| Short-term metabolic change is associated with improvement in measures of diabetic neuropathy: a 1-year placebo cohort analysis. | |
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MedLine Citation:
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PMID: 20950385 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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AIMS: Randomized clinical trials have frequently shown improvement in diabetic sensorimotor polyneuropathy in placebo-treated participants, counter to the prevailing concept that it deteriorates with time. We aimed to determine the variables associated with this paradoxical nerve function improvement. METHODS: Participants with diabetic sensorimotor polyneuropathy randomized to placebo in a multi-centre, double-blind study were evaluated for the primary outcome of 1-year change in the summed sensory nerve conduction velocity of the bilateral sural and non-dominant median nerves. Association with clinical and biochemical variables measured at 13 time points were examined. RESULTS: The 134 participants had mild to moderate diabetic sensorimotor polyneuropathy of 4.6 years' duration and mean 1-year improvement of 2.0 ± 8.0 m/s. Primary outcome measures were available for 122 participants (91%). In multivariate analyses, the change in HbA(1c) and serum triglycerides from baseline to 2 months demonstrated the strongest association, even independent of baseline and end-of-study levels. According to quintiles of change, we determined thresholds: participants with salutary improvement in HbA(1c) (exceeding a drop of -0.8%) or whose triglycerides did not increase (by 0.32 mmol/l or more) experienced significant improvement (2.9 m/s), while those with salutary levels of both these variables had an exaggerated improvement (5.1 m/s). In comparison, those with non-salutary changes in both variables experienced a loss of -4.9 m/s (ANOVA P=0.0014). CONCLUSIONS: In mild to moderate diabetic sensorimotor polyneuropathy, short-term improvements in glycaemic control and serum triglyceride levels have an independent, additive and durable effect on restoration of nerve function. |
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Authors:
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B A Perkins; A Dholasania; R A Buchanan; V Bril |
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Publication Detail:
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Type: Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Diabetic medicine : a journal of the British Diabetic Association Volume: 27 ISSN: 1464-5491 ISO Abbreviation: Diabet. Med. Publication Date: 2010 Nov |
Date Detail:
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Created Date: 2010-10-18 Completed Date: 2011-01-07 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8500858 Medline TA: Diabet Med Country: England |
Other Details:
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Languages: eng Pagination: 1271-9 Citation Subset: IM |
Copyright Information:
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© 2010 The Authors. Diabetic Medicine © 2010 Diabetes UK. |
Affiliation:
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Division of Endocrinology and Metabolism, Department of Medicine, University of Toronto, 200 Elizabeth Street, Toronto, Ontario, Canada. bruce.perkins@uhn.on.ca |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Aged Diabetes Mellitus, Type 1 / complications, metabolism, physiopathology* Diabetes Mellitus, Type 2 / complications, metabolism, physiopathology* Diabetic Neuropathies / drug therapy, metabolism, physiopathology* Female Hemoglobin A, Glycosylated / metabolism* Humans Male Middle Aged Neural Conduction / drug effects, physiology* Placebos Randomized Controlled Trials as Topic Triglycerides / blood* Young Adult |
| Chemical | |
Reg. No./Substance:
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0/Hemoglobin A, Glycosylated; 0/Placebos; 0/Triglycerides; 0/hemoglobin A1c protein, human |
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