Document Detail


Short-term metabolic change is associated with improvement in measures of diabetic neuropathy: a 1-year placebo cohort analysis.
MedLine Citation:
PMID:  20950385     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
B A Perkins; A Dholasania; R A Buchanan; V Bril
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Publication Detail:
Type:  Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't    
Journal Detail:
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:
Created Date:  2010-10-18     Completed Date:  2011-01-07     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8500858     Medline TA:  Diabet Med     Country:  England    
Other Details:
Languages:  eng     Pagination:  1271-9     Citation Subset:  IM    
Copyright Information:
© 2010 The Authors. Diabetic Medicine © 2010 Diabetes UK.
Affiliation:
Division of Endocrinology and Metabolism, Department of Medicine, University of Toronto, 200 Elizabeth Street, Toronto, Ontario, Canada. bruce.perkins@uhn.on.ca
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MeSH Terms
Descriptor/Qualifier:
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:
0/Hemoglobin A, Glycosylated; 0/Placebos; 0/Triglycerides; 0/hemoglobin A1c protein, human

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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