Influence du controle glycemique sur la conduction nerveuse peripherique des diabetiques insulino-dependants

Abstract

In order to better evaluate the influence of glycemic control on diabetic neuropathy, 73 diabetic patients were considered: 42 males and 31 females who had been treated with insulin during 9 years. Twenty-one subjects were examined during 2-12 months. Motor nerve conduction velocity (MCV) was measured on the external sciatic popliteus (ESP). The H reflex parameters from soleus were: latency time for H response (HL), the ratio between the maximum amplitude of the H reflex response and the M motor response: (formula: see text) was determined by a chromatographic method. The reduction of MCV, the rise in HL and the decrease of E in diabetics are more pronounced according to the duration of the disease and are significantly correlated with the rate of HbA1c (respectively MCV: r = -0.39, P less than 0.001; HL: r = 0.42, P less than 0.001; E: r = -0.37, P less than 0.01). There is a slight correlation between HbA1c level and the duration of diabetes. For the 21 diabetics observed during many months there is a very significant correlation between the slope of the evolution curves of HbA2c, MCV and HL.