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Erschienen in: Endocrine 3/2016

06.07.2016 | Mini Review

The impact of glycemic variability on diabetic peripheral neuropathy

verfasst von: Heung Yong Jin, Kyung Ae Lee, Tae Sun Park

Erschienen in: Endocrine | Ausgabe 3/2016

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Abstract

Mean glucose values alone cannot explain the patterns of morbidity and mortality due to dysglycemia in diabetes. Development of continuous glucose monitoring systems has improved the analysis and interpretation of glycemic variability. The roles of glycemic components other than constant hyperglycemia in diabetic complications must be investigated because large clinical studies have indicated that risk factors besides the average glucose value of HbA1c are involved in chronic macrocomplications/microcomplications of diabetes. Among these complications, the pathogenesis of diabetic peripheral neuropathy is particularly complex, and several factors related to glucose and nonglucose pathways have been suggested as risk factors. There is little information regarding the effect of glycemic variability on diabetic peripheral neuropathy, unlike other microvascular complications of retinopathy and nephropathy, and whether glycemic variability causes harmful effects is still a matter of debate. In this review, we discuss the relationships between glycemic variability and diabetic peripheral neuropathy, focusing on somatosensory peripheral neuropathies rather than autonomic neuropathies.
Literatur
1.
Zurück zum Zitat W. Clarke, B. Kovatchev, Statistical tools to analyze continuous glucose monitor data. Diabetes Technol. Ther. 11(Suppl 1) S45–S54 (2009)PubMed W. Clarke, B. Kovatchev, Statistical tools to analyze continuous glucose monitor data. Diabetes Technol. Ther. 11(Suppl 1) S45–S54 (2009)PubMed
2.
Zurück zum Zitat H.S. Jung, Clinical implications of glucose variability: chronic complications of diabetes. Endocrinol. Metab. (Seoul) 30(2), 167–174 (2015)CrossRef H.S. Jung, Clinical implications of glucose variability: chronic complications of diabetes. Endocrinol. Metab. (Seoul) 30(2), 167–174 (2015)CrossRef
3.
Zurück zum Zitat J. Schlichtkrull, O. Munck, M. Jersild, M-value, an index for blood sugar control in diabetics. Ugeskr. Laeger. 126, 815–820 (1964)PubMed J. Schlichtkrull, O. Munck, M. Jersild, M-value, an index for blood sugar control in diabetics. Ugeskr. Laeger. 126, 815–820 (1964)PubMed
4.
Zurück zum Zitat F.J. Service, G.D. Molnar, J.W. Rosevear, E. Ackerman, L.C. Gatewood, W.F. Taylor, Mean amplitude of glycemic excursions, a measure of diabetic instability. Diabetes 19(9), 644–655 (1970)CrossRefPubMed F.J. Service, G.D. Molnar, J.W. Rosevear, E. Ackerman, L.C. Gatewood, W.F. Taylor, Mean amplitude of glycemic excursions, a measure of diabetic instability. Diabetes 19(9), 644–655 (1970)CrossRefPubMed
5.
Zurück zum Zitat K.D. Kohnert, P. Heinke, L. Vogt, E. Salzsieder, Utility of different glycemic control metrics for optimizing management of diabetes. World J. Diabetes 6(1), 17–29 (2015)CrossRefPubMedPubMedCentral K.D. Kohnert, P. Heinke, L. Vogt, E. Salzsieder, Utility of different glycemic control metrics for optimizing management of diabetes. World J. Diabetes 6(1), 17–29 (2015)CrossRefPubMedPubMedCentral
7.
Zurück zum Zitat S. Yagihashi, H. Mizukami, K. Sugimoto, Mechanism of diabetic neuropathy: where are we now and where to go?. J. Diabetes Investig. 2(1), 18–32 (2011)CrossRefPubMed S. Yagihashi, H. Mizukami, K. Sugimoto, Mechanism of diabetic neuropathy: where are we now and where to go?. J. Diabetes Investig. 2(1), 18–32 (2011)CrossRefPubMed
8.
