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Neuropathy detection, quality of life tools & treatment for type 2 diabetes.

机译：神经病检测，生活质量工具和2型糖尿病治疗。

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摘要

Type 2 diabetes (T2D) mellitus has become the epidemic of the new millennium, with an estimated 382 million people affected worldwide as of 2013, and statistics projected towards 592 million by the year 2035. With the development of diabetes, complications have risen, with diabetic neuropathy becoming one of the most prevalent, affecting between 10--90% of those with the disease. Diabetic peripheral neuropathy (DPN) is difficult to detect in early stages of pathology, yet devastating once significant damage has taken place. Cardiac autonomic neuropathy (CAN), which is often silent, is associated with autonomic nervous system (ANS) dysfunction and increased risk for sudden death. Therefore, the purposes of this dissertation were early detection, assessment of quality of life (QOL) and disease intervention. Study I explored the effectiveness of the 128-Hz tuning fork, the 1-g and 10-g monofilaments, and the QOL-DN as tools for the early detection of DPN in overweight, obese and inactive (OOI), prediabetes (PD), and type 2 diabetes (T2D) individuals. Study II compared three QOL assessments: the QOL-DN, the PN-QOL-97 and the NeuroQOL-28, in OOI, PD and T2D individuals. Study III involved the execution of a double blinded, placebo controlled exploration of melatonin as a potential intervention for the improvement of ANS and sleep dysfunction in T2D.;The results of Study I suggest that the 1-g monofilament and QOL-DN measures correlate to NC-Stat DPN Check portable nerve conduction study (NCS) findings, that these measures function well for early detection purposes, and that the 128-Hz tuning fork is a useful screening tool in OOI, PD and T2D populations, despite lack of correlation to NCS measures. The results of Study II suggest that the QOL-DN and the NeuroQOl-28 QOL instruments significantly predict NCS results, indicating that these measures are useful for screening and accurately assessing neuropathy within our populations of interest. Study III results indicate that a 10 mg dose of melatonin taken 30 minutes prior to bedtime for four weeks has a positive effect on PSQI Subjective Sleep Quality, systolic blood pressure (SBP) in deep breathing and Valsalva maneuvers, and HRV SDNN measures in individuals with T2D.
机译：2型糖尿病（T2D）已成为新千年的流行病。截至2013年，全世界估计有3.82亿人受到影响，而到2035年，统计数字预计将达到5.92亿。糖尿病性神经病已成为最普遍的疾病之一，影响了该病患者的10--90％。糖尿病周围神经病变（DPN）很难在病理学的早期阶段检测到，但是一旦发生重大损害就具有破坏性。心脏自主神经病（CAN）通常是沉默的，与自主神经系统（ANS）功能障碍和突然死亡的风险增加有关。因此，本文的目的是早期发现，生活质量评估和疾病干预。研究I探索了128 Hz音叉，1 g和10 g单丝以及QOL-DN作为早期检测超重，肥胖和非活动（OOI），糖尿病前期（PD）中DPN的工具的有效性和2型糖尿病（T2D）个体。研究II在OOI，PD和T2D个体中比较了三种QOL评估：QOL-DN，PN-QOL-97和NeuroQOL-28。研究III涉及进行双盲，安慰剂对照的褪黑激素探索，作为改善T2D中ANS和睡眠功能障碍的潜在干预措施;研究I的结果表明1-g单丝和QOL-DN措施与NC-Stat DPN检查便携式神经传导研究（NCS）的发现，这些措施可很好地用于早期检测目的，并且128 Hz音叉是OOI，PD和T2D人群的有用筛选工具，尽管与NCS措施。研究II的结果表明，QOL-DN和NeuroQOl-28 QOL仪器可显着预测NCS结果，表明这些措施可用于筛查和准确评估我们所关注人群中的神经病变。研究III结果表明，在就寝时间30分钟前四周服用10毫克褪黑激素对PSQI主观睡眠质量，深呼吸和Valsalva动作的收缩压（SBP）以及HRV SDNN措施具有积极的影响。 T2D。

著录项

  • 作者

    Brown, Jennifer J.;

  • 作者单位

    Old Dominion University.;

  • 授予单位 Old Dominion University.;
  • 学科 Health care management.;Alternative medicine.;Medicine.
  • 学位 Ph.D.
  • 年度 2016
  • 页码 245 p.
  • 总页数 245
  • 原文格式 PDF
  • 正文语种 eng
  • 中图分类 古生物学;
  • 关键词

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