The paradox between resistance to hypoxia and liability to hypoxic damage in hyperglycemic peripheral nerves. Evidence for glycolysis involvement

Schneider, U.; Niedermeier, W.; Grafe, P.

doi:10.2337/diabetes.42.7.981

“…The “hyperglycemic neuropathy” has been defined as a rapidly reversible nerve disorder associated with diabetes, including minor sensory symptoms and reduced nerve conduction velocity [7]. This has been referred to an enhanced anaerobic glycolysis secondary to hyperglycemia [8]. This condition may not affect biothesiometric values, as in our case.…”

Section: Discussionmentioning

confidence: 90%

Possible Correlation Between Type 1 Diabetes Mellitus and Female Sexual Dysfunction: Case Report and Literature Review

Bultrini

¹

,

Carosa

²

,

Colpi

³

et al. 2004

The Journal of Sexual Medicine

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Introduction Sexual dysfunction in diabetic women has received less attention in clinical research than the sexual symptoms of diabetic men. Although conflicting results have been reported, several studies suggest an increased prevalence of deficient vaginal lubrication in women with diabetes mellitus. As support to the hypothesis of a potential diabetes-related arousal dysfunction caused by a decrease in vaginal lubrication of women with Type 1 diabetes mellitus, we describe the following case report. Methods A 29-year-old white woman was found with a sexual arousal disorder of sudden onset, complicated by loss of orgasm and sexual desire, in absence of any marital, relational, psychological, or gynecological cause. Results One month later she was diagnosed with severe Type 1 diabetes. With the correction of diabetes and without other treatment of the sexual dysfunction, she experienced a full recovery of her sexual complaints. Conclusion The case illustrates the importance of being aware of female sexual dysfunction as an early symptom of diabetes mellitus and suggests that a good glycemic control would be fundamental to restore a normal sexual activity in diabetic women. It also demonstrates the need to take into account, not only in males, a sexual history in the management of diabetes mellitus.

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“…There is evidence in the literature that alterations in acid\base balance can lead to altered vascular and nerve function [22,23]. In their experiments with isolated peripheral nerves, Strupp et al [22] showed that high glucose availability and low PO # in combination with decreased buffering power and\or inhibition of HCO $ − -dependent pH regulatory mechanisms may damage peripheral mammalian nerves due to pronounced intracellular acidosis.…”

Section: Discussionmentioning

confidence: 98%

Peripheral vascular and nerve function associated with lower limb amputation in people with and without diabetes

Carrington

¹

,

Abbott

²

,

Griffiths

³

et al. 2001

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Multiple factors, including peripheral vascular disease and neuropathy, contribute to the development and perpetuation of complications of the lower extremities in diabetes. The main aim of the present study was to assess the peripheral vascular and nerve status of diabetic and non-diabetic subjects that had undergone lower limb amputation. Various non-invasive tests of peripheral vascular and nerve function were carried out on subjects who had undergone unilateral lower limb amputation and were now attending a Rehabilitation Centre. The control group (n=23), the diabetic amputee group (n=64) and the non-diabetic amputee group (n=32) were age-matched. Only the diabetic amputee group had evidence of medial arterial calcification. Transcutaneous oxygen levels were significantly lower in the diabetic amputee group (median 43 mmHg; interquartile range 33-49 mmHg) than in the control (59; 56-74 mmHg) and non-diabetic amputee (57; 43-65 mmHg) groups (control compared with diabetic amputee group, P<0.001; diabetic amputee compared with non-diabetic amputee group, P<0.01). The same trend was found for carbon dioxide levels in the skin [mmHg: diabetic amputees, 25 (21-37); controls, 38 (32-42); non-diabetic amputee, 34 (31-39)] (control compared with diabetic amputee, P<0.01; diabetic amputee compared with non-diabetic amputee, P<0.05). Vibration and pressure perception measurements (which assess Abeta nerve fibre function) showed that both the diabetic amputee and non-diabetic amputee subjects had significantly greater impairment than the controls. However, measures of Aalpha and C nerve fibre function were abnormal only in the diabetic amputee group. Thus the peripheral vascular and nerve functions of age-matched diabetic and non-diabetic subjects having undergone lower limb amputation show specific differences, with non-diabetic amputees exhibiting signs of neuropathy. This indicates that factors characteristic of diabetes (such as hyperglycaemia and non-enzymic glycation) are associated with calcification, lower oxygen and carbon dioxide levels in the skin, and abnormal Aalpha and C nerve fibre function.

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“…There is evidence in the literature that alterations in acid\base balance can lead to altered vascular and nerve function [22,23]. There is evidence in the literature that alterations in acid\base balance can lead to altered vascular and nerve function [22,23].…”

Section: Discussionmentioning

confidence: 99%

Peripheral vascular and nerve function associated with lower limb amputation in people with and without diabetes

Carrington¹,

Abbott²,

Griffiths³

et al. 2001

View full text Add to dashboard Cite

Multiple factors, including peripheral vascular disease and neuropathy, contribute to the development and perpetuation of complications of the lower extremities in diabetes. The main aim of the present study was to assess the peripheral vascular and nerve status of diabetic and non-diabetic subjects that had undergone lower limb amputation. Various non-invasive tests of peripheral vascular and nerve function were carried out on subjects who had undergone unilateral lower limb amputation and were now attending a Rehabilitation Centre. The control group (n=23), the diabetic amputee group (n=64) and the non-diabetic amputee group (n=32) were age-matched. Only the diabetic amputee group had evidence of medial arterial calcification. Transcutaneous oxygen levels were significantly lower in the diabetic amputee group (median 43 mmHg; interquartile range 33-49 mmHg) than in the control (59; 56-74 mmHg) and non-diabetic amputee (57; 43-65 mmHg) groups (control compared with diabetic amputee group, P<0.001; diabetic amputee compared with non-diabetic amputee group, P<0.01). The same trend was found for carbon dioxide levels in the skin [mmHg: diabetic amputees, 25 (21-37); controls, 38 (32-42); non-diabetic amputee, 34 (31-39)] (control compared with diabetic amputee, P<0.01; diabetic amputee compared with non-diabetic amputee, P<0.05). Vibration and pressure perception measurements (which assess Abeta nerve fibre function) showed that both the diabetic amputee and non-diabetic amputee subjects had significantly greater impairment than the controls. However, measures of Aalpha and C nerve fibre function were abnormal only in the diabetic amputee group. Thus the peripheral vascular and nerve functions of age-matched diabetic and non-diabetic subjects having undergone lower limb amputation show specific differences, with non-diabetic amputees exhibiting signs of neuropathy. This indicates that factors characteristic of diabetes (such as hyperglycaemia and non-enzymic glycation) are associated with calcification, lower oxygen and carbon dioxide levels in the skin, and abnormal Aalpha and C nerve fibre function.

show abstract

The paradox between resistance to hypoxia and liability to hypoxic damage in hyperglycemic peripheral nerves. Evidence for glycolysis involvement

Cited by 12 publications

References 12 publications

Possible Correlation Between Type 1 Diabetes Mellitus and Female Sexual Dysfunction: Case Report and Literature Review

Possible Correlation Between Type 1 Diabetes Mellitus and Female Sexual Dysfunction: Case Report and Literature Review

Peripheral vascular and nerve function associated with lower limb amputation in people with and without diabetes

Peripheral vascular and nerve function associated with lower limb amputation in people with and without diabetes

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