Slowing of Peripheral Nerve Conduction Velocity in Children and Adolescents With Type 1 Diabetes Is Predicted by Glucose Fluctuations.

Nerve conduction velocity (NCV) abnormalities are the forerunners of diabetic peripheral neuropathy (DPN). Therefore, this study aimed to analyze the effect of glucose profile quality on NCV in children and young adults with type 1 diabetes. Fifty-three children age 5 to 23 years with type 1 diabetes were recruited to participate in the study, which was conducted prospectively at the Children's Hospital of Eastern Switzerland from 2016 to 2022. Glycemic targets were recorded, and a cross-sectional nerve conduction study analyzing the peroneal, tibial, median motor, and median sensory nerves was performed. Data were compared with those of a control group of 50 healthy children. In the age- and height-matched diabetes subgroup aged 10-16 years, all four nerves showed significantly slower NCV, most pronounced for the peroneal nerve. Because height has a retarding effect on peroneal NCV, NCV was adjusted for height (dNCV). Peroneal dNCV correlated negatively with long-term glycated hemoglobin and highly significantly with glucose variability. Because high glucose variability clearly increases the risk of neuropathy, together with but also independently of the mean glucose level, this aspect of glycemic control should be given more attention in the care of individuals with diabetes. ARTICLE HIGHLIGHTS: There is a strong need for the better identification of early subclinical manifestations of microvascular complications, such as diabetic peripheral neuropathy, in young individuals with diabetes. To identify peripheral neuropathy and contributing factors at an asymptomatic disease stage, and to exclude height as a known modifying factor, we performed association studies of height-adjusted nerve conduction velocity. We identified high glucose variability, especially the SD of mean glucose, as an unexpectedly strong predictor of slowed nerve conduction velocity. More attention should be paid to the goal of low glucose variability in the care of individuals with diabetes.

[Fritz Kahn's The Life of Man: Production and Transcription of a Bestseller]. / Fritz Kahns Das Leben des Menschen: Zur Produktion und Transkription eines populären Werks.

This paper investigates the production and circulation of the illustrations in Fritz Kahn's five-volume series The Life of Man, one of the most popular medical publications in the German interwar period. In 1912 Kahn (1888-1968), together with a staff of illustrators, began producing what would later become his best-selling series. Illustrations of this series (in particular, the poster The human factory/Der Mensch als Industriepalast) were widespread throughout Germany during the Weimar Republic. With the rise of National Socialism, Kahn was forced to emigrate in 1933. While his books were forbidden by the Nazi regime, their illustrations continued to play an important role in popular scientific discourse: they reappeared in the Nazi health-education programme and were adapted for Kahn's publications in exile at the same time. This paper discusses how their production process and collective authorship made this complex and heterogeneous reception possible.