Earlier Development of Diabetic Neuropathy in Men Than in Women With Type 2 Diabetes Mellitus

Article (PDF Available)inGender Medicine 7(6):600-15 · December 2010with11 Reads
DOI: 10.1016/j.genm.2010.11.001 · Source: PubMed
Abstract
Data about the prevalence of diabetic neuropathy (DN) differ substantially, depending on the population and diagnostic methods. Sex-specific differences in DN are rarely discussed. The aims of the present study were to assess the prevalence of, and analyze sex differences in, DN in a hospital population with type 2 diabetes mellitus (T2DM) over a period of 18 years. In this retrospective study performed at a university hospital endocrinology clinic in Sofia, patient clinical records from 1990-2007 were examined. Patients were included in the database only at their first admission. Data from 1705 patients with T2DM were analyzed (961 women, 744 men; mean [SD] age, 60.0 [11.9] years; diabetes duration, 9.9 [8.4] years; glycosylated hemoglobin, 9.0% [2.2%]; and body mass index, 29.4 [6.0] kg/m²). Obesity (46.3% vs 32.0%; P < 0.001), hypertension (86.7% vs 77.8%; P < 0.001), and dyslipidemia (61.2% vs 55.0%; P < 0.05) were significantly more common in women than in men, respectively. The prevalence of DN was 78.8%, with no significant sex differences. However, prevalence differed with time, corresponding to the frequency of application of electrophysiologic (electromyograms) or semiquantitative instrumental diagnostic methods. In men, the median (25th-75th percentiles) interval between diagnosis of T2DM and diagnosis of DN was 6 (1-12) years; in women, the interval was 8 (4-13) years (P < 0.01). In this study of Bulgarian patients with T2DM, women were at higher macrovascular risk than were men. A high prevalence of DN was observed among these patients. The period from the diagnosis of T2DM to DN was shorter in men than in women-this necessitates earlier screening and therapeutic intervention for DN in men. Reasons for this sex difference may include differences in lifestyle and the testosterone deficiency that is common in men with diabetes, leading to a more pronounced deficit of neurosteroids.
    • "The reason (s) male subjects with diabetes develop neuropathy earlier than female subjects [1,2] is not clear and may be complex, but factors such as testosterone deficiency, which is common in men with diabetes (i.e. leading to a pronounced deficit of neurosteroids), as well as lifestyle differences may contribute to the discrepancy in development, at least in type 2 diabetes in humans [26] . In addition, the mechanisms for the development of neuropathy in type 1 and 2 in humans may be different and particularly complex and multifactorial in type 2 diabetes [27,28] which the present GK rat model resembles. "
    [Show abstract] [Hide abstract] ABSTRACT: Background In view of the global increase in diabetes, and the fact that recent findings indicate that diabetic neuropathy is more frequently seen in males, it is crucial to evaluate any gender differences in nerve regeneration in diabetes. Our aim was to evaluate in short-term experiments gender dissimilarities in axonal outgrowth in healthy and in genetically developed type 2 diabetic Goto-Kakizaki (GK) rats, and also to investigate the connection between activated (i.e. ATF-3, Activating Transcription Factor 3) and apoptotic (cleaved caspase 3) Schwann cells after sciatic nerve injury and repair. Female and male diabetic GK rats, spontaneously developing type 2 diabetes, were compared with corresponding healthy Wistar rats. The sciatic nerve was transected and instantly repaired. After six days the nerve was harvested to measure axonal outgrowth (i.e. neurofilament staining), and to quantify the number of ATF-3 (i.e. activated) and cleaved caspase 3 (i.e. apoptotic) stained Schwann cells using immunohistochemistry. Results Axonal outgrowth was generally longer in male than in female rats and also longer in healthy than in diabetic rats. Differences were observed in the number of activated Schwann cells both in the distal nerve segment and close to the lesion site. In particular the female diabetic rats had a lower number. There were no gender differences in number of cleaved caspase 3 stained Schwann cells, but rats with diabetes exhibited more (such cleaved caspase 3 stained Schwann) cells both at the lesion site and in the distal part of the sciatic nerve. Axonal outgrowth correlated with the number of ATF3 stained Schwann cells, but not with blood glucose levels or the cleaved caspase 3 stained Schwann cells. However, the number of cleaved caspase 3 stained Schwann cells correlated with the blood glucose level. Conclusions We conclude that there are gender differences in nerve regeneration in healthy rats and in type 2 diabetic GK rats.
