title: Acute Hypoglycemia Induces Painful Neuropathy and the Treatment of Coenzyme Q10.
abstract: Diabetic neuropathic pain is reduced with tight glycemic control. However, strict control increases the risk of hypoglycemic episodes, which are themselves linked to painful neuropathy. This study explored the effects of hypoglycemia-related painful neuropathy. Pretreatment with coenzyme Q10 (CoQ10) was performed to explore the preventive effect of CoQ10 on hypoglycemia-related acute neuropathic pain. Two strains of mice were used and 1 unit/kg of insulin was given to induce hypoglycemia. Mechanical sensitivity of hindpaw withdrawal thresholds was measured using von Frey filaments. Blood glucose levels were clamped at normal levels by joint insulin and glucose injection to test whether insulin itself induced hypersensitivity. Results suggest that the increased mechanical sensitivity after insulin injection is related to decreased blood glucose levels. When blood glucose levels remained at a normal level by the linked administration of insulin and glucose, mice demonstrated no significant change in mechanical sensitivity. Pretreatment with CoQ10 prevented neuropathic pain and the expression of the stress factor c-Fos. These results support the concept that pain in the diabetic scenario can be the result of hypoglycemia and not insulin itself. Additionally, pretreatment with CoQ10 may be a potent preventive method for the development of neuropathic pain.
authors.affiliation: Department of Anesthesiology, Perioperative Medicine and Pain Management, University of Miami Miller School of Medicine, Miami, FL 33136, USA.
authors.forename: Yan Ping
authors.initials: YP
authors.lastname: Zhang
authors.affiliation: Department of Obstetrics and Gynecology, Guangzhou Women and Children's Medical Center, Guangzhou 510120, China.
authors.forename: Shanshan
authors.initials: S
authors.lastname: Mei
authors.affiliation: Department of Anesthesiology, The Affiliated Cancer Hospital of Xiangya School Of Medicine, Central South University, Changsha, Hunan 410013, China.
authors.forename: Jinfeng
authors.initials: J
authors.lastname: Yang
authors.affiliation: Department of Anesthesiology, Perioperative Medicine and Pain Management, University of Miami Miller School of Medicine, Miami, FL 33136, USA.
authors.forename: Yiliam
authors.initials: Y
authors.lastname: Rodriguez
authors.affiliation: Department of Anesthesiology, Perioperative Medicine and Pain Management, University of Miami Miller School of Medicine, Miami, FL 33136, USA.
authors.forename: Keith A
authors.initials: KA
authors.lastname: Candiotti
mesh_terms: D000208:Acute Disease; D000700:Analgesics / Q000494:pharmacology*; D000818:Animals; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000378:metabolism; D004195:Disease Models, Animal; D006930:Hyperalgesia / Q000139:chemically induced / Q000503:physiopathology / Q000517:prevention & control*; D007003:Hypoglycemia / Q000097:blood / Q000139:chemically induced / Q000188:drug therapy*; D007328:Insulin; D008810:Mice, Inbred C57BL; D008808:Mice, Inbred CBA; D009437:Neuralgia / Q000097:blood / Q000139:chemically induced / Q000503:physiopathology / Q000517:prevention & control*; D017288:Pain Threshold / Q000187:drug effects*; D016760:Proto-Oncogene Proteins c-fos / Q000378:metabolism; D013116:Spinal Cord / Q000187:drug effects* / Q000378:metabolism / Q000503:physiopathology; D013997:Time Factors; D014451:Ubiquinone / Q000031:analogs & derivatives* / Q000494:pharmacology
chemical_list: D000700:Analgesics; D015415:Biomarkers; D001786:Blood Glucose; D007328:Insulin; D016760:Proto-Oncogene Proteins c-fos; D014451:Ubiquinone; C024989:coenzyme Q10
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