The Acute Effects of Glycemic Control on Axonal Excitabiliy in Human Diabetic Nerves.

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Objective To investigate whether glycemic control is associated with reversible changes in axonal excitability in human diabetic nerves. It is known that voluntary contraction or compression ischemia alters nerve Na+/K+) pump activity, and axonal excitability changes due to the pump activity can be estimated by threshold tracking.Methods Threshold, the current required to produce a compound muscle action potential 50% of maximum, was determined from the stimulus-response curve, and threshold changes produced by maximal voluntary contraction or ischemia were measured before and after insulin treatment in 10 diabetic patients.Results Within 3 weeks of the start of treatment, the threshold changes became greater following voluntary contractions (+13±4% versus +23±5%; mean±SEM; p=0.04) and during ischemia (-5±2% versus -11±2%; p=0.04).Conclusions The extent of threshold fluctuation depends on multiple metabolic factors associated with diabetes such as decreased Na+/K+) ATPase activity, increased anaerobic glycolysis, and tissue acidosis, and nerve excitability can respond quickly to glycemic control in diabetic patients.(Internal Medicine 41: 360-365, 2002)
社団法人　日本内科学会の論文