title: Exercise increases cutaneous nerve density in diabetic patients without neuropathy.
abstract: Early diabetic neuropathy is characterized by loss of unmyelinated axons, resulting in pain, numbness, and progressive decline in intraepidermal nerve fiber density. Patients with type 2 diabetes, without neuropathy, were assigned to quarterly lifestyle counseling (N = 40) or structured, supervised weekly exercise (N = 60) for 1 year. Distal leg IENFD significantly increased in the exercise cohort and remained unchanged in the counseling cohort (1.5 ± 3.6 vs. -0.1 ± 3.2 fibers/mm, P = 0.03). These results suggest preclinical injury to unmyelinated axons is potentially reversible, and that IENFD may be a responsive biomarker useful in future neuropathy prevention clinical trials.
authors.affiliation: Department of Neurology, University of Utah Salt Lake City, Utah.
authors.forename: John R
authors.initials: JR
authors.lastname: Singleton
authors.affiliation: Department of Physical Therapy, University of Utah Salt Lake City, Utah.
authors.forename: Robin L
authors.initials: RL
authors.lastname: Marcus
authors.affiliation: Department of Physical Therapy, University of Utah Salt Lake City, Utah.
authors.forename: Justin E
authors.initials: JE
authors.lastname: Jackson
authors.affiliation: Department of Neurology, University of Utah Salt Lake City, Utah.
authors.forename: Margaret
authors.initials: M
authors.lastname: K Lessard
authors.affiliation: Department of Internal Medicine, University of Utah Salt Lake City, Utah.
authors.forename: Timothy E
authors.initials: TE
authors.lastname: Graham
authors.affiliation: Department of Neurology, University of Utah Salt Lake City, Utah.
authors.forename: Albert G
authors.initials: AG
authors.lastname: Smith