Log in

Peripheral nerve function in relation to quality of metabolic control in diabetes

  • Original Investigations
  • Published:
Journal of Neurology Aims and scope Submit manuscript

Summary

It has been proposed that increased polyol pathway activity resulting from hyperglycaemia induces neuropathy in diabetic patients. Recently, it has been demonstrated that erythrocyte sorbitol content is a reflection of polyol pathway activity in nerve. In the present study the relationship of erythrocyte sorbitol and glycosylated haemoglobin (HbA1) levels to peripheral nerve functions were investigated in 62 diabetic patients. Peroneal and median motor nerve conduction velocities, H-M intervals of the Hoffmann reflex, thermal discrimination thresholds and vibratory perception thresholds, either singly or in combination, were not significantly correlated with erythrocyte sorbitol or HbA1 levels. These findings show that a single measurement of erythrocyte sorbitol or HbA1 content cannot predict impairment of nerve function in diabetic subjects.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Subscribe and save

Springer+ Basic
EUR 32.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or Ebook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price includes VAT (Germany)

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Bertelsmann FW, Heimans JJ, Weber EJM, van der Veen EA, Schouten JA (1985) Thermal discrimination thresholds in normal subjects and in patients with diabetic neuropathy. J Neurol Neurosurg Psychiatry 48:686–690

    Google Scholar 

  2. Bertelsmann FW, Heimans JJ, van Rooy JCGM, Heine RJ, van der Veen EA (1986) Reproducibility of vibratory perception thresholds in patients with diabetic neuropathy. Diabetes Res (in press)

  3. Boulton AJM, Knight G, Drury J, Ward JD (1985) The prevalence of symptomatic diabetic neuropathy in an insulin-treated population. Diabetes Care 8:125–128

    Google Scholar 

  4. Clements RS (1979) Diabetic neuropathy—new concepts of its etiology. Diabetes 28:604–611

    Google Scholar 

  5. DiBenedetto M (1970) Sensory nerve conduction in lower extremities. Arch Phys Med Rehabil 51:253–258

    Google Scholar 

  6. Dyck PJ, Sherman WR, Hallcher LM, et al. (1980) Human diabetic endoneurial sorbitol, fructose, and myo-inositol related to sural nerve morphometry. Ann Neurol 8:590–596

    Google Scholar 

  7. Finegold D, Lattimer SA, Nolle S, Bernstein M, Greene DA (1983) Polyol pathway activity and myoinositol metabolism. A suggested relationship in the pathogenesis of diabetic neuropathy. Diabetes 32:985–922

    Google Scholar 

  8. Graf RJ, Halter JB, Halar E, Porte D (1979) Nerve conduction abnormalities in untreated maturity-onset diabetes: relation to levels of fasting plasma glucose and glycosylated hemoglobin. Ann Intern Med 90:298–303

    Google Scholar 

  9. Greene DA (1983) Metabolic abnormalities in diabetic peripheral nerve: relation to impaired function. Metabolism 32:118–123

    Google Scholar 

  10. Greene DA, DeJesus PV, Winegrad AI (1975) Effects of insulin and dietary myoinositol on impaired peripheral motor nerve conduction velocity in acute streptozotocin diabetes. J Clin Invest 55:1326–1336

    Google Scholar 

  11. Greene DA, Lattimer S, Ulbrecht J, Carroll P (1985) Glucose-induced alterations in nerve metabolism: current perspective on the pathogenesis of diabetic neuropathy and future directions for research and therapy. Diabetes Care 8:290–299

    Google Scholar 

  12. Gregersen G (1967) Diabetic neuropathy: influence of age, sex, metabolic control, and duration of diabetes on motor conduction velocity. Neurology 17:972–980

    Google Scholar 

  13. Ludin HP (1980) Electromyography in practice. Thieme-Stratton, New York

    Google Scholar 

  14. Malone JI, Knox G, Benford S, Tedesco TA (1980) Red cell sorbitol. An indicator of diabetic control. Diabetes 29:861–864

    Google Scholar 

  15. Malone JI, Leavengood H, Peterson MJ, O'Brien MM, Page MG, Aldinger CE (1984) Red blood cell sorbitol as an indicator of polyol pathway activity. Inhibition by sorbinil in insulin-dependent diabetic subjects. Diabetes 33:45–49

    Google Scholar 

  16. Mayhew JA, Gillon KRW, Hawthorne JN (1983) Free and lipid inositol, sorbitol and sugars in sciatic nerve obtained post-mortem from diabetic patients and control subjects. Diabetologia 24:13–15

    Google Scholar 

  17. McCann VJ, Davis RE (1979) Glycosylated hemoglobin concentrations in patients with diabetic neuropathy. Acta Diabet Lat 16:205–209

    Google Scholar 

  18. Pirart J (1978) Diabetes mellitus and its degenerative complications: a prospective study of 4400 patients observed between 1947 and 1973. Diabetes Care 1:168–188, 252–263

    Google Scholar 

  19. Popp-Snijders C, Lomecky MZ, deJong AP (1983) Determination of sorbitol in erythrocytes of diabetic and healthy subjects by capillary gas chromatography. Clin Chim Acta 132:83–89

    Google Scholar 

  20. Popp-Snijders C, Lomecky-Janousek MZ, Schouten JA, van der Veen EA (1984) Myo-inositol and sorbitol in erythrocytes from diabetic patients before and after sorbinil treatment. Diabetologia 27:514–516

    Google Scholar 

  21. Troni W, Cantello R, Rainero E (1983) The use of the H-reflex in serial evaluation of nerve conduction velocity. Electroencephalogr Clin Neurophysiol 55:82–90

    Google Scholar 

  22. Visser SL, Zonneveldt A, de Rijke W, Don JA, Martens EIF, Stam D (1983) Normal Hoffman reflex latencies (H-M interval) in relation to age and body length. Clin Neurol Neurosurg 85:85–91

    Google Scholar 

  23. Ward JD, Barnes CG, Fisher DJ, Jessop JD, Baker RWR (1971) Improvement in nerve conduction following treatment in newly diagnosed diabetics. Lancet I:428–431

    Google Scholar 

  24. Ward JD, Baker RWR, Davis BH (1972) Effect of blood sugar control on the accumulation of sorbitol and fructose in nervous tissues. Diabetes 21:1173–1178

    Google Scholar 

  25. Winegrad AI, Simmons DA, Martin DB (1983) Has one diabetic complication been explained? N Engl J Med 308:52–54

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Bertelsmann, F.W., Heimans, J.J., van Rooy, J.C.G.M. et al. Peripheral nerve function in relation to quality of metabolic control in diabetes. J Neurol 234, 334–336 (1987). https://doi.org/10.1007/BF00314290

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF00314290

Key words

Navigation