Zurück zum Zitat F. Garcia Soriano, L. Virag, P. Jagtap, E. Szabo, J.G. Mabley, L. Liaudet, A. Marton, D.G. Hoyt, K.G. Murthy, A.L. Salzman, G.J. Southan, C. Szabo, Diabetic endothelial dysfunction: the role of poly(ADP-ribose) polymerase activation. Nat. Med. 7(1), 108–113 (2001)CrossRefPubMed F. Garcia Soriano, L. Virag, P. Jagtap, E. Szabo, J.G. Mabley, L. Liaudet, A. Marton, D.G. Hoyt, K.G. Murthy, A.L. Salzman, G.J. Southan, C. Szabo, Diabetic endothelial dysfunction: the role of poly(ADP-ribose) polymerase activation. Nat. Med. 7(1), 108–113 (2001)CrossRefPubMed
9.
Zurück zum Zitat R.J. Heine, B. Balkau, A. Ceriello, S. Del Prato, E.S. Horton, M.R. Taskinen, What does postprandial hyperglycaemia mean?. Diabet. Med. 21(3), 208–213 (2004)CrossRefPubMed R.J. Heine, B. Balkau, A. Ceriello, S. Del Prato, E.S. Horton, M.R. Taskinen, What does postprandial hyperglycaemia mean?. Diabet. Med. 21(3), 208–213 (2004)CrossRefPubMed
10.
Zurück zum Zitat A.E. Caballero, S. Arora, R. Saouaf, S.C. Lim, P. Smakowski, J.Y. Park, G.L. King, F.W. LoGerfo, E.S. Horton, A. Veves, Microvascular and macrovascular reactivity is reduced in subjects at risk for type 2 diabetes. Diabetes 48(9), 1856–1862 (1999)CrossRefPubMed A.E. Caballero, S. Arora, R. Saouaf, S.C. Lim, P. Smakowski, J.Y. Park, G.L. King, F.W. LoGerfo, E.S. Horton, A. Veves, Microvascular and macrovascular reactivity is reduced in subjects at risk for type 2 diabetes. Diabetes 48(9), 1856–1862 (1999)CrossRefPubMed
11.
Zurück zum Zitat S. Thrainsdottir, R.A. Malik, L.B. Dahlin, P. Wiksell, K.F. Eriksson, I. Rosen, J. Petersson, D.A. Greene, G. Sundkvist, Endoneurial capillary abnormalities presage deterioration of glucose tolerance and accompany peripheral neuropathy in man. Diabetes 52(10), 2615–2622 (2003)CrossRefPubMed S. Thrainsdottir, R.A. Malik, L.B. Dahlin, P. Wiksell, K.F. Eriksson, I. Rosen, J. Petersson, D.A. Greene, G. Sundkvist, Endoneurial capillary abnormalities presage deterioration of glucose tolerance and accompany peripheral neuropathy in man. Diabetes 52(10), 2615–2622 (2003)CrossRefPubMed
12.
Zurück zum Zitat R. Stavniichuk, V.R. Drel, H. Shevalye, I. Vareniuk, M.J. Stevens, J.L. Nadler, I.G. Obrosova, Role of 12/15-lipoxygenase in nitrosative stress and peripheral prediabetic and diabetic neuropathies. Free Radic. Biol. Med. 49(6), 1036–1045 (2010)CrossRefPubMedPubMedCentral R. Stavniichuk, V.R. Drel, H. Shevalye, I. Vareniuk, M.J. Stevens, J.L. Nadler, I.G. Obrosova, Role of 12/15-lipoxygenase in nitrosative stress and peripheral prediabetic and diabetic neuropathies. Free Radic. Biol. Med. 49(6), 1036–1045 (2010)CrossRefPubMedPubMedCentral
13.
Zurück zum Zitat S. Tesfaye, N. Chaturvedi, S.E. Eaton, J.D. Ward, C. Manes, C. Ionescu-Tirgoviste, D.R. Witte, J.H. Fuller, E.P.C.S. Group, Vascular risk factors and diabetic neuropathy. N. Engl. J. Med. 352(4), 341–350 (2005)CrossRefPubMed S. Tesfaye, N. Chaturvedi, S.E. Eaton, J.D. Ward, C. Manes, C. Ionescu-Tirgoviste, D.R. Witte, J.H. Fuller, E.P.C.S. Group, Vascular risk factors and diabetic neuropathy. N. Engl. J. Med. 352(4), 341–350 (2005)CrossRefPubMed
14.
