Associations between acute glucose control and peripheral nerve structure and function in type 1 diabetes
| Autor: | Maria Markoulli, Arun V. Krishnan, Jeremy Chung Bo Chiang, Shyam Sunder Tummanapalli, Natalie Kwai, Ria Arnold, Ann M. Poynten, Tushar Issar |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Adult
Blood Glucose Male Diabetes duration medicine.medical_specialty Intravital Microscopy Glucose control Endocrinology Diabetes and Metabolism Neural Conduction Monitoring Ambulatory 030209 endocrinology & metabolism Cornea Young Adult 03 medical and health sciences 0302 clinical medicine Endocrinology Internal medicine Internal Medicine medicine Humans Hypoglycemic Agents Insulin Peripheral Nerves 030212 general & internal medicine Type 1 diabetes Microscopy Confocal business.industry Continuous glucose monitoring Blood Glucose Self-Monitoring Peripheral nerve structure Organ Size Odds ratio Middle Aged medicine.disease Confidence interval Diabetes Mellitus Type 1 Female Nerve conduction business |
| Zdroj: | Diabetic Medicine. 37:1553-1560 |
| ISSN: | 1464-5491 0742-3071 |
| DOI: | 10.1111/dme.14306 |
| Popis: | AIM To examine the associations between continuous overlapping net glycaemic action (CONGA), percentage time in hyperglycaemia (%HG) or normoglycaemia (%NG) and peripheral nerve structure and function in type 1 diabetes. METHODS Twenty-seven participants with type 1 diabetes underwent continuous glucose monitoring followed by corneal confocal microscopy and nerve excitability assessments. CONGA, %HG (> 10.0 mmol/l) and %NG (3.9-10.0 mmol/l) were correlated against corneal nerve fibre length and density in the central cornea and inferior whorl region, corneal microneuromas, and a nerve excitability score while controlling for age, sex, diabetes duration and HbA1c . RESULTS An increase in CONGA [median 2.5 (2.0-3.1) mmol/l] or %HG (mean 46 ± 18%) was associated with a worse nerve excitability score (r = -0.433, P = 0.036 and r = -0.670, P = 0.0012, respectively). By contrast, greater %NG (51 ± 17%) correlated with better nerve excitability scores (r = 0.672, P = 0.0011). Logistic regression revealed that increasing %HG increased the likelihood of abnormal nerve function [odds ratio (OR) 1.11, 95% confidence interval (CI) 1.01-1.23; P = 0.037). An increase in CONGA and %HG were associated with worsening nerve conduction measures, whereas longer %NG correlated with improved nerve conduction variables. CONGA and %HG were associated with inferior whorl corneal nerve fibre length (r = 0.483, P = 0.034 and r = 0.591, P = 0.021, respectively) and number of microneuromas (r = 0.433, P = 0.047 and r = 0.516, P = 0.020, respectively). CONCLUSIONS Short-term measures of glucose control are associated with impaired nerve function and alterations in corneal nerve morphology. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Plný text