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Indian Journal of Medical Sciences
Medknow Publications on behalf of Indian Journal of Medical Sciences Trust
ISSN: 0019-5359 EISSN: 0019-5359
Vol. 63, No. 4, 2009, pp. 131-138
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Bioline Code: ms09027
Full paper language: English
Document type: Research Article
Document available free of charge
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Indian Journal of Medical Sciences, Vol. 63, No. 4, 2009, pp. 131-138
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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
Norlinah, M.I.; Hamizah, R.; Md Isa, S.H.; Wan Nazaimoon, W.M. & Khalid, B.A.K
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 and Design : 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.
Keywords
Cell adhesion molecules, diabetic nephropathies
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