title: Median nerve conduction impairment in patients with diabetes and its impact on patients' perception of health condition: a quantitative study.
abstract: BACKGROUND
  Impaired mobility and compromised manual dexterity leading to difficulties with the activities of daily living (ADL) are an inherent part of the clinical picture in diabetes. Hand function in diabetes is influenced by a variety of pathologies: the median nerve, the most important nerve of the hand, can suffer from metabolic disturbances, ischemia and/or entrapment neuropathies. The resulting deterioration in functional capacity is likely to have significant consequences for the ability to perform ADL, influencing adjustment to diabetes and affecting quality of life. The aim of the present study was to examine the influence of hand function as measured by median motor nerve conduction on quality of life, taking into account various aspects of functioning in patients with diabetes, including activities of daily living, psychological status and acceptance of illness.
  
  
  METHODS
  Seventy one hospital patients with diabetes participated in the study. Electrophysiological recordings of conductance in the median nerve were obtained for both hands and the relationship between hand function and functional status (BI), depression and anxiety (HADS), adjustment to illness (AIS) and their effect on quality of life (SF-36v2 and QLI) was studied.
  
  
  RESULTS
  Damage to the median nerve of the left hand was associated with significant differences in functioning in the physical, but not the mental component of the SF-36v2, p = 0.03 and in functional status (p = 0.006). QOL was associated with depression, patient age, acceptance of illness, functional ability and to a small, but significant extent with median nerve damage to the right hand on the measure of conduction velocities (R2 =0.726).
  
  
  CONCLUSIONS
  Nerve conductance studies demonstrated a small, but significant effect of hand function on quality of life. Impairment of the median nerve in the left hand was associated with functional difficulties in the activities of daily living and a diminished quality of life in the area of physical functioning. No dependencies of this kind were found for the right hand, which may reflect the greater compensatory capacity of the right hand resulting from improved efficiency due to practice.
authors.affiliation: Department of Integrated Medical Care, Medical University of Bialystok, M, Skłodowskiej-Curie str, 7A, Bialystok, 15-096, Poland. jola.lewko@wp.pl.
authors.forename: Jolanta
authors.initials: J
authors.lastname: Lewko
authors.forename: Barbara
authors.initials: B
authors.lastname: Polityńska
authors.forename: Jan
authors.initials: J
authors.lastname: Kochanowicz
authors.forename: Wiesław
authors.initials: W
authors.lastname: Zarzycki
authors.forename: Zenon
authors.initials: Z
authors.lastname: Mariak
authors.forename: Maria
authors.initials: M
authors.lastname: Górska
authors.forename: Elżbieta
authors.initials: E
authors.lastname: Krajewska-Kułak