جستجوی مقالات مرتبط با کلیدواژه « نوروپاتی دیابتی » در نشریات گروه « پزشکی »

Diabetes is a significant global health issue, often linked to disturbances in restoring balance following postural disorders. Individuals with diabetic neuropathy, are 15 times more prone to injuries such as falls, fractures, sprained ankles, and bruises when walking and standing, compared to those with diabetes who do not have neuropathy. Therefore, preventing falls is an issue that deserves special attention in the care of individuals with diabetic neuropathy. In the present study, various articles on the relationship between diabetic neuropathy and reactive balance control disorders were reviewed in PubMed, Scopus, ScienceDirect, Iran Medex, Magiran, and Google Scholar databases. Based on the results obtained from the studies, individuals with diabetic neuropathy exhibit greater postural fluctuation and slower speed, as well as a longer delay, in initiating balance responses to postural disturbances compared to individuals with diabetes who do not have neuropathy. The studies conducted so far on the control of reactive balance in individuals with diabetic neuropathy have determined that the disruption of automatic postural responses can lead to postural instability and limitations in the daily activities of this group of patients. It is suggested that preventive solutions and appropriate training programs be specifically designed for these patients to enhance automatic postural responses and reduce the risk of falling and injury.

Diabetic neuropathy (DN) is one of the most common complications of diabetes which causes disability and mortality. Nearly half of patients with diabetes develop DN. A few studies have been conducted to evaluate the prevalence of DN in children. More than 90% of diabetic children have type 1 diabetes mellitus (T1DM). The most accurate way to diagnose neuropathy is NCV. Accordingly, the present study investigates the prevalence of DN in children with T1DM by clinical symptoms, neurological examinations, and NCV.

This cross-sectional study was conducted between 2021 and 2023 after approval. Patients (younger than 18 years old) with T1DM, diagnosed for at least 5 years, and not suffering from other diseases such as hypothyroidism and neuromuscular diseases were included. Children who were not willing to undergo NCV were excluded from the study. Demographic data of patients (age, gender, weight, height, body mass index (BMI), and duration of diabetes) were collected. Neurological symptoms were evaluated using the neuropathy symptom score (NSS). Patients were asked about tingling, burning, numbness, fatigue, cramping, and pain in the lower extremities. The clinical history of the patients, including HbA1c levels, blood pressure, retinopathy, lipodystrophy, nephropathy, history of diabetic ketoacidosis, and daily insulin dosage, was evaluated. The Achilles reflex was evaluated using the case reflex hammer and peripheral nerve function through 10g monofilament in patients. Patients who met the inclusion criteria of the study underwent NCV. NCV was performed by a specialist in physical medicine and rehabilitation. In NCV, peroneal, tibial, and sural sensory and motor nerves were performed in both lower limbs, and median and ulnar sensory and motor nerves in both upper limbs.

In the present study, 32 patients with T1DM met the study criteria. The mean age was (14.16±2.55 years), height (154.28±8.96 cm), weight (44.88±12.32 kg), and BMI (18.55±3.787) of the patients. The mean duration of diabetes in the studied patients was 7.1±2.428 years. The mean HbA1c was 9.54%±1.941. The mean NSS was 2.94±2.862. The NSS results showed that 18.75% (score: 3 or 4), 31.25% (score: 5 or 6), and 6.25% of patients had mild, moderate, and severe symptoms (score: 7 to 9), respectively. The blood pressure of the examined patients was in the normal range. The most common complications of type 1 diabetes mellitus in patients were lipodystrophy (21.87%), nephropathy (12.5%), and retinopathy (3.12%). The results of Achilles reflex evaluation revealed no disorder in any of the patients. Only one (3.12%) of the studied patients was diagnosed with peripheral nerve disorder in the evaluation by monofilament. However, the NCV results of this patient showed that the patient did not have peripheral neuropathy.

We found that the prevalence of DN in children and adolescents with T1DM is very low. Our results, similar to those of other studies, showed that a mere clinical evaluation and having DN symptoms are not sensitive enough to diagnose DN. Further investigation through a standard test (NCV) is needed in this regard. Based on the results of the present study, NCV is not recommended for T1DM patients under 18 years of age, whose 10g monofilament results were also negative. A limited number of patients were evaluated in the present study and it is necessary to conduct studies with a larger population.

