title: Association between glycemic variability and peripheral nerve dysfunction in type 1 diabetes.
abstract: Glycemic variability (GV) may be a novel factor in the pathogenesis of diabetic complications. However, the effect of GV on peripheral nerve function has not been explored systematically.
  
  
  
  The relationship between GV and acute glucose levels on motor and sensory nerve function in 17 patients with type 1 diabetes mellitus (T1DM) was assessed using continuous glucose monitoring and nerve excitability techniques to provide insight into the behavior of axonal voltage-gated ion channels. The mean amplitude of glycemic excursions (MAGE) was calculated to quantify GV.
  
  
  
  MAGE strongly correlated with excitability markers of altered motor and sensory axonal function, including superexcitability (r = 0.54), S2 accommodation (r = -0.76), minimum current threshold (I/V) slope (r = 0.71), strength duration time constant (r = 0.66), and latency (r = 0.65; P <  0.05). Acute glucose levels did not correlate with markers of axonal function.
  
  
  
  These findings suggest that GV may be an important mediator of axonal dysfunction in T1DM and a contributing factor in development of diabetic neuropathy. Muscle Nerve, 2016 Muscle Nerve 54: 967-969, 2016.
authors.affiliation: Prince of Wales Clinical School, University of New South Wales Australia, NSW 2052, Sydney, Australia.
authors.forename: Natalie C G
authors.initials: NC
authors.lastname: Kwai
authors.affiliation: School of Medical Sciences, University of New South Wales Australia, Sydney, Australia.
authors.forename: Ria
authors.initials: R
authors.lastname: Arnold
authors.affiliation: Department of Endocrinology, Prince of Wales Hospital, Sydney.
authors.forename: Ann M
authors.initials: AM
authors.lastname: Poynten
authors.affiliation: Prince of Wales Clinical School, University of New South Wales Australia, NSW 2052, Sydney, Australia. arun.krishnan@unsw.edu.au.
authors.forename: Arun V
authors.initials: AV
authors.lastname: Krishnan
mesh_terms: D000328:Adult; D001786:Blood Glucose / Q000378:metabolism*; D003922:Diabetes Mellitus, Type 1 / Q000150:complications*; D005260:Female; D038321:Glycemic Index / Q000502:physiology*; D006801:Humans; D008297:Male; D010523:Peripheral Nervous System Diseases / Q000209:etiology*; D011237:Predictive Value of Tests
chemical_list: D001786:Blood Glucose
keywords: continuous glucose monitoring; diabetic neuropathy; glycemic variability; nerve excitability; type 1 diabetes mellitus