Zurück zum Zitat R.M. Herman, J.B. Brower, D.G. Stoddard, A.R. Casano, J.H. Targovnik, J.H. Herman, P. Tearse, Prevalence of somatic small fiber neuropathy in obesity. Int. J. Obes. (Lond) 31(2), 226–235 (2007)CrossRef R.M. Herman, J.B. Brower, D.G. Stoddard, A.R. Casano, J.H. Targovnik, J.H. Herman, P. Tearse, Prevalence of somatic small fiber neuropathy in obesity. Int. J. Obes. (Lond) 31(2), 226–235 (2007)CrossRef
15.
Zurück zum Zitat A.G. Smith, K. Rose, J.R. Singleton, Idiopathic neuropathy patients are at high risk for metabolic syndrome. J. Neurol. Sci. 273(1-2), 25–28 (2008)CrossRefPubMedPubMedCentral A.G. Smith, K. Rose, J.R. Singleton, Idiopathic neuropathy patients are at high risk for metabolic syndrome. J. Neurol. Sci. 273(1-2), 25–28 (2008)CrossRefPubMedPubMedCentral
16.
Zurück zum Zitat L. Quagliaro, L. Piconi, R. Assaloni, L. Martinelli, E. Motz, A. Ceriello, Intermittent high glucose enhances apoptosis related to oxidative stress in human umbilical vein endothelial cells: the role of protein kinase C and NAD(P)H-oxidase activation. Diabetes 52(11), 2795–2804 (2003)CrossRefPubMed L. Quagliaro, L. Piconi, R. Assaloni, L. Martinelli, E. Motz, A. Ceriello, Intermittent high glucose enhances apoptosis related to oxidative stress in human umbilical vein endothelial cells: the role of protein kinase C and NAD(P)H-oxidase activation. Diabetes 52(11), 2795–2804 (2003)CrossRefPubMed
17.
Zurück zum Zitat M.J. Kim, H.S. Jung, Y. Hwang-Bo, S.W. Cho, H.C. Jang, S.Y. Kim, K.S. Park, Evaluation of 1,5-anhydroglucitol as a marker for glycemic variability in patients with type 2 diabetes mellitus. Acta. Diabetol. 50(4), 505–510 (2013)CrossRefPubMed M.J. Kim, H.S. Jung, Y. Hwang-Bo, S.W. Cho, H.C. Jang, S.Y. Kim, K.S. Park, Evaluation of 1,5-anhydroglucitol as a marker for glycemic variability in patients with type 2 diabetes mellitus. Acta. Diabetol. 50(4), 505–510 (2013)CrossRefPubMed
18.
Zurück zum Zitat A. Ceriello, K. Esposito, L. Piconi, M.A. Ihnat, J.E. Thorpe, R. Testa, M. Boemi, D. Giugliano, Oscillating glucose is more deleterious to endothelial function and oxidative stress than mean glucose in normal and type 2 diabetic patients. Diabetes 57(5), 1349–1354 (2008)CrossRefPubMed A. Ceriello, K. Esposito, L. Piconi, M.A. Ihnat, J.E. Thorpe, R. Testa, M. Boemi, D. Giugliano, Oscillating glucose is more deleterious to endothelial function and oxidative stress than mean glucose in normal and type 2 diabetic patients. Diabetes 57(5), 1349–1354 (2008)CrossRefPubMed
19.
Zurück zum Zitat L. Monnier, C. Colette, D.R. Owens, Integrating glycaemic variability in the glycaemic disorders of type 2 diabetes: a move towards a unified glucose tetrad concept. Diabetes Metab. Res. Rev. 25(5), 393–402 (2009)CrossRefPubMed L. Monnier, C. Colette, D.R. Owens, Integrating glycaemic variability in the glycaemic disorders of type 2 diabetes: a move towards a unified glucose tetrad concept. Diabetes Metab. Res. Rev. 25(5), 393–402 (2009)CrossRefPubMed
20.
