Sains Malaysiana 40(8)(2011): 945–951

 

Hubungan Antara Sensori Neuropati dan Ketidakseimbangan Badan di kalangan Wanita Melayu Diabetik

(Relationship between Sensory Neuropathy and Body Imbalance among Diabetic Malay Women)

 

Sazlina Kamaralzaman*

Program Terapi Carakerja, Fakulti Sains Kesihatan Bersekutu, Universiti Kebangsaan Malaysia

Jalan Raja Muda Abdul Aziz, 50300 Kuala Lumpur, Malaysia

 

Siti Balkis Budin & Jamaludin Mohamed

Jabatan Sains Bioperubatan, Fakulti Sains Kesihatan Bersekutu, Universiti Kebangsaan Malaysia

Jalan Raja Muda Abdul Aziz, 50300 Kuala Lumpur, Malaysia

 

Hatta Sidi

Jabatan Psikiatri, Pusat Perubatan UKM, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif

Bandar Tun Razak, 56000 Kuala Lumpur, Malaysia

 

Matthew Yau

Discipline of Occupational Therapy, School of Public Health, Tropical Medicine & Rehabilitation Sciences, James Cook University, Townsville, QLD 4811, Australia

 

Anuar Sani

Jabatan Sains Perubatan II, Fakulti Perubatan dan Sains Kesihatan, Universiti Sains Islam Malaysia, Menara B, Persiaran MPAJ, Pandan Indah, 55100 Kuala Lumpur, Malaysia

 

Received: 22 Mac 2010 / Accepted: 1 September 2010

 

 

ABSTRAK

Neuropati ialah masalah yang sering dideritai oleh pesakit diabetes mellitus. Jenis neuropati yang kerap terjadi termasuklah neuropati periferi dan autonomik. Kajian keratan rentas ini dilakukan bagi menentukan hubungkait antara tempoh menghidapi diabetes dan kehilangan sensasi perlindungan dan kaitan ketidakseimbangan badan dan kehilangan sensori perlindungan di kalangan wanita Melayu yang menghidapi diabetes melitus. Seramai 81 orang wanita Melayu yang menghidapi diabetes melitus, berumur antara 20 dan 60 tahun, daripada tiga klinik kesihatan di daerah Hulu Langat menyertai kajian. Maklumat sosio-demografik diambil daripada responden menggunakan borang soal selidik. Penilaian sensori kaki dijalankan dengan menggunakan Semmes-Weinstein Monofilamen gred 5.07. Penilaian keseimbangan badan pula dilakukan dengan kaedah Tempoh berdiri satu kaki. Ujian Khi Kuasa Dua telah digunakan di dalam kajian ini untuk menentukan hubungan di antara dua pembolehubah. Hasil kajian mendapati 56.8% daripada responden mempunyai kehilangan sensori perlindungan pada sekurang-kurangnya satu kaki. Manakala, 17.3% mempunyai ketidakseimbangan semasa mata dibuka dan 60.5% mengalami ketidakseimbangan semasa mata ditutup. Namun begitu, tiada hubungan yang bererti di antara ketidakseimbangan (semasa mata dibuka [χ2=3.27, p=0.07] dan semasa mata ditutup [χ2=0.29, p=0.59]) dengan kehilangan sensori perlindungan pada kaki. Hasil yang sama juga didapati antara tempoh menghidapi diabetes dan kehilangan sensasi perlindungan (χ2=3.27, p=0.20). Walaupun tiada hubungkait antara pelbagai faktor kajian, program penyaringan harus bermula dari awal untuk memastikan masalah dikesan pada peringkat awal sebelum komplikasi yang lebih teruk berlaku.

 

Kata kunci: Diabetes mellitus; kehilangan sensasi perlindungan; ketidakseimbangan badan; wanita Melayu

 

ABSTRACT

 

Neuropathy is a problem often suffered by patients with diabetes mellitus. Types of neuropathy that occur are peripheral neuropathy and autonomic neuropathy. This cross sectional study was conducted to determine the association between duration of diabetes and loss of protective sensation and the association between imbalance and loss of protective sensation among Malay women with diabetes mellitus. Eighty one Malay women with diabetes mellitus, aged 20 to 60 years from three clinics in Hulu Langat District participated in this study. Socio-demographic information were obtained from respondent using a questionnaire. Foot sensory evaluation was conducted using Semmes-Weinstein Monofilament grade 5.07. Assessment of balance was done using Timed One-leg Stance. Chi-squared test was used to determine the association between the two variables. Result showed that 56.8% of respondent had loss of protective sensation on at least one foot. While, 17.3% had imbalance while eyes were open and 60.5% experienced imbalance while eyes were closed. However, there was no significant correlation (p<0.05) between imbalance while eyes opened [χ2=3.27, p=0.07] and while eyes close [χ2=0.29, p=0.59]) with loss of protective sensation in at least one foot. Similar result were obtained between duration of diabetes and the loss of protective sensation. (χ2=3.27, p=0.20). Although there was no association between these factors, a screening program should start early to ensure early problems are identified before more severe complications occur.

