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Nerve Ischaemia‐Resistance: An early Abnormality in Diabetes
Author(s) -
Newrick P. G.,
Boulton A. J. M.,
Ward J. D.
Publication year - 1987
Publication title -
diabetic medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.474
H-Index - 145
eISSN - 1464-5491
pISSN - 0742-3071
DOI - 10.1111/j.1464-5491.1987.tb00921.x
Subject(s) - medicine , diabetes mellitus , ischemia , insulin resistance , body mass index , cardiology , insulin , endocrinology
Vibration perception threshold (VPT) has been measured before and 30 min after limb ischaemia in 17 newly diagnosed non‐insulin‐dependent diabetic patients and matched controls. Mean baseline VPT was higher in the diabetics than in controls (14 vs 11, p <0.01) while VPT at 30 min was lower (25 vs 30, p <0.05). The ischaemic index (VPT at 30 min/baseline VPT), calculated as a measure of nerve ischaemia‐resistance, was lower in the diabetics compared with controls ( p <0.01), and correlated with blood glucose ( r = −0.53, p <0.03) but not glycosylated haemoglobin at the time of testing. The difference in ischaemic index persisted even when baseline VPT measurements, rather than patients, were matched. Ischaemic index was re‐tested in 15 patients after a median interval of 17 months (range 6–19), at which time mean ±SD glycosylated haemoglobin had improved significantly (12.2%±0.4 versus 9.5%±0.05, p <0.001), but this bore no relation to changes in ischaemic index. Peripheral nerve ischaemia‐resistance is present at the time of diagnosis of non‐insulin‐dependent diabetes, even in the absence of other neurophysiological abnormalities, and is not explicable by glycaemic control alone.