Zurück zum Zitat E.S. Kilpatrick, A.S. Rigby, S.L. Atkin, For debate. Glucose variability and diabetes complication risk: we need to know the answer. Diabet. Med. 27(8), 868–871 (2010)CrossRefPubMed E.S. Kilpatrick, A.S. Rigby, S.L. Atkin, For debate. Glucose variability and diabetes complication risk: we need to know the answer. Diabet. Med. 27(8), 868–871 (2010)CrossRefPubMed
21.
Zurück zum Zitat L. Quagliaro, L. Piconi, R. Assaloni, R. Da Ros, A. Maier, G. Zuodar, A. Ceriello, Intermittent high glucose enhances ICAM-1, VCAM-1 and E-selectin expression in human umbilical vein endothelial cells in culture: the distinct role of protein kinase C and mitochondrial superoxide production. Atherosclerosis 183(2), 259–267 (2005)CrossRefPubMed L. Quagliaro, L. Piconi, R. Assaloni, R. Da Ros, A. Maier, G. Zuodar, A. Ceriello, Intermittent high glucose enhances ICAM-1, VCAM-1 and E-selectin expression in human umbilical vein endothelial cells in culture: the distinct role of protein kinase C and mitochondrial superoxide production. Atherosclerosis 183(2), 259–267 (2005)CrossRefPubMed
22.
Zurück zum Zitat S. Kalopita, S. Liatis, P. Thomakos, I. Vlahodimitris, C. Stathi, N. Katsilambros, N. Tentolouris, K. Makrilakis, Relationship between autonomic nervous system function and continuous interstitial glucose measurement in patients with type 2 diabetes. J. Diabetes Res. 2014, 835392 (2014)CrossRefPubMedPubMedCentral S. Kalopita, S. Liatis, P. Thomakos, I. Vlahodimitris, C. Stathi, N. Katsilambros, N. Tentolouris, K. Makrilakis, Relationship between autonomic nervous system function and continuous interstitial glucose measurement in patients with type 2 diabetes. J. Diabetes Res. 2014, 835392 (2014)CrossRefPubMedPubMedCentral
23.
Zurück zum Zitat J.E. Jun, S.M. Jin, J. Baek, S. Oh, K.Y. Hur, M.S. Lee, M.K. Lee, J.H. Kim, The association between glycemic variability and diabetic cardiovascular autonomic neuropathy in patients with type 2 diabetes. Cardiovasc. Diabetol. 14, 70 (2015)CrossRefPubMedPubMedCentral J.E. Jun, S.M. Jin, J. Baek, S. Oh, K.Y. Hur, M.S. Lee, M.K. Lee, J.H. Kim, The association between glycemic variability and diabetic cardiovascular autonomic neuropathy in patients with type 2 diabetes. Cardiovasc. Diabetol. 14, 70 (2015)CrossRefPubMedPubMedCentral
25.
Zurück zum Zitat S.E. Siegelaar, E.S. Kilpatrick, A.S. Rigby, S.L. Atkin, J.B. Hoekstra, J.H. Devries, Glucose variability does not contribute to the development of peripheral and autonomic neuropathy in type 1 diabetes: data from the DCCT. Diabetologia 52(10), 2229–2232 (2009)CrossRefPubMedPubMedCentral S.E. Siegelaar, E.S. Kilpatrick, A.S. Rigby, S.L. Atkin, J.B. Hoekstra, J.H. Devries, Glucose variability does not contribute to the development of peripheral and autonomic neuropathy in type 1 diabetes: data from the DCCT. Diabetologia 52(10), 2229–2232 (2009)CrossRefPubMedPubMedCentral
26.