Diabetic nephropathy and peripheral neuropathy complications are attributed to the elevated concentration of the pro-inflammatory cytokine TNF-α. This cytokine, recognized as a crucial biomarker, plays a pivotal role in investigating the pathogenesis of diabetes due to its level fluctuations in glomerular, tubular damage, and fibrosis. This study explores the dose-dependent effect of magnesium sulfate on the serum concentration of TNF-α in an animal model induced with paclitaxel.

Twenty-four male Wistar rats with a mean weight of 200±40 g were randomly divided into four groups: three experimental groups (E1, E2, and E3) and a control group, each comprising six mice. To induce neuropathy, paclitaxel (10 mg/kg) was intraperitoneally administered every other day. To prevent neuropathy occurrence, magnesium sulfate (doses of 75, 150, and 300 mg/kg) was intraperitoneally prescribed daily. Sampling was conducted after 10 days, and serums were separated to measure TNF-α concentration using the ELISA method.

The mean±SD serum level of TNF-α in the E1 group (2.31±0.26 pg/ml) significantly increased compared to the control group (1.46±0.21) (P<0.05). In the E3 group, the mean±SD serum level of TNF-α (4.54±1.32) also significantly increased compared to the control group. However, there was an insignificant increase in TNF-α serum level in the E2 group (3.34±1.08) compared to the control group (P>0.05).

This study, confirming the rise in TNF-α serum level induced by paclitaxel, demonstrates that the dose-dependent administration of magnesium sulfate (300 and 150 mg/kg) reduces the potential incidence of nephropathy and peripheral neuropathy by lowering TNF-α serum levels

Diabetes mellitus is a common metabolic disorder, with worldwide increasing rates and many complications. Nervous system disorders are the most commonly encountered diabetes, so that about half of diabetic patients will ultimately develop neuropathy. Diabetic neuropathy leads to consequences like recurrent lower limb infections, diabetic foot ulcers and subsequent amputation. Considering the many problems caused by diabetic neuropathy and the need to know more about this complication and helping to improve prevention and control strategies, this study was conducted to determine the frequency of diabetic neuropathy in diabetic patients and its risk factors in patients referred to the Diabetes Clinic of the Hospital Golestan Ahwaz was conducted during the years 1393-95.Methods & Materials: This retrospective study carried out on 605 patients with type 2 diabetes who referred to Ahwaz Golestan Hospital from 1393 to 1395. The frequency of diabetic neuropathy was evaluated in these patients and the risk factors for the development of neuropathy were studied using data registration forms and analyzed by software ...

Of the 605 patients studied in this study, 213 (35.2%) patients had diabetic neuropathy.Of these 213 people (51%) were women and (49%) were men. With the increase in HbA1c level or smoking, the prevalence of diabetic neuropathy also increased significantly.

Diabetic neuropathy is a common and prevalent complication of diabetes. With attention to the early diagnosis, treatment of complications and risk factors, efforts should be made to reduce this complication in order to reduce its many medical, social and financial problems.

Reduced ability to control balance is one of the disorders affecting the qualityof life and daily activities of people with diabetic polyneuropathy (DPN), which can lead to dangerousconsequences such as falling. By identifying the causes of balance disorders, we can better understandthis condition to provide effective and evidence-based treatments for these patients. This study aimsto investigate and compare the use of motor strategies in people with and without impaired sensoryorganization suffering from DPN.

In this cross-sectional study, 40 people with DPN participated. Their demographicinformation were recorded and then underwent balance performance test using the sensory organizationtest. Based on the results, they were divided into two groups: Control group without impaired sensoryorganization (n=18) and Patient group with impaired sensory organization (n=22).

The prevalence of inappropriate use of motor strategies to restore balance in DPN patients withimpaired sensory organization was higher than in the control group. The adopted inappropriate strategywas mostly in using ankle strategy, where the somatosensory and visual perturbations were higher.

