Glycemic control effect on diabetic neuropathy and antioxidants in type 2 diabetes mellitus

To assess the relationship between glycemic control, the oxidative stress and antioxidant vitamin status and their influence on diabetic neuropathy. Thirty six type 2 diabetic patients with diabetic neuropathy were included in this study. They were classified into good and poor glycemic controlled groups [12 and 24 patients respectively]. All patients underwent multiple nerve conduction parameters including F wave latencies. Fasting serum glucose and glycosylated hemoglobin [HbAcl%], Lipogram, malondialdehyde [MDA], nitric oxide [NO] and antioxidants vitamin C and E plasma levels were determined. Poor glycemic controlled group recorded significant longer F wave latency of ulnar nerve, slower sensory conduction velocities of median nerve [P<0.05] and segmental motor conduction velocities of ulnar and median nerves [P <0.05; 0.01; 0.001], compared with that of good glycemic controlled group. Poor glycemic controlled group had significant rising oxidative stress markers [MDA] and reducing NO and vitamins [E and C] plasma level compared to that of good glycemic controlled group [P<0.001]. HbAlc% is significantly correlated with plasma MDA, vitamin C and E levels and segmental conduction velocities [P<0.001; 0.05]. Poor glycemic control is associated with high oxidative stress, lipid peroxidation and depletion of vitamins C and E plasma levels, that may be contributing to diabetic neuropathy progress

Short term effect of glycemic and dyslipidemia control on nerve conduction study and antioxidants status in type 2 DM

The importance of glycemic control in patients with diabetes is well known, but neurological studies suggest that dyslipidemia is actually a more significant contributor to diabetic neuropathy. Is to study the relationship between the degree of hyper glycemic and hyperlipidemic control on one hand and the degree of improvement in clinical, neurophysiological parameters, and level of oxidative stress markers and antioxidants in type 2 DM. Twenty four type 2 diabetics with hyperglycemia, dyslipidemia and diabetic neuropathy were included in this study. They received treatment for control of hyperglycemia and dyslipidemia for 3 months. Clinical assessment, nerve conduction, F-wave studies, lipid profile, oxidative stress markers as Plasma malondialdehyde [MDA] and antioxidant status [Nitric Oxide and vitamin C and E] were measured for each patient before, one and 3 months after beginning of treatment. They were classified according to percentage changes [PC] of glucosylated heamoglobin level [HbAlc%] into 2 groups. The first group had low PC of HbAlc% [< 25%] and the second group had high PC of HbAlc%[> 25%][n=11 and 13 respectively]. There were no significant differences in demographic and clinical data between both groups. Higher PC group had significant greater improvement compared to lower PC group in motor conduction velocity of median nerve [p = 0.017], serum triglyceride [p= 0.005], lipidperoxidation [MDA] and antioxidants levels [p= 0.0001 for each]. Efficient glycemic and dyslipidemia control significantly improved peripheral nerves function and antioxidant status