Effect of acute hyperglycaemia on sensory processing in diabetic autonomic neuropathy.
BACKGROUND
Acute hyperglycaemia is known to increase gastrointestinal (GI) sensitivity in healthy subjects and may contribute to the increased prevalence of GI symptoms in diabetes patients. The aim of this study was to evaluate the effect of acute hyperglycaemia on perception and brain responses to painful visceral and somatic stimuli in diabetic patients.


METHODS
The sensitivity and evoked brain potentials (EPs) to electrical oesophageal and median nerve stimulations were assessed in 14 type-1 diabetes patients with autonomic neuropathy and GI symptoms using a hyperinsulinaemic clamp at 6 and 15 mM.


RESULTS
No differences between the normo- and hyperglycaemic conditions were found in sensitivity to both oesophageal (P=0·72) and median nerve (P=0·66) stimulations. The latencies and amplitudes of EPs did not differ between the normo- and hyperglycaemic conditions following oesophageal (P=0·53 and 0·57) and median nerve (P=0·78 and 0·52) stimulations.


CONCLUSIONS
Acute hyperglycaemia itself does not contribute to the sensations in patients with longstanding diabetes and autonomic neuropathy. Any potential sensory effects of acute hyperglycaemia can likely be blurred by the neuropathic-like changes in the sensory nervous system.
Frøkjaer
Jens B
JB
Mech-Sense, Department of Gastroenterology, Aalborg Hospital, Aarhus University Hospital, Aalborg, Denmark. jf@mech-sense.com
Søfteland
Eirik
E
Graversen
Carina
C
Dimcevski
Georg
G
Drewes
Asbjørn M
AM
D000328:Adult; D001786:Blood Glucose / Q000378:metabolism*; D003922:Diabetes Mellitus, Type 1 / Q000503:physiopathology*; D003929:Diabetic Neuropathies / Q000503:physiopathology*; D004558:Electric Stimulation; D004947:Esophagus; D005071:Evoked Potentials; D005260:Female; D015309:Glucose Clamp Technique; D006801:Humans; D006943:Hyperglycemia / Q000503:physiopathology*; D008297:Male; D008475:Median Nerve; D008875:Middle Aged; D055815:Young Adult
D001786:Blood Glucose