title: The acute effects of glycemic control on axonal excitability in human diabetic nerves.
abstract: OBJECTIVE
  To investigate whether glycemic control is associated with reversible changes in axonal excitability in human diabetic nerves. It is known that voluntary contraction or compression ischemia alters nerve Na+/K+ pump activity, and axonal excitability changes due to the pump activity can be estimated by threshold tracking.
  
  
  METHODS
  Threshold, the current required to produce a compound muscle action potential 50% of maximum, was determined from the stimulus-response curve, and threshold changes produced by maximal voluntary contraction or ischemia were measured before and after insulin treatment in 10 diabetic patients.
  
  
  RESULTS
  Within 3 weeks of the start of treatment, the threshold changes became greater following voluntary contractions (+13+/-4% versus +23+/-5%; mean+/-SEM; p=0.04) and during ischemia (-5+/-2% versus -11+/-2%; p=0.04).
  
  
  CONCLUSIONS
  The extent of threshold fluctuation depends on multiple metabolic factors associated with diabetes such as decreased Na+/K+ ATPase activity, increased anaerobic glycolysis, and tissue acidosis, and nerve excitability can respond quickly to glycemic control in diabetic patients.
authors.affiliation: Department of Neurology, Chiba University School of Medicine.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Kuwabara
authors.forename: Kazue
authors.initials: K
authors.lastname: Ogawara
authors.forename: Takamichi
authors.initials: T
authors.lastname: Harrori
authors.forename: Yoshifumi
authors.initials: Y
authors.lastname: Suzuki
authors.forename: Naotake
authors.initials: N
authors.lastname: Hashimoto
mesh_terms: D000200:Action Potentials / Q000502:physiology; D000328:Adult; D000368:Aged; D001369:Axons / Q000502:physiology*; D001786:Blood Glucose / Q000032:analysis; D003922:Diabetes Mellitus, Type 1 / Q000188:drug therapy / Q000503:physiopathology; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy / Q000503:physiopathology; D003929:Diabetic Neuropathies / Q000097:blood / Q000503:physiopathology*; D004576:Electromyography; D004594:Electrophysiology; D005260:Female; D006801:Humans; D006943:Hyperglycemia / Q000188:drug therapy*; D007328:Insulin / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009119:Muscle Contraction / Q000502:physiology; D009431:Neural Conduction / Q000502:physiology; D010525:Peripheral Nerves / Q000503:physiopathology*; D000254:Sodium-Potassium-Exchanging ATPase / Q000378:metabolism
chemical_list: D001786:Blood Glucose; D007328:Insulin; D000254:Sodium-Potassium-Exchanging ATPase