Patients with DPN use ankle strategy, instead of hip strategy, to restore balance. This non-useof hip strategy is more common in patients with impaired sensory organization.

Diabetes is the most common cause of peripheral neuropathy throughout the world and has negative impact on patient's quality of life. There is no cure and to date several drugs have been used for its symptomatic treatment, including antidepressants and antiepileptics. Neurotec is a herbal medicine (combination of wild star anise, nettle and tansy) that can be potentially effective in the treatment of this disorder. Proposed mechanisms include its effects on increasing nerve conduction velocity and repairing peripheral nerves.

In a single-blind randomized clinical trial from April to September 2018 in Kermanshah of patients referred to Taleghani Hospital Clinic, 100 diabetic patients with sensory complaints, were randomly divided into two groups. The first group received 100 to 300 mg gabapentin (a well-known effective antiepileptic drug) daily and the second group received 100 mg Neurotec daily. At the beginning of the study and at the weeks of 6 and 12, patients were evaluated with DN4 questionnaire and the visual analog scale (VAS) for severity of sensory symptoms including paresthesia and numbness and the results were compared and analyzed. In each serial visit, possible drug side effects were asked from patients and recorded.

Neurotec reduced the feeling of coldness, pain, paresthesia and numbness VAS and DN4 scores (P of 0.01,0.05, 0.05, 0.05, 0.001, 0.05 respectively). Neurotec showed a significant advantage over gabapentin in reducing pain intensity and in other parameters the difference between the two groups was not significant. The only significant complication of Neurotec was dyspepsia that could be minimal in patients who receive the drug after a meal. Conversely in the gabapentin group, dizziness, drowsiness, and vertigo were significantly more common (P>0.05).

Neurotec can be useful for sensory symptoms of diabetic neuropathy. Its effect on symptomatic therapy is comparable to gabapentin or even better for painful diabetic neuropathies. Its proposed mechanism in neuronal repair needs to be evaluated and can be a potential advantage over symptomatic therapies. Neurotic has no serious side effects.

Diabetic neuropathy is the most common diabetic complication. In more than 50% of patients with diabetic neuropathy, significant and irreversible nerve damage occurs before diagnosis. Diabetic neuropathy is associated with increased mortality (2). Half of patients with diabetic neuropathy suffer from neuropathic pain. These painful symptoms are usually severe and often lead to depression, anxiety and sleep disorders and reduced quality of life (2). Oxidative stress caused by hyperglycemia causes damage to mitochondria in nerve cells, but its mechanisms are not fully understood (4, 5). Sequential oxidation reactions in the mitochondria cause unpaired electron leakage in the electron transfer chain in the inner mitochondrial membrane and the production of free radicals (4). Mitochondria are primary targets for ROS-induced injury; because they are the main site of ROS formation in diabetic hyperglycemia (4). Therefore, examining the factors affecting the structural and functional components of mitochondria, such as electron transfer chain components, can provide useful information for the goals and programs of treatment and prevention of neurological damage caused by diabetic neuropathy. Cytochrome C is a small hemoprotein in the inner membrane of the mitochondria; this protein is highly soluble in water and is a key component of the electron transfer chain (6). Velayutham et al. In a study stated that cytochrome C and Fe3 play a significant role in the harmful effects of ischemia / reperfusion and diabetes due to increased production of superoxide radicals (7). On the other hand, insulin therapy has been shown to modulate neurotrophin-dependent treatment of mitochondrial membranes and the expression of genes associated with metabolite pathways and the mitochondrial electron transport chain (8). Although much research has been done on the effect of exercise on diabetic neuropathy, there is no research specifically examining the effect of exercise on cytochrome C as one of the factors affecting the mitochondrial function of the nervous system in mice with diabetic neuropathy; Therefore, the aim of the present study was to determine the effect of six weeks of aerobic exercise on the level of cytochrome C in the sensory part of the spinal cord in rats with diabetic neuropathy.

