Long-Term Hyperglycemia Is Related to Peripheral Nerve Changes at a Diabetes Duration of 4 years
- Catherine Allen, PHD,
- Guanghong Shen, MS,
- Mari Palta, PHD,
- Barend Lotz, MD,
- Richard Jacobson, MD, PHD,
- Donn D'Alessio, MD and
- For the Wisconsin Diabetes Registry
- Department of Preventive Medicine, University of Wisconsin Medical School Madison
- Department of Neurology, University of Wisconsin Medical School Madison
- Department of Medicine, University of Wisconsin Medical School Madison
- Department of Neurology, Medical College of Wisconsin Milwaukee, Wisconsin
- Address correspondence and reprint requests to Catherine Allen, PhD, Department of Preventive Medicine, University of Wisconsin-Madison, 504 North Walnut St., Room 107, Madison, WI 53705. E-mail: allen{at}episys.epi.wise.edu.
Abstract
OBJECTIVE To examine longitudinal hyperglycemia and peripheral nerve responses in a population-based incident cohort.
RESEARCH DESIGN AND METHODS A sample from an incident cohort of young people was comprehensively followed from diagnosis of IDDM. Participants were invited to submit blood samples three times per year for central testing of GHb. During their 4th year of diabetes, nerve conduction studies were performed on the median sensory and motor, peroneal motor, and sural sensory nerves. Relationships between mean GHb and nerve latencies, velocities, and amplitudes were explored.
RESULTS GHb was positively related to all nerve latencies and negatively related to all nerve velocities. The relationships between mean GHb and nerve conduction latencies and velocities differed by sex for the peroneal nerve latency (β = 0.17 male subjects, β = −0.01 female subjects; P < 0.001). Pubertal participants had lower velocities and longer latencies than prepubertal participants (β = 0.37; P = 0.05 peroneal latency), after adjustment for GHb, height, and extremity temperature. Sensory and motor nerve amplitudes were related to GHb, and these relationships did not differ by sex.
CONCLUSIONS Our study indicates that sustained hyperglycemia is related to functional changes, at the minimum, in peripheral sensory and motor nerve conduction at a diabetes duration of 4 years. Our findings are consistent with a dying-back neuropathy, and there is some suggestion that chronic hyperglycemia may be more detrimental to nerves in male subjects than in female subjects.
- Received November 7, 1996.
- Revision received March 4, 1997.
- Accepted March 4, 1997.
- Copyright © 1997 by the American Diabetes Association
