The evolving natural history of neurophysiologic function in patients with well-controlled diabetes
Autor: | Roy Freeman, Charalambos Gnardellis, Thanh Dinh, Aristidis Veves, Francisco Tecilazich, Christopher H. Gibbons, Thomas E. Lyons |
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Přispěvatelé: | Gibbons, Christopher H., Freeman, Roy, Tecilazich, Francesco, Dinh, Thanh, Lyons, Thomas E., Gnardellis, Charalambo, Veves, Aristidis |
Jazyk: | angličtina |
Rok vydání: | 2013 |
Předmět: |
Male
medicine.medical_specialty diabetes natural history neuropathy neurophysiology small fiber Diabetes Mellitus Type 1 Diabetes Mellitus Type 2 Diabetic Neuropathies Disease Progression Electrophysiology Female Humans Middle Aged Neurologic Examination Neurology (clinical) Neuroscience (all) Population Sural nerve Article Forearm Diabetes mellitus Internal medicine medicine Diabetes Mellitus Clinical significance In patient education education.field_of_study business.industry General Neuroscience medicine.disease Surgery Natural history medicine.anatomical_structure diabete Cardiology Diabetic Neuropathie Autonomic testing business Type 2 Human Type 1 |
Popis: | This study aimed to investigate prospective changes to neurophysiologic function over 3 years in patients with well-controlled diabetes. Sixty-two subjects had neurologic examinations, symptom scores, autonomic testing, nerve conduction studies, quantitative sensory testing, and laser-Doppler flowmetry at 18-month intervals for 3 years. During the study, there was a 1 µV decrease in sural amplitude (p < 0.05), an increase in monofilament detection threshold of 0.36 g (p < 0.001), and a decrease in the axon-reflex vasodilation in the foot (p < 0.005) and forearm (p < 0.05). There was an increase in symptoms of distal hypersensitivity (p < 0.005) but no change in neuropathy frequency or severity. Our findings suggest that laser-Doppler flowmetry, a test of small fiber function, can detect the largest neurophysiologic change over time in groups of patients with diabetes. Sural nerve amplitude and monofilament thresholds may be more effective at detecting change in individual patients. Other tests of neurophysiologic function may require longer periods of time and greater numbers of participants to detect a difference. We conclude that patients with well-controlled diabetes and optimal medical management of comorbid risk factors have low rates of neuropathy development and progression although the clinical relevance of this finding to the general population of individuals with diabetes is unknown. |
Databáze: | OpenAIRE |
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