The effects of short-term, rapid glycemic control on the peroneal nerve function and serum VCAM-1 and AGE in type 2 diabetic patients in Malaysia.
Indian J Med Sci
;
2009 Apr; 63(4): 131-8
Article
in English
| IMSEAR
| ID: sea-68984
ABSTRACT
Background:
The role of endothelial injury and circulating adhesion molecule in the development and progression of diabetic peripheral neuropathy in the long-term has been established previously.Aims:
0 To study the effects of short-term glycemic control using insulin and oral hypoglycemic agent therapy (OHA) on the peroneal nerve function and vascular cell adhesion molecule-1 (VCAM-1) and advanced glycation endproducts (AGE) levels in type 2 diabetic patients. Settings andDesign:
A randomized controlled study involving poorly controlled (HbA1c, 7.5%-11%) type 2 diabetic patients attending the endocrinology outpatient center in a tertiary hospital in Kuala Lumpur. Materials and Methods Twenty-nine patients were randomized to receive insulin (n=15) or OHA (n=14) for 8 weeks. The glycemic variables (HbA1c, fasting plasma glucose [FPG], fructosamine), VCAM-1, serum AGE and the peroneal motor conduction velocity (PMCV) were measured at baseline and at 4-week intervals. Statistical Analysis Used Paired 't' test or Kruskal Wallis test; and the unpaired 't' test or Mann-Whitney U test were used for within-group and between-group analyses, respectively. Correlation was analyzed using Spearman's correlation coefficient.Results:
Within-group analysis showed significant progressive improvement in HbA1c at weeks 4 and 8 in the insulin group. The PMCV improved significantly in both groups by week 8, and by week 4 (P = 0.01) in the insulin group. PMCV correlated negatively with VCAM-1 (P = 0.031) and AGE (P = 0.009) at week 8.Conclusion:
Aggressive glycemic control with insulin improves the peroneal nerve function within 4 weeks. Improvement in the serum VCAM-1 and AGE levels correlated significantly with improvement in peroneal nerve conduction velocity only in the insulin group.
Full text:
Available
Index:
IMSEAR (South-East Asia)
Main subject:
Peroneal Nerve
/
Time Factors
/
Blood Glucose
/
Female
/
Humans
/
Male
/
Glycated Hemoglobin
/
Administration, Oral
/
Vascular Cell Adhesion Molecule-1
/
Peroneal Neuropathies
Type of study:
Controlled clinical trial
Country/Region as subject:
Asia
Language:
English
Journal:
Indian J Med Sci
Year:
2009
Type:
Article
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