Open AccessExercise increases cutaneous nerve density in diabetic patients without neuropathy
Author(s) -
Singleton John R.,
Marcus Robin L.,
Jackson Justin E.,
K. Lessard Margaret,
Graham Timothy E.,
Smith Albert G.
Publication year - 2014
Publication title -
annals of clinical and translational neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.824
H-Index - 42
ISSN - 2328-9503
DOI - 10.1002/acn3.125
Subject(s) - medicine , cohort , diabetic neuropathy , biomarker , diabetes mellitus , nerve fiber , neuropathic pain , cohort study , physical therapy , surgery , anesthesia , endocrinology , anatomy , biochemistry , chemistry
Early diabetic neuropathy is characterized by loss of unmyelinated axons, resulting in pain, numbness, and progressive decline in intraepidermal nerve fiber density. Patients with type 2 diabetes, without neuropathy, were assigned to quarterly lifestyle counseling ( N = 40) or structured, supervised weekly exercise ( N = 60) for 1 year. Distal leg IENFD significantly increased in the exercise cohort and remained unchanged in the counseling cohort (1.5 ± 3.6 vs. −0.1 ± 3.2 fibers/mm, P = 0.03). These results suggest preclinical injury to unmyelinated axons is potentially reversible, and that IENFD may be a responsive biomarker useful in future neuropathy prevention clinical trials.