Zurück zum Zitat J. Bragd, U. Adamson, L.B. Backlund, P.E. Lins, E. Moberg, P. Oskarsson, Can glycaemic variability, as calculated from blood glucose self-monitoring, predict the development of complications in type 1 diabetes over a decade?. Diabetes Metab. 34(6 Pt 1), 612–616 (2008)CrossRefPubMed J. Bragd, U. Adamson, L.B. Backlund, P.E. Lins, E. Moberg, P. Oskarsson, Can glycaemic variability, as calculated from blood glucose self-monitoring, predict the development of complications in type 1 diabetes over a decade?. Diabetes Metab. 34(6 Pt 1), 612–616 (2008)CrossRefPubMed
27.
Zurück zum Zitat J. Soupal, J. Skrha Jr. M. Fajmon, E. Horova, M. Mraz, J. Skrha, M. Prazny, Glycemic variability is higher in type 1 diabetes patients with microvascular complications irrespective of glycemic control. Diabetes Technol. Ther. 16(4), 198–203 (2014)CrossRefPubMed J. Soupal, J. Skrha Jr. M. Fajmon, E. Horova, M. Mraz, J. Skrha, M. Prazny, Glycemic variability is higher in type 1 diabetes patients with microvascular complications irrespective of glycemic control. Diabetes Technol. Ther. 16(4), 198–203 (2014)CrossRefPubMed
28.
Zurück zum Zitat F. Xu, L.H. Zhao, J.B. Su, T. Chen, X.Q. Wang, J.F. Chen, G. Wu, Y. Jin, X.H. Wang, The relationship between glycemic variability and diabetic peripheral neuropathy in type 2 diabetes with well-controlled HbA1c. Diabetol Metab. Syndr. 6(1), 139 (2014)CrossRefPubMedPubMedCentral F. Xu, L.H. Zhao, J.B. Su, T. Chen, X.Q. Wang, J.F. Chen, G. Wu, Y. Jin, X.H. Wang, The relationship between glycemic variability and diabetic peripheral neuropathy in type 2 diabetes with well-controlled HbA1c. Diabetol Metab. Syndr. 6(1), 139 (2014)CrossRefPubMedPubMedCentral
29.
Zurück zum Zitat S.O. Oyibo, Y.D. Prasad, N.J. Jackson, E.B. Jude, A.J. Boulton, The relationship between blood glucose excursions and painful diabetic peripheral neuropathy: a pilot study. Diabet. Med. 19(10), 870–873 (2002)CrossRefPubMed S.O. Oyibo, Y.D. Prasad, N.J. Jackson, E.B. Jude, A.J. Boulton, The relationship between blood glucose excursions and painful diabetic peripheral neuropathy: a pilot study. Diabet. Med. 19(10), 870–873 (2002)CrossRefPubMed
30.
Zurück zum Zitat S. Tesfaye, A.J. Boulton, P.J. Dyck, R. Freeman, M. Horowitz, P. Kempler, G. Lauria, R.A. Malik, V. Spallone, A. Vinik, L. Bernardi, P. Valensi, Toronto Diabetic Neuropathy Expert, G.: diabetic neuropathies: update on definitions, diagnostic criteria, estimation of severity, and treatments. Diabetes Care 33(10), 2285–2293 (2010)CrossRefPubMedPubMedCentral S. Tesfaye, A.J. Boulton, P.J. Dyck, R. Freeman, M. Horowitz, P. Kempler, G. Lauria, R.A. Malik, V. Spallone, A. Vinik, L. Bernardi, P. Valensi, Toronto Diabetic Neuropathy Expert, G.: diabetic neuropathies: update on definitions, diagnostic criteria, estimation of severity, and treatments. Diabetes Care 33(10), 2285–2293 (2010)CrossRefPubMedPubMedCentral
31.
Zurück zum Zitat X. Meng, C. Gong, B. Cao, X. Peng, D. Wu, Y. Gu, L. Wei, X. Liang, M. Liu, W. Li, C. Su, Glucose fluctuations in association with oxidative stress among children with T1DM: comparison of different phases. J. Clin. Endocrinol. Metab. 100(5), 1828–1836 (2015)CrossRefPubMed X. Meng, C. Gong, B. Cao, X. Peng, D. Wu, Y. Gu, L. Wei, X. Liang, M. Liu, W. Li, C. Su, Glucose fluctuations in association with oxidative stress among children with T1DM: comparison of different phases. J. Clin. Endocrinol. Metab. 100(5), 1828–1836 (2015)CrossRefPubMed
32.
