Peripheral nerve function and metabolic control in diabetes mellitus.

Area of Science:

• Neurology
• Endocrinology
• Diabetology

Background:

• Diabetic neuropathy is a common complication of diabetes mellitus.
• Nerve conduction slowing is a hallmark of diabetic neuropathy.
• The reversibility of nerve conduction abnormalities in diabetes is not fully understood.

Purpose of the Study:

• To investigate the impact of short- and long-term hyperglycemia improvement on sensorimotor peripheral nerve function in diabetic patients.
• To differentiate between reversible and slowly reversible changes in diabetic nerve conduction.

Main Methods:

• Measurement of conduction velocity along the H reflex arc.
• Studying type I diabetic patients undergoing short-term glycemic control using an artificial endocrine pancreas.
• Assessing type I diabetic patients undergoing long-term glycemic control with continuous subcutaneous insulin injection for 6 months.

Main Results:

• A slight but significant increase in nerve conduction velocity was observed after 6 hours of normalized glycemia.
• A more pronounced improvement in nerve conduction velocity was noted in patients treated with continuous subcutaneous insulin injection for 6 months.
• These findings indicate both rapidly reversible and slowly reversible components contributing to nerve conduction abnormalities in diabetes.

Conclusions:

• Nerve conduction slowing in diabetic patients is partly due to reversible, nonstructural abnormalities.
• More slowly reversible morphological or chemical changes also contribute to persistent nerve dysfunction.
• Improving glycemic control can lead to measurable improvements in peripheral nerve function in diabetics.