The effect of intensive diabetes therapy on the development and progression of neuropathy

Article Abstract:

Intensive treatment of diabetics aimed at maintaining normal blood glucose levels may reduce the risk of developing neuropathies. Neuropathies are incurable disorders of the nervous system manifested by impaired sensation and motor skills, incontinence, impotence and loss of tendon reflexes. A total of 1,441 insulin-dependent diabetics aged 13 to 39 years were randomly assigned to receive conventional therapy (one or two insulin injections per day) or intensive therapy (three or more injections per day or continuous insulin infusion). After five years, clinical examination and nerve conduction tests showed a 64% reduction in the development of neuropathies among patients treated with intensive therapy. Preventing or delaying diabetic neuropathies could substantially reduce the incidence of foot infections and amputations.

Development and progression, Type 1 diabetes, Diabetic neuropathies

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Normalization of intracellular calcium: a sweet solution to neutrophil dysfunction in diabetes?

Article Abstract:

Diabetics may experience more infections because the ability of their polymorphonuclear leukocyte (PMNL) cells to eliminate foreign material is impaired. The impairment of the PMNLs may be caused by high blood glucose levels, which in turn may cause an influx of calcium into PMNLs. A three-month treatment with glyburide in patients with non-insulin-dependent diabetes brought high glucose levels down to normal, which subsequently caused levels of calcium in PMNLs to return to normal. The ability of PMNLs to kill foreign bacteria improved as well. Treatment with calcium channel blockers may cause calcium levels in PMNLs to return to normal. Better control of blood glucose levels may improve the bacteria-fighting ability of PMNLs.

Editorial, Physiological aspects, Diabetes, Diabetes mellitus, Calcium metabolism, Leukocyte disorders

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• Abstracts: Effect of intensive therapy on residual beta-cell function in patients with type 1 diabetes in The Diabetes Control and Complications Trial: a randomized, controlled trial

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