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Association between glycemic variability and peripheral nerve dysfunction in type 1 diabetes
Author(s) -
Kwai Natalie C.G.,
Arnold Ria,
Poynten Ann M.,
Krishnan Arun V.
Publication year - 2016
Publication title -
muscle and nerve
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.025
H-Index - 145
eISSN - 1097-4598
pISSN - 0148-639X
DOI - 10.1002/mus.25274
Subject(s) - glycemic , medicine , diabetes mellitus , peripheral neuropathy , diabetic neuropathy , peripheral , endocrinology , pathogenesis , motor nerve , type 1 diabetes , sensory nerve , peripheral nervous system , sensory system , neuroscience , anatomy , central nervous system , biology
ABSTRACT Introduction : Glycemic variability (GV) may be a novel factor in the pathogenesis of diabetic complications. However, the effect of GV on peripheral nerve function has not been explored systematically. Methods : The relationship between GV and acute glucose levels on motor and sensory nerve function in 17 patients with type 1 diabetes mellitus (T1DM) was assessed using continuous glucose monitoring and nerve excitability techniques to provide insight into the behavior of axonal voltage‐gated ion channels. The mean amplitude of glycemic excursions (MAGE) was calculated to quantify GV. Results : MAGE strongly correlated with excitability markers of altered motor and sensory axonal function, including superexcitability (r = 0.54), S2 accommodation (r = ‐0.76), minimum current threshold (I/V) slope (r = 0.71), strength duration time constant (r = 0.66), and latency (r = 0.65; P < 0.05). Acute glucose levels did not correlate with markers of axonal function. Conclusions : These findings suggest that GV may be an important mediator of axonal dysfunction in T1DM and a contributing factor in development of diabetic neuropathy. Muscle Nerve , 2016 Muscle Nerve 54 : 967–969, 2016