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The effects of short-term, rapid glycemic control on the peroneal nerve function and serum VCAM-1 and AGE in type 2 diabetic patients in Malaysia.
Indian J Med Sci 2009; 63(4):131-8IJ

Abstract

BACKGROUND

The role of endothelial injury and circulating adhesion molecule in the development and progression of diabetic peripheral neuropathy in the long-term has been established previously.

AIMS

To study the effects of short-term glycemic control using insulin and oral hypoglycemic agent therapy (OHA) on the peroneal nerve function and vascular cell adhesion molecule-1 (VCAM-1) and advanced glycation endproducts (AGE) levels in type 2 diabetic patients.

SETTINGS AND DESIGN

A randomized controlled study involving poorly controlled (HbA1c, 7.5%-11%) type 2 diabetic patients attending the endocrinology outpatient center in a tertiary hospital in Kuala Lumpur.

MATERIALS AND METHODS

Twenty-nine patients were randomized to receive insulin (n=15) or OHA (n=14) for 8 weeks. The glycemic variables (HbA1c, fasting plasma glucose [FPG], fructosamine), VCAM-1, serum AGE and the peroneal motor conduction velocity (PMCV) were measured at baseline and at 4-week intervals.

STATISTICAL ANALYSIS USED

Paired 't' test or Kruskal Wallis test; and the unpaired 't' test or Mann-Whitney U test were used for within-group and between-group analyses, respectively. Correlation was analyzed using Spearman's correlation coefficient.

RESULTS

Within-group analysis showed significant progressive improvement in HbA1c at weeks 4 and 8 in the insulin group. The PMCV improved significantly in both groups by week 8, and by week 4 (P = 0.01) in the insulin group. PMCV correlated negatively with VCAM-1 (P = 0.031) and AGE (P = 0.009) at week 8.

CONCLUSION

Aggressive glycemic control with insulin improves the peroneal nerve function within 4 weeks. Improvement in the serum VCAM-1 and AGE levels correlated significantly with improvement in peroneal nerve conduction velocity only in the insulin group.

Authors+Show Affiliations

Department of Medicine, Universiti Kebangsaan Malaysia Medical Center (UKMMC), Kuala Lumpur, Malaysia. norlinah@mail.hukm.ukm.myNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

19414982

Citation

Norlinah, M I., et al. "The Effects of Short-term, Rapid Glycemic Control On the Peroneal Nerve Function and Serum VCAM-1 and AGE in Type 2 Diabetic Patients in Malaysia." Indian Journal of Medical Sciences, vol. 63, no. 4, 2009, pp. 131-8.
Norlinah MI, Hamizah R, Md Isa SH, et al. The effects of short-term, rapid glycemic control on the peroneal nerve function and serum VCAM-1 and AGE in type 2 diabetic patients in Malaysia. Indian J Med Sci. 2009;63(4):131-8.
Norlinah, M. I., Hamizah, R., Md Isa, S. H., Wan Nazaimoon, W. M., & Khalid, B. A. (2009). The effects of short-term, rapid glycemic control on the peroneal nerve function and serum VCAM-1 and AGE in type 2 diabetic patients in Malaysia. Indian Journal of Medical Sciences, 63(4), pp. 131-8. doi:10.4103/0019-5359.49365.
Norlinah MI, et al. The Effects of Short-term, Rapid Glycemic Control On the Peroneal Nerve Function and Serum VCAM-1 and AGE in Type 2 Diabetic Patients in Malaysia. Indian J Med Sci. 2009;63(4):131-8. PubMed PMID: 19414982.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The effects of short-term, rapid glycemic control on the peroneal nerve function and serum VCAM-1 and AGE in type 2 diabetic patients in Malaysia. AU - Norlinah,M I, AU - Hamizah,R, AU - Md Isa,S H, AU - Wan Nazaimoon,W M, AU - Khalid,B A K, PY - 2009/5/6/entrez PY - 2009/5/6/pubmed PY - 2009/10/8/medline SP - 131 EP - 8 JF - Indian journal of medical sciences JO - Indian J Med Sci VL - 63 IS - 4 N2 - BACKGROUND: The role of endothelial injury and circulating adhesion molecule in the development and progression of diabetic peripheral neuropathy in the long-term has been established previously. AIMS: To study the effects of short-term glycemic control using insulin and oral hypoglycemic agent therapy (OHA) on the peroneal nerve function and vascular cell adhesion molecule-1 (VCAM-1) and advanced glycation endproducts (AGE) levels in type 2 diabetic patients. SETTINGS AND DESIGN: A randomized controlled study involving poorly controlled (HbA1c, 7.5%-11%) type 2 diabetic patients attending the endocrinology outpatient center in a tertiary hospital in Kuala Lumpur. MATERIALS AND METHODS: Twenty-nine patients were randomized to receive insulin (n=15) or OHA (n=14) for 8 weeks. The glycemic variables (HbA1c, fasting plasma glucose [FPG], fructosamine), VCAM-1, serum AGE and the peroneal motor conduction velocity (PMCV) were measured at baseline and at 4-week intervals. STATISTICAL ANALYSIS USED: Paired 't' test or Kruskal Wallis test; and the unpaired 't' test or Mann-Whitney U test were used for within-group and between-group analyses, respectively. Correlation was analyzed using Spearman's correlation coefficient. RESULTS: Within-group analysis showed significant progressive improvement in HbA1c at weeks 4 and 8 in the insulin group. The PMCV improved significantly in both groups by week 8, and by week 4 (P = 0.01) in the insulin group. PMCV correlated negatively with VCAM-1 (P = 0.031) and AGE (P = 0.009) at week 8. CONCLUSION: Aggressive glycemic control with insulin improves the peroneal nerve function within 4 weeks. Improvement in the serum VCAM-1 and AGE levels correlated significantly with improvement in peroneal nerve conduction velocity only in the insulin group. SN - 0019-5359 UR - https://www.unboundmedicine.com/medline/citation/19414982/The_effects_of_short_term_rapid_glycemic_control_on_the_peroneal_nerve_function_and_serum_VCAM_1_and_AGE_in_type_2_diabetic_patients_in_Malaysia_ L2 - https://medlineplus.gov/diabeticnerveproblems.html DB - PRIME DP - Unbound Medicine ER -