title: Long-term hyperglycemia is related to peripheral nerve changes at a diabetes duration of 4 years. The Wisconsin Diabetes Registry.
abstract: OBJECTIVE
  To examine longitudinal hyperglycemia and peripheral nerve responses in a population-based incident cohort.
  
  
  METHODS
  A sample from an incident cohort of young people was comprehensively followed from diagnosis of IDDM. Participants were invited to submit blood samples three times per year for central testing of GHb. During their 4th year of diabetes, nerve conduction studies were performed on the median sensory and motor, peroneal motor, and sural sensory nerves. Relationships between mean GHb and nerve latencies, velocities, and amplitudes were explored.
  
  
  RESULTS
  GHb was positively related to all nerve latencies and negatively related to all nerve velocities. The relationships between mean GHb and nerve conduction latencies and velocities differed by sex for the peroneal nerve latency (beta = 0.17 male subjects, beta = -0.01 female subjects; P < 0.001). Pubertal participants had lower velocities and longer latencies than prepubertal participants (beta = 0.37; P = 0.05 peroneal latency), after adjustment for GHb, height, and extremity temperature. Sensory and motor nerve amplitudes were related to GHb, and these relationships did not differ by sex.
  
  
  CONCLUSIONS
  Our study indicates that sustained hyperglycemia is related to functional changes, at the minimum, in peripheral sensory and motor nerve conduction at a diabetes duration of 4 years. Our findings are consistent with a dying-back neuropathy, and there is some suggestion that chronic hyperglycemia may be more detrimental to nerves in male subjects than in female subjects.
authors.affiliation: Department of Preventive Medicine, University of Wisconsin Medical School, Madison 53705, USA. allen@episys.epi.wisc.edu
authors.forename: C
authors.initials: C
authors.lastname: Allen
authors.forename: G
authors.initials: G
authors.lastname: Shen
authors.forename: M
authors.initials: M
authors.lastname: Palta
authors.forename: B
authors.initials: B
authors.lastname: Lotz
authors.forename: R
authors.initials: R
authors.lastname: Jacobson
authors.forename: D
authors.initials: D
authors.lastname: D'Alessio
mesh_terms: D000293:Adolescent; D002648:Child; D015331:Cohort Studies; D003922:Diabetes Mellitus, Type 1 / Q000150:complications / Q000503:physiopathology*; D003929:Diabetic Neuropathies / Q000209:etiology / Q000503:physiopathology*; D004594:Electrophysiology; D005260:Female; D006801:Humans; D006943:Hyperglycemia / Q000150:complications / Q000503:physiopathology*; D008137:Longitudinal Studies; D008297:Male; D009431:Neural Conduction / Q000502:physiology*; D017933:Peripheral Nervous System / Q000502:physiology*; D014922:Wisconsin