Zurück zum Zitat K. Esposito, F. Nappo, R. Marfella, G. Giugliano, F. Giugliano, M. Ciotola, L. Quagliaro, A. Ceriello, D. Giugliano, Inflammatory cytokine concentrations are acutely increased by hyperglycemia in humans: role of oxidative stress. Circulation 106(16), 2067–2072 (2002)CrossRefPubMed K. Esposito, F. Nappo, R. Marfella, G. Giugliano, F. Giugliano, M. Ciotola, L. Quagliaro, A. Ceriello, D. Giugliano, Inflammatory cytokine concentrations are acutely increased by hyperglycemia in humans: role of oxidative stress. Circulation 106(16), 2067–2072 (2002)CrossRefPubMed
33.
Zurück zum Zitat K.D. Kohnert, P. Augstein, P. Heinke, E. Zander, K. Peterson, E.J. Freyse, E. Salzsieder, Chronic hyperglycemia but not glucose variability determines HbA1c levels in well-controlled patients with type 2 diabetes. Diabetes Res. Clin. Pract. 77(3), 420–426 (2007)CrossRefPubMed K.D. Kohnert, P. Augstein, P. Heinke, E. Zander, K. Peterson, E.J. Freyse, E. Salzsieder, Chronic hyperglycemia but not glucose variability determines HbA1c levels in well-controlled patients with type 2 diabetes. Diabetes Res. Clin. Pract. 77(3), 420–426 (2007)CrossRefPubMed
34.
Zurück zum Zitat N. Colomo, M.J. Tapia, M.R. Vallejo, F. Garcia-Torres, E. Rubio-Martin, F.F. Caballero, J.M. Jimenez, M.J. Pelaez, A.M. Gomez, I. Sanchez, J.P. Lopez-Siguero, F. Soriguer, M.S. Ruiz de Adana, Glycemic variability and oxidative stress in children, with type 1 diabetes attending a summer camp. An Pediatr (Barc) 81(3), 174–180 (2014)CrossRef N. Colomo, M.J. Tapia, M.R. Vallejo, F. Garcia-Torres, E. Rubio-Martin, F.F. Caballero, J.M. Jimenez, M.J. Pelaez, A.M. Gomez, I. Sanchez, J.P. Lopez-Siguero, F. Soriguer, M.S. Ruiz de Adana, Glycemic variability and oxidative stress in children, with type 1 diabetes attending a summer camp. An Pediatr (Barc) 81(3), 174–180 (2014)CrossRef
35.
Zurück zum Zitat E.S. Kilpatrick, A.S. Rigby, S.L. Atkin, A1C variability and the risk of microvascular complications in type 1 diabetes: data from the Diabetes Control and Complications Trial. Diabetes Care 31(11), 2198–2202 (2008)CrossRefPubMedPubMedCentral E.S. Kilpatrick, A.S. Rigby, S.L. Atkin, A1C variability and the risk of microvascular complications in type 1 diabetes: data from the Diabetes Control and Complications Trial. Diabetes Care 31(11), 2198–2202 (2008)CrossRefPubMedPubMedCentral
36.
Zurück zum Zitat Y. Kitahara, K. Miura, K. Takesue, T. Mine, R. Wada, Y. Uchida, S. Ito, S. Yagihashi, Decreased blood glucose excursion by nateglinide ameliorated neuropathic changes in Goto-Kakizaki rats, an animal model of non-obese type 2 diabetes. Metabolism 51(11), 1452–1457 (2002)CrossRefPubMed Y. Kitahara, K. Miura, K. Takesue, T. Mine, R. Wada, Y. Uchida, S. Ito, S. Yagihashi, Decreased blood glucose excursion by nateglinide ameliorated neuropathic changes in Goto-Kakizaki rats, an animal model of non-obese type 2 diabetes. Metabolism 51(11), 1452–1457 (2002)CrossRefPubMed
37.
