Glycemic control is related to the electrophysiologic severity of diabetic peripheral sensorimotor polyneuropathy.
OBJECTIVE
The aim of the present study was to examine risk factors for the electrophysiologic severity of diabetic peripheral sensorimotor polyneuropathy (DSP).


METHODS
A total of 97 patients with type 1 diabetes (25 patients) or type 2 diabetes (72 patients) were included in this cross-sectional study. Nerve conduction studies (NCS) were performed on median motor and sensory nerves, peroneal motor nerve, and both sural nerves. The severity of DSP was expressed as the sum of nerve conduction velocities (SNCV) and the score of distal amplitudes (SAMP) of the above-mentioned nerves. General linear models were used to assess the relationship between overall severity of DSP as well as the severity of lower extremity, upper extremity, motor nerve, or sensory nerve involvement and various risk factors.


RESULTS
GHb was significantly related to both SNCV and SAMP in univariate and multivariate regression analyses. This relationship was present in models where GHb was handled either as a continuous variable or as a categorical variable with highest significance level, with a GHb cutoff level of 9%. The difference in NCV for individual nerves in patients with good-to-moderate glycemic control (GHb < or =9%) and those with poor glycemic control (GHb > or =9%) ranged from 1.8 to 3.6 m/s. SAMP was also significantly lower in patients with poor control. SNCV was also significantly related in multivariate analysis to duration of diabetes and height, while SAMP was related to duration of diabetes, age, and male sex.


CONCLUSIONS
The severity of DSP expressed by electrophysiologic criteria was significantly related to glycemic control in a study including patients with type 1 or type 2 diabetes. Based on the results of the present study, it might be predicted that better diabetic control would decrease the severity of DSP.
Tkac
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University of Toronto, Ontario, Canada.
Bril
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D000449:Aldehyde Reductase / Q000037:antagonists & inhibitors; D000704:Analysis of Variance; D001786:Blood Glucose / Q000378:metabolism*; D003430:Cross-Sectional Studies; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000188:drug therapy / Q000503:physiopathology*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000188:drug therapy / Q000503:physiopathology*; D003929:Diabetic Neuropathies / Q000097:blood / Q000188:drug therapy / Q000503:physiopathology*; D004311:Double-Blind Method; D004594:Electrophysiology / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008475:Median Nerve / Q000503:physiopathology; D008875:Middle Aged; D009431:Neural Conduction; D010543:Peroneal Nerve / Q000503:physiopathology; D012044:Regression Analysis; D012307:Risk Factors; D012720:Severity of Illness Index; D013497:Sural Nerve / Q000503:physiopathology
D001786:Blood Glucose; D000449:Aldehyde Reductase