In the present experimental study, 12 male Wistar rats were divided into 4 groups: healthy exercise, control exercise, control diabetes and control diabetes. In order to induce diabetes, half of the rats became intraperitoneally diabetic by injecting a single dose of streptozotocin (STZ) (55 mg / kg body weight). Forty-eight hours after STZ injection, hyperglycemic rats with serum glucose above 300 mg / dL were considered diabetic. To confirm the neuropathy of rats, the thermal hyperalgesia test was used with a tail-flick device (20). After confirmation of neuropathy, the animals were placed in the diabetic neuropathy group. The training program included 6 weeks of running training on the treadmill in 5 sessions per week. After dissection of the animals, the dorsal part of the spinal cord was analyzed as sensory neurons. Immunohistochemistry was used to measure the amount of cytochrome C protein. One-way analysis of variance and Tukey's post hoc test were used for statistical analysis. Statistical analysis was performed using SPSS software version 26 at a significant level of P ≤ 0.05.

The results showed that six weeks of aerobic training reduced blood glucose in the diabetic group compared to the control diabetic group (P = 0.002), but there was not observed make a significant difference in the weight of rats. The results also showed that after the training period, the level of cytochrome C protein in the healthy exercise group significantly increased compared to the healthy control group (P = 0.041) and in the diabetic group the exercise significantly decreased compared to the control diabetes group (P < 0.001).

The results of the present study showed that induction of diabetes increased the level of cytochrome C in spinal tissue in diabetic neuropathic rats compared to healthy groups. Previous research has shown that diabetic neuropathy is associated with mitochondrial degradation due to stress due to hyperglycemia and oxidative stress due to diabetes (21, 22); in the present study, an increase in cytochrome C in diabetic neuropathy groups was positively correlated with an increase in glucose levels. In the study of the effect of exercise on cytochrome C levels, the results of the present study showed that after six weeks of aerobic exercise, a significant increase in cytochrome C protein content of spinal cord sensory tissue was observed in healthy exercise rats compared to the healthy control group. While in the diabetic exercise group, the results showed a significant decrease in cytochrome C levels compared to the diabetic control group, which showed the difference in the effect of exercise on changes in cytochrome C of sensory neurons in mice with diabetic neuropathy compared to healthy mice. Scientific research has shown that exercise is one of the effective factors in reducing hyperglycemia due to diabetes (11, 25), on the other hand, by controlling blood sugar, the level of inflammatory factors and oxidative stress in these patients is reduced (26, 27); It can be said that aerobic exercise with glycemic control reduces mitochondrial stress and thus reduces cytochrome C as one of the mechanisms of apoptosis signaling (23, 24), in the cells of the spinal cord, Which can prevent the complications of diabetic neuropathy as well as neuropathic pain. The results of the present study also showed that six weeks of aerobic exercise increased the amount of cytochrome C protein in the spinal cord of healthy rats, this was consistent with the results of Yoo et al. (28) and Bashiri and Pourrazi (29) who studied the effect of exercise on cytochrome C in the myocardial of healthy rats. It can be said that the increase in cytochrome C levels in healthy rats is one of the adaptations associated with aerobic exercise and indicates an increase in mitochondrial capacity in ATP production. It can be said that changes in cytochrome C in spinal sensory tissue are different in adapting to six weeks of training in healthy rats with neuropathy, and the increase in cytochrome C in healthy rats is associated with increased mitochondrial capacity in energy production. While the reduction of cytochrome C in rats with diabetic neuropathy is associated with a reduction in hyperglycemia and indicates the protective role of exercise on nerve tissue and reducing neuropathic damage caused by diabetes. According to the results, in addition to controlling hyperglycemia in diabetic patients, aerobic exercise can be used as one of the non-pharmacological and useful treatment methods in reducing the complications of diabetic neuropathy.

In this study, the effect of oral administration of recombinant human interleukin-2 (rhIL-2) on brain NO level and AChE activity in hyperglycemic conditions induced by high-sucrose diet (HSD), as a type-2 diabetes model, was investigated in Drosophila melanogaster.