Zurück zum Zitat R.J. Strilka, M.C. Stull, M.S. Clemens, S.C. McCaver, S.B. Armen, Simulation and qualitative analysis of glucose variability, mean glucose, and hypoglycemia after subcutaneous insulin therapy for stress hyperglycemia. Theor. Biol. Med. Model 13, 3 (2016)CrossRefPubMedPubMedCentral R.J. Strilka, M.C. Stull, M.S. Clemens, S.C. McCaver, S.B. Armen, Simulation and qualitative analysis of glucose variability, mean glucose, and hypoglycemia after subcutaneous insulin therapy for stress hyperglycemia. Theor. Biol. Med. Model 13, 3 (2016)CrossRefPubMedPubMedCentral
38.
Zurück zum Zitat M. Kuroda, T. Shinke, K. Sakaguchi, H. Otake, T. Takaya, Y. Hirota, D. Sugiyama, M. Nakagawa, H. Hariki, T. Inoue, T. Osue, Y. Taniguchi, M. Iwasaki, R. Nishio, H. Kinutani, A. Konishi, N. Hiranuma, H. Takahashi, D. Terashita, K. Hirata, Effect of daily glucose fluctuation on coronary plaque vulnerability in patients pre-treated with lipid-lowering therapy: a prospective observational study. JACC Cardiovasc. Interv. 8(6), 800–811 (2015)CrossRefPubMed M. Kuroda, T. Shinke, K. Sakaguchi, H. Otake, T. Takaya, Y. Hirota, D. Sugiyama, M. Nakagawa, H. Hariki, T. Inoue, T. Osue, Y. Taniguchi, M. Iwasaki, R. Nishio, H. Kinutani, A. Konishi, N. Hiranuma, H. Takahashi, D. Terashita, K. Hirata, Effect of daily glucose fluctuation on coronary plaque vulnerability in patients pre-treated with lipid-lowering therapy: a prospective observational study. JACC Cardiovasc. Interv. 8(6), 800–811 (2015)CrossRefPubMed
39.
Zurück zum Zitat D.J. Zdarska, M. Kvapil, Z. Rusavy, M. Krcma, J. Broz, B. Krivska, P. Kadlecova, Comparison of glucose variability assessed by a continuous glucose-monitoring system in patients with type 2 diabetes mellitus switched from NPH insulin to insulin glargine: the COBIN2 study. Wien. Klin. Wochenschr. 126(7-8), 228–237 (2014)CrossRefPubMed D.J. Zdarska, M. Kvapil, Z. Rusavy, M. Krcma, J. Broz, B. Krivska, P. Kadlecova, Comparison of glucose variability assessed by a continuous glucose-monitoring system in patients with type 2 diabetes mellitus switched from NPH insulin to insulin glargine: the COBIN2 study. Wien. Klin. Wochenschr. 126(7-8), 228–237 (2014)CrossRefPubMed
40.
Zurück zum Zitat S.E. Olsen, M.R. Bjorgaas, B.O. Asvold, T. Sand, M. Stjern, B.M. Frier, K.B. Nilsen, Impaired awareness of hypoglycemia in adults with type 1 diabetes is not associated with autonomic dysfunction or peripheral neuropathy. Diabetes Care 39(3), 426–433 (2016)CrossRefPubMed S.E. Olsen, M.R. Bjorgaas, B.O. Asvold, T. Sand, M. Stjern, B.M. Frier, K.B. Nilsen, Impaired awareness of hypoglycemia in adults with type 1 diabetes is not associated with autonomic dysfunction or peripheral neuropathy. Diabetes Care 39(3), 426–433 (2016)CrossRefPubMed
Metadaten
Titel
The impact of glycemic variability on diabetic peripheral neuropathy
verfasst von
Heung Yong Jin
Kyung Ae Lee
Tae Sun Park
Publikationsdatum
06.07.2016
Verlag
Springer US
Erschienen in
Endocrine / Ausgabe 3/2016
Print ISSN: 1355-008X
Elektronische ISSN: 1559-0100
DOI
https://doi.org/10.1007/s12020-016-1005-7

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