Diyabetes mellitusta iyi glisemik kontrol ile nöropati gelişimi önlenebilir mi?

Abstract

Objective: In our study, we aimed to investigate the effect of insulin treatment on peripheral nerves in patients with diabetes mellitus (DM) who under the oral antidiabetic therapy changed to insulin treatment. Additionally, we have searched for answer to the question that could F response used for as a parameter on monitoring the course of polyneuropathy with glycemic control. F response which use in the detection of polyneuropathy has been emphasized in previous studies. Material and Method: Ten voluntary diabetic patients who received indication insulin treatment while being monitored with oral antidiabetic treatment and diagnosed according to the American Diabetes Association (ADA) criteria were included in our study. All our patients were outpatients of Sisli Etfal Training and Research Hospital Diabetes Mellitus Clinic. All patients were evaluated for neurological examination, serum glucose and HbA1c levels, total neuropathy score (TNS) and electrophysiological evaluations before insulin treatment and in the first and fourth week of the treatment. Results: Seven of patients were women and three of them were men. Age of patients were ranged from 40 to 69 and the mean age was 55±9.01. DM duration of patients ranged from 1 to 15 years (mean: 6.2±4.83). On the first Electrophysiologic evaluations of four patients were assessed within normal limits. We detected sensory polyneuropathy in lower extremities in five patients and a polyneuropathy syndrome which affecting sensory fibers in the upper extremity and both sensory and motor fibers in the lower extremities in the remaining patient. We observed particularly improvement the sensory conduction amplitude in the control electrophysiological evaluation of the patients with moderate neuropathy or without polyneuropathy but there was not a significant difference in control electrophysiological evaluation of the patients with severe polyneuropathy in the initial evaluation. Conclusion: After occurring severe polineuropathy syndrome there is not any improvement with good glicemic control whereas early stage of polyneuropathy.