Long-Term Hyperglycemia Is Related to Peripheral Nerve Changes at a Diabetes Duration of 4 years

Allen, Catherine; Shen, Guanghong; Palta, Mari; Lotz, Barend P.; Jacobson, Ryan; D’Alessio, Donn J.

doi:10.2337/diacare.20.7.1154

Cited by 19 publications

(12 citation statements)

References 19 publications

(26 reference statements)

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“…Some studies have shown a relationship between diabetic control and NCV of separate nerves both in type 1 diabetes (12,13) and type 2 diabetes (14,15), as well as a relationship between GHb and nerve amplitudes in type 1 diabetes (13). The present study extends this knowledge by showing that, in multivariate analysis taking into account various confounding factors, the overall severity of DSP, as well as the severity of involvement in different nerve groups Qower extremities, upper extremities, motor nerves, sensory nerves), is consistently related to diabetic control.…”

Section: Results-mentioning

confidence: 99%

Glycemic Control Is Related to the Electrophysiologic Severity of Diabetic Peripheral Sensorimotor Polyneuropathy

Tkáč

Bril

1998

Diabetes Care

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Section: Results-mentioning

confidence: 99%

Glycemic Control Is Related to the Electrophysiologic Severity of Diabetic Peripheral Sensorimotor Polyneuropathy

Tkáč

Bril

1998

Diabetes Care

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“…Sustained hyperglycemia has been found to be related to functional changes in both peripheral sensory and motor nerve conduction at duration of diabetes of 4 years [6]. The exact mechanisms leading to nerve damage are unknown.…”

Section: Discussionmentioning

confidence: 99%

“…The actual cause of diabetic neuropathy is not well understood. Metabolic, vascular, and probably genetic factors are thought to be involved [6][7][8]. Identification of risk factors in a particular patient group is very important so that appropriate treatment can be given for prevention of further deterioration, and preventive measures can be initiated for high-risk patients to prevent foot problems.…”

mentioning

confidence: 99%

Quantitative sensory testing and risk factors of diabetic sensory neuropathy

Cheng

Jiang

Chuang

et al. 1999

Journal of Neurology

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The goal of this study was to identify risk factors for diabetic peripheral sensory neuropathy in type 2 diabetes mellitus in a Chinese population. Peripheral sensory neuropathy was detected by quantitative sensory testing (5.07/10 g monofilament, neurometer and 128-Hz Riedel Seiffert graduated tuning fork). Those who had two or more abnormal quantitative sensory testings were defined as having diabetic sensory neuropathy. Of the 558 non-insulin dependent diabetes mellitits subjects, 62 (11.1%) had peripheral neuropathy. In 59 (10.6%) detection was by monofilament testing, 45 (8.1%) by graduated tuning fork, and 189 (33.9%) by neurometer. In a multivariate logistic regression model, age and insulin therapy were significantly associated with peripheral neuropathy. Age, serum triglyceride, height, and fasting plasma glucose were independently associated with large fiber neuropathy. Our results confirm the previously identified multiple risk factors of diabetic neuropathy. Different quantitative sensory testings detect different nerve fiber defects. The weak correlation between these tests indicates the need to use more than one test in screening for diabetic neuropathy.

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“…Furthermore, there were no significant effects on plasma glucose and GHb levels as a result of the steroid and insulin injections (results not shown). It has also been reported that nerve conduction values are related to glycemic control (Allen et al ., 1997). Plasma glucose and GHb levels were similar in both groups in our study, and did not change significantly during the course of study.…”

Section: Discussionmentioning

confidence: 93%

Local insulin injection improves median nerve regeneration in NIDDM patients with carpal tunnel syndrome

Ozkul

Sabuncu

Yazgan

et al. 2001

Euro J of Neurology

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It has been suggested that insulin has an effect on nerve regeneration similar to that of nerve growth factor (NGF). Therefore, we aimed to evaluate the effectiveness of local insulin injection on median nerve in patients with non-insulin-dependent diabetes (NIDDM) mellitus who have mild-to-moderate carpal tunnel syndrome (TS). We carried out a prospective, randomized, double-blind, placebo-controlled study in these patients. At the baseline, 20 mg methylprednisolone was injected directly into the carpal tunnel in all patients [n=43 (62 hands)]. A week after prednisolone, the placebo or NPH insulin (12 U) was injected into the carpal tunnel weekly for 7 weeks. The patients were followed up for 23 weeks. A significant improvement in mean median nerve motor distal latency (MNMDL), median nerve sensory velocity (MNSV), and global symptom score (GSS) occurred in both groups (with the exception of mean MNMDL in the placebo group). A more significant improvement in the mean MNMDL, MNSV, and GSS was observed in the insulin group when compared with the placebo group. This study suggests that local insulin treatment may be of great potential benefit in the improvement of nerve functions in NIDDM patients with mild-to-moderate CTS who opt for conservative treatment.

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Long-Term Hyperglycemia Is Related to Peripheral Nerve Changes at a Diabetes Duration of 4 years

Cited by 19 publications

References 19 publications

Glycemic Control Is Related to the Electrophysiologic Severity of Diabetic Peripheral Sensorimotor Polyneuropathy

Glycemic Control Is Related to the Electrophysiologic Severity of Diabetic Peripheral Sensorimotor Polyneuropathy

Quantitative sensory testing and risk factors of diabetic sensory neuropathy

Local insulin injection improves median nerve regeneration in NIDDM patients with carpal tunnel syndrome

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