Progressive Axonal Dysfunction Precedes Development of Neuropathy in Type 2 Diabetes
Article Figures & Tables
Figures
- FIG. 1.
Flowchart categorizing 108 diabetic patients into patients with (DN group) and without (DWN group) neuropathy and subsequently into neuropathy severity grades 0, 1, and 2/3, according to TNS.
- FIG. 2.
Nerve excitability changes in patients with diabetes. Healthy control subjects are depicted by solid lines, DWN patients as open circles, and DN patients as filled circles. A: Progressive changes in stimulus-response curves, demonstrating increasing stimulus threshold. B: Strength-duration relationship, with increased rheobase in patients with diabetes. C: TE curves demonstrating reduced threshold change in patients with diabetic neuropathy. D: Recovery cycles illustrating reduced progressive reductions in superexcitability and subexcitability.
- FIG. 3.
Comparison of excitability findings between healthy control subjects and patients with diabetes (TNS grades 0, 1, and 2/3). A: Latency (ms) was significantly increased in grade 2/3 patients. B: RRP (ms) was prolonged in grade 2/3 patients. Recovery cycle parameters (C) superexcitability (%) and (D) subexcitability (%) demonstrated significant changes in all TNS grades. E: TEh (overshoot) was reduced in all TNS grades. F: TEd (10–20 ms) was reduced in patients with TNS grades 1 and 2/3. *P < 0.05; **P < 0.005; ***P < 0.0005.
- FIG. 4.
Correlations in diabetic patients without neuropathy (DWN group) between (A) HbA1c level and latency and (B) HbA1c level and subexcitability, demonstrating correlations between high HbA1c levels, increased latency, and reduced subexcitability.
Tables
In this Issue