In this experimental research, adult fruit flies of both sexes (30 in each group) were divided into the six groups: receiving normal diet (ND); high-sucrose diet (HSD); ND with rhIL-2 at 0.01 and 0.1 ng/ml; and HSD with rhIL-2 at 0.01 and 0.1 ng/ml. Flies were bred on these culture media for three weeks. At the end of the experiments, the brains of the flies were extracted, homogenized, and glucose, NO, and AChE activity levels were measured by the kit.

Glucose level, AChE activity and NO level increased in brain homogenate of HFD flies compared to ND group. The body weight of HSD flies was reduced compared to the ND. Administration of rhIL-2 along with HFD significantly prevented these changes.

These findings suggest that rhIL-2 partially prevents diabetic neuropathy in Drosophila. It seems that the preventive effects of this compound are mediated through mechanisms dependent on nitric oxide and acetylcholinesterase in the brain.

Failure to control glucose levels for a long time leads to various complications, including neuropathy and decreased muscle mass. Our aim was to investigate the effect of controlling high blood sugar levels and improving insulin sensitivity following aerobic exercise on changes in lean body mass and frequency of ground reaction forces during running in patients with diabetic neuropathy.

In the current study, which was a time series, the statistical sample of the current study included 40 patients with diabetic neuropathy who were randomly divided into two equal control and experimental groups. The experimental group performed aerobic exercises for 12 weeks (3 sessions per week), with an intensity of 55-75% of maximum heart rate. Blood factors and ground reaction force data were collected before and after sports activity. The data was analyzed using SPSS version 26 software.

In the experimental group, blood factors including blood sugar (P=0.002), hemoglobin A1c (P=0.001), fasting insulin (P=0.001) and insulin resistance index (P=0.031) There was a significant decrease in the post-test compared to the pre-test. But the lean body mass did not show any significant change after 12 weeks of aerobic training in the experimental group (P=0.057). The number of essential harmonics of the GRF frequency spectrum of the earth in the internal-external direction in the experimental group was significantly reduced during the post-test compared to the pre-test (P=0.031). The results showed a significant difference in the effect of group*time factor in the mean frequency in the anterior-posterior direction (P=0.035).

Controlling glucose levels and increasing insulin sensitivity and reducing frequency content in both anterior-posterior and internal-external directions after the training period can lead to a reduction in the probability of injury in diabetic patients.

The aim of this study was to evaluate the effectiveness of the unified protocol of transdiagnostic treatment on improving the psychological symptoms of people with chronic pain, including reducing the experienced severity of health anxiety and improving self-compassion.

The research method is quasi-experimental research (pre-test-post-test design with unequal control group). This study is a randomized controlled trial that has an experimental group receiving unified protocol of transdiagnostic treatment and a control group receiving no intervention. The statistical population of this study is all people with neuropathic pain who referred to Mashhad Diabetes Association in 2019. Twenty-four participants were assessed using two self-compassion questionnaires (SCS) and short health anxiety (SHAI).

The results of analysis of covariance showed that there was a significant difference between the groups at the level of 0.001, which means that the unified protocol of transdiagnostic treatment decreased the mean of health anxiety in the post-test phase and increased the mean of self-compassion.

The unified protocol of transdiagnostic treatment is one of the most successful approaches in the field of health anxiety and self-compassion.

Diabetes is associated with dysfunction, and failure of various organs, especially the nerves, heart, and blood vessels. This study aimed to evaluate the effect of aerobic training on ankle joint co-contraction in patients with Diabetic neuropathy during walking.

The statistical sample of the present study included 20 patients (age: 54.9±7.3, Body mass index: 28.4±5.1) with diabetic neuropathy in the experimental group and 20 patients (age: 54.1±7.1, Body mass index: 28.5±5.1) with diabetic neuropathy in the control group who were selected by convenience sampling. The electrical activity of selected lower limb muscles was recorded using an electromyography system during walking. The experimental group did aerobic training for eight weeks (three sessions per week). The 2-ways ANOVA with repeated measures was used for statistical analysis.

The results demonstrated lower general ankle co-contraction in the post-test loading phase than the pre-test in the experimental group (P=0.001). Other components of directed co-contraction in all phases and general co-contraction in different phases did not demonstrate any significant differences after training protocol (P>0.05).

