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Exp Clin Endocrinol Diabetes 2012; 120(08): 451-459
DOI: 10.1055/s-0032-1306350
Article
© J. A. Barth Verlag in Georg Thieme Verlag KG Stuttgart · New York

Comparison of Peripheral Nerve Damages According to Glucose Control Timing in Experimental Diabetes

H. Y. Jin   *
1   Department of Internal Medicine, Division of Endocrinology and Metabolism, Research Institute of Clinical Medicine of Chonbuk National University-chonbuk National University Hospital, Jeonju, South Korea
,
S. M. Kang   *
2    Department of Internal Medicine, Division of Endocrinology and Metabolism, Seoul National University Bundang Hospital, Seongnam, South Korea
,
W. Y. Liu
1   Department of Internal Medicine, Division of Endocrinology and Metabolism, Research Institute of Clinical Medicine of Chonbuk National University-chonbuk National University Hospital, Jeonju, South Korea
,
C. H. Song
3    Department of Anatomy, Chonbuk National University Medical School, Jeonju, South Korea
,
K. A. Lee
1   Department of Internal Medicine, Division of Endocrinology and Metabolism, Research Institute of Clinical Medicine of Chonbuk National University-chonbuk National University Hospital, Jeonju, South Korea
,
H. S. Baek
1   Department of Internal Medicine, Division of Endocrinology and Metabolism, Research Institute of Clinical Medicine of Chonbuk National University-chonbuk National University Hospital, Jeonju, South Korea
,
T. S. Park
1   Department of Internal Medicine, Division of Endocrinology and Metabolism, Research Institute of Clinical Medicine of Chonbuk National University-chonbuk National University Hospital, Jeonju, South Korea
› Author Affiliations
Further Information

Publication History

received 29 December 2011
first decision 21 February 2012

accepted 28 February 2012

Publication Date:
11 June 2012 (online)

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Abstract

Objective:

In addition to tight glucose control, early intensive therapy has been reported to be more important for the prevention of diabetic micro- and macro-vascular complications. What is not known exactly is the quantitative difference according to timing delay in glucose control and whether early period control is really better than late control in terms of diabetic peripheral neuropathy. In this study, we investigated the effect of timing differences in glucose control on the peripheral nerves in an experimental diabetic model.

Methods:

5 groups (6–8 rats in each group) were comprised of normal glucose rats (designated control), rats with hyperglycemia (designated DM), rats with glucose control for the entire 28-week study period (designated DM + INS [W0–28]), rats with glucose control for the early 14-week period followed by hyperglycemia for the late 14-week period (designated DM + INS [W0–14]), and rats with hyperglycemia for the early 14-week period followed by glucose control in the late 14-week period (designated DM + INS [W15–28]).

Results:

We found that the current perception threshold (CPT) was lower in the DM + INS (W0–28) and DM + INS (W15–28) groups than in the DM + INS (W0–14) or DM groups (P<0.05). The mean myelinated fiber area of the sciatic nerve was significantly greater in the DM + INS (W0–28) and DM + INS (W15–28) groups (63.5±2.32 and 60.1±2.14 um, respectively) than in the DM + INS (W0–14) or DM groups (55.5±2.81 or 51.5±2.64 um, respectively) (P<0.05), and the intraepidermal nerve fiber (IENF) density was significantly higher in the DM + INS (W0–28) and DM + INS (W15–28) groups (6.9±0.46 and 6.8±0.11, respectively) than in the DM + INS (W0–14) or DM groups (59.5±0.32 and 5.3±0.39/mm, respectively) (P<0.05).

Conclusion:

Our results indicate that continuous glucose control is necessary to alleviate peripheral nerve damage and that glycemic control during the later period may be more important than early period management. The importance of continuous glucose control, including the later period of diabetes, should therefore be emphasized in diabetic peripheral neuropathy.

Key words

diabetic peripheral neuropathy - intraepidermal nerve fiber density - timing of glucose control
* 

* Authors equally contributed to this manuscript.


 

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