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Small fibre dysfunction, microvascular complications and glycaemic control in type 1 diabetes: a case-control study.
MedLine Citation:
PMID:  22193513     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
AIMS/HYPOTHESIS: The aim of this study was to determine the influence of microvascular disease on C-fibre function in patients with type 1 diabetes of moderate duration. METHODS: The axon-reflex flare area induced on the dorsum of the foot by local skin heating to 47°C was measured with a laser Doppler imager (LDI) in sex-, age- and height-matched groups with type 1 diabetes, with and without microvascular disease (MV+ and MV-, respectively) and in healthy controls (HC). Each group consisted of 24 individuals and all were free from clinical neuropathy (neuropathy disability score <3 and Toronto clinical neuropathy score <5). RESULTS: LDI flare (LDIflare) was reduced in MV+ compared with HC (5.1 ± 1.8 vs 10.0 ± 3.1 cm(2), p < 0.0001) and MV- groups (9.9 ± 2.9 cm(2), p < 0.0001). MV- and HC groups did not differ. There was no difference in diabetes duration between MV- and MV+ groups (17.5 ± 5.7 and 20.1 ± 5.2 years, p = 0.21) nor current HbA(1c) (MV- 8.0 ± 1.2% [64 ± 10 mmol/mol]; MV+ 8.0 ± 0.9% [64 ± 9 mmol/mol], p = 0.53); neither variable correlated with flare size. In contrast, duration-averaged HbA(1c) was higher in the MV+ group (8.6 ± 0.9% [70 ± 9 mmol/mol] vs 7.6 ± 0.6% [60 ± 7 mmol/mol], p < 0.001) and correlated with LDIflare size (r = -0.50, p < 0.001). Triacylglycerols were higher in MV+ compared with MV- (1.23 ± 0.121 vs 0.93 ± 0.7 mmol/l, p = 0.04), but other metabolic variables did not differ between the groups. CONCLUSIONS/INTERPRETATION: We have shown that glycaemic burden and the presence of microvascular complications are associated with small fibre dysfunction in type 1 diabetes.
Authors:
P R J Vas; A Q Green; G Rayman
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-12-23
Journal Detail:
Title:  Diabetologia     Volume:  -     ISSN:  1432-0428     ISO Abbreviation:  -     Publication Date:  2011 Dec 
Date Detail:
Created Date:  2011-12-23     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0006777     Medline TA:  Diabetologia     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
The Diabetes Research Centre, Ipswich Hospital NHS Trust, Heath Road, Ipswich, Suffolk, IP4 5PD, UK.
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