Damage to the peripheral nerve due to diabetic neuropathy in patients with moderate neuropathy causes abnormal co-contraction contentment of lower limb muscles during walking; therefore, lowering the general ankle co-contraction results in proper control of the lower limbs, which could decrease the likelihood of injury and falls in patients.

Neuropathy is a common complication of diabetes mellitus. Syntaphillin is involved in the anchoring of mitochondria to microtubules. The present study aimed to investigate the effect of six weeks of endurance training on Syntaphillin expression in spinal cord tissue of rats with experimental diabetic neuropathy.

40 rats were randomly divided into four groups, diabetes control (DC), diabetes training (DT), healthy control (HC), and healthy training (HT). Induction of diabetes was performed by intraperitoneal injection of the Streptozotocin solution (45 mg/kg). Endurance training was performed for six weeks. Tail-Flick and Von Frey tests were used to measure thermal hyperalgesia and mechanical allodynia. The expression of Syntaphillin was evaluated by immunohistochemistry. The data were analyzed using two-way ANOVA.

Teal-flick and von-Frey tests showed that pain threshold was significantly reduced in diabetic groups compared to non-diabetic groups (p<0.05). After STZ injection, blood glucose in diabetic groups increased significantly compared to non-diabetic groups (p<0.05). At the end of the study, the weight of diabetic groups decreased significantly compared to non-diabetic groups (p<0.05). In addition, there was a significant difference in the expression of Syntaphilin between HT, DC, and DT groups with HC group (p=0.001), between HT and DT groups with DC group (p=0.001) and between HT group and DT group (p=0.002).

Endurance training improves neuropathic pain responses and increases the Syntaphilin expression in the spinal cord of diabetic rats. These findings can be considered as a treatment for the complications of diabetic neuropathy.

Diabetic neuropathy is one of the most common complications of diabetesand no suitable drug treatment has been found for this complication. The aim of this study was to determinethe effect of six weeks of aerobic exercise on KIF1B protein in the sensory part of the spinal cord inrats with diabetic neuropathy.

In the present experimental study, 12 male Wistar rats were divided into 4 groups:healthy exercise, control exercise, healthy diabetes and control diabetes. The training program included6 weeks of running training on the treadmill in 5 sessions per week. The dorsal part of the spinal cordwas analyzed as sensory neurons.

The results showed that aerobic exercise significantly reduced blood glucose in the diabeticgroup compared to the control diabetes group (P=0.002), but no significant difference was observed inthe weight of rats. The results also showed that a significant increase (P=0.044) in KIF1B in healthy exercisegroup compared to healthy control group and a significant increase (P=0.027) in KIF1B in diabeticexercise group compared to control diabetes.

The results showed that aerobic exercise increases the amount of KIF1B protein in healthyand diabetic rats, and this increase in KIF1B motor protein can improve axonal transmission and thusimprove nerve function.

The most common cause of polyneuropathy is diabetes. Very few studies have investigated the effects of combined training on diabetes and diabetic-peripheral neuropathy complications. The purpose of this study was to investigate the effect of four months aerobicresistance training on glycosylated haemoglobin, total cholesterol, triglyceride and insulin resistance in postmenopausal women with diabetic-peripheral neuropathy .

For this purpose, 21 patients with diabetic neuropathy, were divided into two groups of control (n =10) and experimental (n =11). The experimental group performed resistance - aerobic training three sessions per week for four months. Subjects’ fasting serum samples were obtained before the start of the study and after the first, second, third and fourth months of training. Data were analyzed by one-way ANOVA and repeated measures ANOVA .

Total cholesterol, triglyceride, insulin resistance and glycosylated hemoglobin levels, as well as weight and fat percentage in the experimental group did not change significantly (P> 0.05) .

Stabilized glucose and glycosylated hemoglobin in diabetic-neuropathy patients and no increase in total cholesterol, insulin resistance and triglyceride levels within four months is clinically important and indicate that regular resistance - aerobic training can delay progression and complications of the disease.

