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The natural course of peripheral and autonomic neural function during the first two years after diagnosis of type 1 diabetes

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Summary

Motor and sensory nerve conduction velocities (MNCV, SNCV), beat-to-beat variation (BBV) at rest, speed of pupillary dilation (SPD), and pupillary latency time (PLT) were measured in 32 patients aged 12–36 years after 19±2 (mean±SEM) days and again after 3, 12, and 24 months of insulin treatment. Moreover, BBV under deep respiration was determined after 12 and 24 months, and thermal discrimination thresholds (TDT) as well as pain and vibration perception thresholds (PPT, VPT) were evaluated after 24 months. Mean HbA1 levels during months 3–24 within the normal range (7.2±0.2%; mean±SEM) were observed in 20 patients (group 1), while in 12 patients (group 2) mean HbA1 of months 3–24 was elevated (10.1±0.4%). There were no significant differences between both groups with regard to the nerve function tests at baseline and after 3 months. After 12 months mean median MNCV and median, ulnar, and sural SNCV were significantly lower in group 2 than in group 1 (p<0.05). After 24 months mean median MNCV, peroneal MNCV, median SNCV, and sural SNCV as well as both BBV tests and PLT were significantly impaired in group 2 as compared to group 1 (p<0.05). In addition, mean malleolar VPT and PPT to heat and cold stimuli on the thenar and the foot were significantly elevated in group 2 as compared to group 1 (p<0.05). These findings suggest that early deterioration of somatic nerve function after one year and of autonomic function after 2 years of diabetes may be prevented by effective glycemic control initiated immediately after diagnosis of the disease.

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Abbreviations

BBV:

beat-to-beat variation

CSII:

continuous subcutaneous insulin infusion

IDDM:

insulin-dependent diabetes mellitus

MNCV:

motor nerve conduction velocity

NS:

not significant

PLT:

pupillary latency time

PPT:

pain perception threshold

SNCV:

sensory nerve conduction velocity

SPD:

speed of pupillary dilation

TDT:

thermal discrimination threshold

VPT:

vibration perception threshold

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Authors and Affiliations

  1. Diabetes-Forschungsinstitut an der Universität Düsseldorf, Germany

    D. Ziegler, I. Cicmir, P. Mayer, K. Wiefels & F. A. Gries

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  1. D. Ziegler
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  2. I. Cicmir
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  3. P. Mayer
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  4. K. Wiefels
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  5. F. A. Gries
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Ziegler, D., Cicmir, I., Mayer, P. et al. The natural course of peripheral and autonomic neural function during the first two years after diagnosis of type 1 diabetes. Klin Wochenschr 66, 1085–1092 (1988). https://doi.org/10.1007/BF01711924

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  • DOI: https://doi.org/10.1007/BF01711924

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