    Full-text · Article · Sep 2014
    • "Diabetes mellitus (DM) is a chronic, progressive, incurable metabolic disorder characterized by hyperglycemia due to defective insulin action, insulin secretion or both [1]. The long-term elevated blood glucose level can easily cause a variety of diabetic complications such as ketoacidosis [2], neuropathy [3], nephropathy [4], cardiopathy [5] and retinopathy [6]. With the total number of diabetics projected to rise from 171 million in 2000 to 366 million in 2030 [7], DM has become a serious problem which is threatening world public health [8], therefore, various methods for the treatment of DM have been developed to maintain normal blood glucose or insulin levels. "
    [Show abstract] [Hide abstract] ABSTRACT: Mai Tong Fang (MTF), a Chinese herbal combination, has been used for the treatment of diabetic nephropathy in traditional medical clinics in China. However, the anti-adipogenic and anti-hyperglycemic effects of MTF have not been fully elucidated, so this study explored these pharmacological activities in 3T3-L1 adipocytes and ob/ob mice, respectively, of the water fraction of milkvetch root, salviae miltiorrhizae and mulberry as key components of MTF. MTF was found to inhibit adipogenesis and triglyceride accumulation in 3T3-L1 adipocytes. Oral administration of MTF in ob/ob mice for 8 weeks, exhibited positive controls on blood glucose and body weight, and further improved glucose tolerance according to an oral glucose tolerance test. Importantly, MTF extract alleviated fat deposition and ballooning degeneration in liver tissue and blocked the increase of adipocyte size in adipose tissue from treated ob/ob mice. These results indicated that the extract of key components in the traditional Chinese prescription MTF continue a potent anti-adipogenic and glucose-lowering agent.
    Full-text · Article · Sep 2014
    • "Moreover, more evidence suggests a role of resistin in the etiology of both insulin resistance and type 2 diabetes mellitus [6, 7]. Long-term elevated glucose level in the blood likely leads to a variety of diabetic complications such as neuropathy [8], nephropathy [9], and retinopathy [10]. These are partly caused by an increase of oxidative stress. "
    [Show abstract] [Hide abstract] ABSTRACT: Carassius auratus complex formula, including Carassius auratus, Rhizoma dioscoreae, Lycium chinense, and Rehmannia glutinosa Libosch, is a combination prescription of traditional Chinese medicine, which has always been used to treat diabetes mellitus in ancient China. In this study, we provided experimental evidence for the use of Carassius auratus complex formula in the treatment of high fat diet combined streptozotocin- (STZ-) induced type 2 diabetes. Carassius auratus complex formula aqueous extract was prepared and the effects of it on blood glucose, serum insulin, adipose tissue weight, oral glucose tolerance test (OGTT), total cholesterol, and triglyceride (TG) levels in mice were measured. Moreover, adiponectin, TG synthesis related gene expressions, and the inhibitory effect of aldose reductase (AR) were performed to evaluate its antidiabetic effects. After the 8-week treatment, blood glucose, insulin levels, and adipose tissue weight were significantly decreased. OGTT and HOMA-IR index showed improved glucose tolerance. It could also lower plasma TG, TC, and liver TG levels. Furthermore, Carassius auratus complex formula could inhibit the activity of AR and restore adiponectin expression in serum. Based on these findings, it is suggested that Carassius auratus complex formula possesses potent anti-diabetic effects on high fat diet combined STZ-induced diabetic mice.
    Full-text · Article · Jan 2014
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