The aim of the present study was to compare the frequency spectrum of lower limb muscles in patients with Covid-19 and healthy control individuals during gait.

The statistical sample of the present study included 15 patients with Covid-19 (age: 24.6± 9.1) and 15 healthy individuals (age: 23.2 ±8.0) who were selected using convenience sampling. The electrical activity of selected lower limb muscles was recorded using electromyography system during gait. Independent sample t-test was used for statistical analysis.

During loading response phase, the frequency spectrum in the vastus medialis, vastus lateralis, and gluteus medius muscles were significantly greater in the patient group than those in the healthy group (p < 0.05). During mid-stance phase, all of the selected muscles showed a similar median frequency values in the two groups (P>0.05).

Lowering the functional capacity of the lower limb muscles results in a lack of proper control of the ground reaction forces, which could increase the likelihood of injury and falls in patients.

The aim of the present study was to compare the frequency spectrum of selected lower limb muscles between patients with diabetic neuropathy and healthy peers during walking.

The statistical sample of the present study included 20 patients (age: 54.85± 19.7, Body mass index: 28.38±5.03) with diabetic neuropathy and 10 healthy individuals (age: 52.60 ±4.06, Body mass index: 26.74 ±1.86) who were selected using convenience sampling. The electrical activity of selected lower limb muscles was recorded using electromyography system during walking. Independent sample t-test was used for statistical analysis.

During loading response phase, the frequency spectrum in the vastus medialis, biceps femoris, semitendinosus, and gluteus medius muscles were significantly greater in the patient group compared with that in the healthy group (p < 0.05). During mid-stance phase, all of the selected muscles showed a lower median frequency values in the patient group (p < 0.05).Duringpush off phase, gastrocnemius muscle had lower frequency spectrum in patient group compared with the healthy group (p < 0.05). During swing phase, vastus medialis, biceps femoris, semitendinosus, and gluteus medius muscles had a significantly lower frequency spectrum in the patient group as compared with the healthy group (p < 0.05).

Damage to peripheral nerve due to diabetic neuropathy in patients with moderate neuropathy results in abnormal frequency contentment of lower limb muscles during walking. Also, lowering the functional capacity of the lower limb muscles can lead to a lack of proper control of the ground reaction forces, which could increase the likelihood of injury and falls in patients.

Diabetic neuropathy leads to a reduction in the balance due to peripheral nerves involvement. On the other hand, quantitative studies have shown changes in balance indicators after using the body's entire body vibration. The purpose of the present study was to evaluate the changes of equilibrium indices immediately after using the apparatus for whole body vibration in patients with type II diabetic neuropathy.

In the current single-session, single-blind clinical trial study, 32 patients with diabetic neuropathy were divided into two experimental and control groups. Patients in the intervention group, stood on the laser screen of the body's total vibration, with a frequency of 30HZ and an amplitude of 2 mm, knees bent to 30 degrees for six times with a one-minute rest. In the control group, there were patients with the same conditions, but they stood still on the device screen. Patients in both groups were evaluated before and after intervention using Biodex device. Regarding the normal distribution of data, Shapiro-Wilk test was used. Also, t-paired test and covariance analysis were run for further comparisons.

Based on t-paired sample test, general balance (p = 0.000), balance in the anterior-posterior direction (p = 0.000), and balance in side direction (p = 0.033), before and after intervention, revealed significant changes (P = 0.06); however, in the control group, general balance (p = 0.06), balance in the anterior-posterior direction (p = 0.33), and balance in side direction (p = 0.79) were not significantly different compared between pretest and posttest. Comparing the results of the two groups, using independent t-test, general equilibrium (p = 0.000), balance in the anterior-posterior direction (p = 0.000), and bilateral balance (p = 0.027) showed statistically significant differences.

According to the results, the whole body vibration can be effective in improving the balance in the short time.