 

Keywords: Diabetes mellitus; imbalance; loss of protective sensation; Malay women

 

REFERENCES

 

Ali R.A. 2003. Management of diabetic neuropathy. Malaysian Journal of Medical Sciences 10(2): 27-30.

Bonnet C., Carello C. & Turvey M.T. 2009. Diabetes and postural stability. Journal of motor behaviour 41(2): 172-190.

Boyko E.J., Ahroni J.H., Stensel V., Forsberg R.C., Davignon D.R. & Smith D.G. 1999. A prospective study of risk factors for diabetic foot ulcer: The Seattle Diabetic Foot Study. Diabetes Care 22(7): 1036-1042.

Cimbiz A. & Cakir O. 2005. Evaluation of balance and physical fitness in diabetic neuropathic patients. Journal of Diabetes and its Complications 19(3): 160-164.

Feng Y., Schlosser F.J. & Sumpio B.E. 2009. The Semmes Weinstein monofilamaent examination as a screening tool for diabetic peripheral neuropathy. Journal of Vascular Surgery 50: 675-82.

Forouzandeh H.L., Lianal J.I., Vincent Y.B., Fong K.Y. & Thumboo J. 2005. The influence of sensory neuropathy in quality of life in diabetes mellitus: A population-based, multiethnic study. Journal of Diabetes and its Complications 28:123-129.

Gerich J.E. 1997. Metabolic abnormalities in impaired glucose tolerance. Metabolism 46:10–43.

Hamilton N. & Luttgens K. 2002. Assessment of balance and sensory neuropathy in diabetic patients without diabetic foot problems. Journal of Diabetes and its Complications 24(2): 127-132.

Ismail M. 2010. Setting up a National Diabetes Register to Improve the Quality of Care for Patients. https://app.acrm.org.my/ADCM/Presentation.aspx [21 Februari 2010]

Kastenbauer T., Irsigler P., Sauseng S., Grimm A. & Prager R. 2004. The prevalence of symptoms of sensorimotor and autonomic neuropathy in Type 1 and Type 2 diabetic subjects. Journal of Diabetes and its Complications 18(1): 27-31.

Matsumura B.A. & Ambrose A.F. 2006. Balance in the Elderly. Clinics in Geriatric Medicine 22(2): 395-412.

Nardone A., Grassoa M. & Schieppati M. 2006. Balance control in peripheral neuropathy: Are patients equally unstable under static and dynamic conditions? Gait & Posture 23(3): 364-373.

Nather A., Neoa S.H., Chionha S.B., Liewa S.C.F., Sima E.Y. & Chewa J.L.L. 2008. Assessment of sensory neuropathy in diabetic patients without diabetic foot problems. Journal of Diabetes and its Complications 22(2): 126-131.

National Health and Morbidity Survey 1 (NHMS). 1996. Institute of Public Health, Ministry of Health, Malaysia

Özdirenç M., Biberoğub S. & Özcan A. 2003. Evaluation of physical fitness in patients with Type 2 diabetes mellitus. Diabetes Research and Clinical Practice 60(3): 171-176.

Rolland Y., Kan G.A.V., Fati N., Andrieu S. 2009. An Abnormal ‘One- leg Balance’ Test predicts cognitve decline during Alzheimer’s Disease. Jurnal of Alzheimer’s Disease 16: 525-531

Rubeinstien R.R. & Peyrot M. 1999. Quality of life and diabetes. Diabetes Metabolic Research Review 15: 205-218.

Severinsen K. & Andersen H. 2007. Evaluation of atrophy of foot muscles in diabetic neuropathy – A comparative study of nerve conduction studies and ultrasonography. Clinical Neurophysiology 118(10): 2172-2175.

Sridhar G.R., Madhu K., Veena S., Madhavi R., Sangeetha B.S. & Asha R. 2007. Living with diabetes: Indian experience. Diabetes & Metabolic Syndrome: Clinical Research & Reviews 1(3): 181-187.

Tinetti M.E., Speechly M. & Ginter H.F. 1988. Risk Factors for falls among elderly person living in the community Journal of Medicine 319: 1701-1707.

Turcot K., Allet L., Golay A., Hoffmeyer P. & Armand S. 2009. Investigating of standing balance in diabetic patients with and without peripheral neuropathy using accelerometer. Clinical Biomechanic 24: 716-721.

Valensi P., Giroux C., Seeboth-Ghalayini B. & Attali J. 1997. Diabetic peripheral neuropathy: Effects of age, duration of diabetes, glycemic control, and vascular factors. Journal of Diabetes and its Complications 11(1): 27-34.

Vellas, S. F., Tilton, R.G., Dixon, R.A. & Brock, T.A. 1997. Growth factor antagonists for the treatment of diabetic vascular complications. Expert Opinion Investigation Drugs 6: 1671-84.

Yim-Chiplis P.K. & Talbot L.A. 2000. Defining and Measuring Balance in Adults. Biological Research For Nursing 1(4): 321-331.

Zaini A. 2000. Where is Malaysia in the midst of the Asian epidemic of diabetes mellitus? Diabetes Research and Clinical Practice 50(Supp 2): S23-S28.

 

*Corresponding author, email: sazlina@gmail.com

 

 

 

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