Associations between acute glucose control and peripheral nerve structure and function in type 1 diabetes
| العنوان: | Associations between acute glucose control and peripheral nerve structure and function in type 1 diabetes |
|---|---|
| المؤلفون: | Maria Markoulli, Arun V. Krishnan, Jeremy Chung Bo Chiang, Shyam Sunder Tummanapalli, Natalie Kwai, Ria Arnold, Ann M. Poynten, Tushar Issar |
| المصدر: | Diabetic Medicine. 37:1553-1560 |
| بيانات النشر: | Wiley, 2020. |
| سنة النشر: | 2020 |
| مصطلحات موضوعية: | 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 |
| الوصف: | 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. |
| تدمد: | 1464-5491 0742-3071 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::f85578aa6d6b79fcdb3aa20cac932a08Test https://doi.org/10.1111/dme.14306Test |
| حقوق: | CLOSED |
| رقم الانضمام: | edsair.doi.dedup.....f85578aa6d6b79fcdb3aa20cac932a08 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 14645491 07423071 |
|---|