T1DM, independently of known risk factors of atherosclerosis. Such a finding suggests that CAN may play a role in the pathogenesis of carotid atherosclerosis. Another...
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Changes in eye tissues in patients with diabetes mellitus, with emphasis on the tissue surface of the eye
Česká Burdová, Marie ; Mahelková, Gabriela (advisor) ; Kalvodová, Bohdana (referee) ; Kvapil, Milan (referee)
Introduction: Relation of diabetes mellitus (DM) to the diabetic keratopathy and various stages of corneal nerve fiber damage has been well accepted. A possible association between changes in the cornea of diabetic patients and diabetic retinopathy (DR), DM duration, and age at the time of DM diagnosis were evaluated. Neuropathies are among the most common long-term complications of diabetes mellitus. Good glycemic control is essential in prevention of this complication. DM patients with similar mean glucose levels or glycated hemoglobin (HbA1c) levels often exhibit differences in evaluation of diabetic complications. One reason for these differences may be the differences in glucose variability. DM patients with similar mean glucose levels or HbA1c levels often exhibit differences in glucose variability Hypothesis: Diabetes mellitus damages the subbasal nerve fibers of the corneal and affects the density of epithelial, endothelial and stromal cells. Corneal changes in patients with DM are dependent on the degree of diabetic retinopathy (DR), age at diagnosis, duration of DM, and compensation parameters. Purpose: To compare changes in cell density in individual layers of cornea and status of subbasal nerve fibers in patients with type 1 DM (DM 1) and in healthy subjects. To evaluate the dependence...
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Proprioception disorder as a physiotheraphy complication
MAŠÁT, Pavel
This thesis deals with the disorder of proprioception in diabetics with an amputated lower extremity and factors influencing subsequent physiotherapy. The main goal of this thesis was to bring this problem closer and design a therapeutic procedure in order to improve the patient´s postural and locomotion functions. The incidence of diabetes mellitus illness is rising violently and lower extremity amputations mean its worst complication. In the theoretical part I have first defined the term of proprioception and characterized the important proprioreceptors. I have approached the basic mechanisms of the transfer of the inner and outer stimuli into the CNS. An important part of the theory is also presented by the section devoted to proprioception disorders and their examination. Further on I have focused on the description of diabetes mellitus and the complications that are connected to it. Most problems linked to diabetes influence the proprioception negatively. In the last section of the theoretical part I focus on amputations where I also mention their consequences on the ability to receive proprioceptive information. All these parts gather information about the causes of proprioception disorders which subsequently complicate physiotherapy significantly. The practical part was processed through a qualitative research. The research includes the probands´ elaborated case studies containing individual anamneses, examinations and conducted therapeutic units. An important part is made up by the input and output kineziologic analyses. In the practical part I have tried to apply the obtained theoretical knowledge into excercise units. I have carried out the research for my practical part in the Technical Orthopedics Center in České Budějovice. I have chosen 4 probands of both sexes between the ages of 60 to 65 to carry out my research. All participants had femural amputation. Two probands were suffering from diabetes with a proven diabetic neuropathy. Other two were diagnosed with diabetes without diabetic neuropathy, therefore their proprioception was violated only through the extremity loss. All participants were equipped with the first prosthetics with similar structural components. Therapy took place individually, for a time period of five weeks. Excercise units took place twice a week for 60 minutes. They included excercises according to the individual needs of the probands. The main goal of the therapy was a practice of stable stand and coordinated walk. I carried out the research evaluation on the basis of the input and output examination. I compared the individual results of probands suffering from diabetic neuropathy and those not suffering from this illness. Through the carried-out research I wanted to point to the fact that even diabetics with a femural amputation in the lower extremity may reach a high quality of lifestyle through a well-designed rehabilitation care. That is why this thesis may serve not only as educational material for sanitary staff but also for the amputated themselves.
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Evaluation of selected postural stability parameters of diabetic patients
Mrázková, Lucie ; Zahálka, František (advisor) ; Strnad, Pavel (referee)
Title: Evaluation of selected postural stability parameters of diabetic patients Objectives: The main objective of this thesis is to describe the level of postural stability using the selected parameters in diabetes mellitus type 2 and to try to find a relationship between the severity of disease. We also want to compare the level of postural stability for such an illness with respect to the values of selected parameters of the healthy population. Methods: It is a descriptive study. The theoretical part was the basis of the processing problems of diabetes mellitus, with a focus on neuropathy. After that we evaluate data of selected parameters of postural stability in diabetes mellitus type 2. The second part involves the experiment, which refers to the evaluation of this issue in terms of posturographic analysis. A group of 30 type 2 diabetic patients were divided according to their diabetologist disease severity into 4 groups. A control group of healthy subjects included a sample of 7 probands. The patient group was composed of 18 men and 12 women, whose average age was 62.63 ± 15.55 years, average weight 91.17 ± 19.97 kg, who were subjected to measurement using a pressure plate FootScan (RScan International, Belgium). Results: We managed to prove, that subjects with diabetic neuropathy have...
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The Incidence of Complications in Patients with Diabetes Mellitus
Korytenská, Kristýna ; Pavlíková, Pavla (advisor) ; Hrdličková, Renáta (referee)
1 Abstract This thesis deals with the occurrence of complications in patients with diabetes mellitus. The aim of this bachelor thesis is determine which acute and chronic complications prevail in relation to gender, type of diabetes and duration of diabetes. The thesis is divided into theoretical and practical part. In the theoretical part of the thesis I described themselves diabetes mellitus, types of diabetes mellitus, acute complications and chronic complications. Among the acute complications include hyperglycemia and hypoglycemia. Chronic complications are divided into specific and nonspecific. In the empirical part, I followed the incidence of complications. I realized quantitative research using questionnaires. The questionnaire was own of design. Participated in this research 78 respondents who were acquired in diabetes clinics. I divided respondents into subsequent categories: women with type I diabetes, women with type II diabetes, men with type I diabetes and men with type II diabetes. The thesis results that, overall acute and chronic complications suffered total 41 % of respondents. The most common complication of acute hyperglycemia reported 25.6 % of respondents. The most common complications were chronic diabetic neuropathy and diabetic retinopathy, each with 6.5% of respondents. Keywords:...
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