Chronic hyperglycemia during diabetes is the leading cause of nerve tissue damage and neuronal dysfunction, which is defined as diabetic neuropathy. This activation, through the activation of a wide range of destructive cellular markers in the brain and then a defect in the learning and memory process, leads to a kind of forgetfulness called diabetic dementia. Increased production and accumulation of free radicals that lead to oxidative damage in brain tissue is one of the key pathways to damage neurons and nerve tissue. In addition to damaging cellular structures, these radicals induce various brain pathways, including PI3-kinase, AKT, and ERK1/2, by inducing the production of various inflammatory cytokines and mTOR (mammalian target of rapamycin) proteins in the brain. It then plays a key role in the destruction of neurons and dementia caused by diabetes by hyper-phosphorylation of tau protein and accumulation of beta-amyloid proteins. Fluorine nanoparticles (C60), as a powerful antioxidant and free radical scavenger, can prevent the accumulation of a variety of free radicals in brain tissue during diabetes. The use of these nanoparticles can prevent neuronal damage and diabetic neuropathy by inhibiting destructive signaling pathways that are activated by increased production of free radicals. Therefore, due to the lack of significant toxicity of these nanoparticles in biological environments, the use of these agents can be considered as a new treatment to maintain brain health and prevent neuropathy and dementia during diabetes.

Diabetes mellitus (DM) is a major epidemic public health problem of the 20th century. One of the most common complications of DM is peripheral neuropathy. This complication remains a big unsolved challenge for DM patients, endocrinologists, and nurses. The purpose of this study was to investigate the effectiveness of a warm foot bath on peripheral neuropathy in diabetic patients.

This randomized clinical trial was conducted on 70 diabetic patients at the Yazd Diabetes Research Center, Yazd, Iran. The study population was selected using the convenience sampling technique. They were randomly assigned into two groups of control (receiving routine care) and intervention (receiving routine care plus a warm foot bath). A warm foot bath was administered for 8 sessions lasting 20 min every other day, over 2 weeks. The data collection tool (i.e., a questionnaire) was completed by interviewing and examination in three phases (i.e., before the intervention and two weeks and one month after the intervention). The data were analyzed in SPSS software.

According to results, the mean neuropathy scores were obtained as 7.24, 4.51, and 4.39 before the intervention, two weeks post-intervention, and one month after the intervention, respectively. Based on the physical examination, these values were estimated at 4.09, 3.12, and 2.90 for the mentioned time points, respectively. With regard to the control group, the mean neuropathy scores in the three phases were respectively 7.48, 7.7, and 6.78 based on the history taking and 4.33, 4.7, and 3.84 according to the physical examination. The results revealed a significant difference between the intervention and control groups in terms of the posttest mean neuropathic score (P<0.001).

Considering the mean changes in peripheral neuropathy in diabetic patients, a warm foot bath can be recommended as an effective and simple nonpharmacological and home care intervention. However, it is required to perform further research in this domain.

Diabetic neuropathy is one of the most common and severe complications of diabetes. Very few studies have investigated the effects of resistance-aerobic training on diabetic-peripheral neuropathy. This study was performed with aim to investigate the effect of combined exercise (Resistance - Aerobic ) on neurotrophic changes, neuropathic pain, aerobic endurance and lower body strength in postmenopausal women with diabetic peripheral neuropathy

This practical and semi experimental study was performed on 21 patients with diabetic peripheral neuropathy in Sabzevar in 2017. The subjects were assigned into experimental and control groups. The experimental group performed resistance-aerobic exercises for four months. In fast condition, serum level of Brain-derived neurotrophic factor were taken before the start of the study and after the first, second, third and fourth months after the study. The neuropathic pain was measured with visual analog scale. Six-minute walking test (Rickly Jones) and sitting and standing test were used to estimate aerobic endurance and lower trunk performance, respectively. Data were analyzed by SPSS software (version 16) and Repeated Measure variance analysis and one-way ANOVA. P

Serum neurotrophin levels were not significantly increased in the experimental group compared to the control group (P> 0.05). Pain index significantly decreased compared to the control group (P< 0.05). Aerobic endurance and lower trunk functional strength significantly increased compared to the control group (P< 0.05).

two months of combined exercise (Resistance - Aerobic ) reduces pain index and strengthens aerobic endurance and lower trunk functional strength. Probably, to increase serum neurotrophin levels, the training period should be longer than four months.