Potter C G, Sharma A K, Farber M O, Peterson R G
Program in Medical Neurobiology, Indiana University School of Medicine, Indianapolis 46223.
J Neurol Sci. 1988 Dec;88(1-3):293-301. doi: 10.1016/0022-510x(88)90226-2.
Morphological and electrophysiological observations were made over 4 weeks on 5 groups of 8-week-old male Sprague-Dawley rats. These were comprised of controls, untreated diabetics, and diabetic animals in which sustained hypoglycemia, moderate hypoglycemia, or normoglycemia was induced by continuous subcutaneous insulin infusion (CSII) therapy. Teased fiber studies showed a marked increase in the number of myelinated fibers undergoing axonal degeneration and regeneration in the tibial nerve of severe hypoglycemic and also in moderate hypoglycemic animals but not in controls, untreated diabetic and normoglycemic groups. There was also a significant correlation between episodes of hypoglycemia (less than or equal to 2.0 mmol/l) and the prevalence of axonal degeneration and regeneration in CSII-treated diabetics. Motor nerve conduction velocity was significantly reduced in the moderate and severe hypoglycemic groups and also in untreated diabetic animals when compared with controls. However, it was significantly improved in the normoglycemic group over the untreated diabetic and severe hypoglycemic groups. In conclusion, this study has demonstrated that severe or even mild hypoglycemia produced a detrimental effect on peripheral nerve structure and function in experimental diabetes. Therefore, it may be desirable to avoid even asymptomatic hypoglycemia in the management of diabetes.
对5组8周龄雄性斯普拉格-道利大鼠进行了为期4周的形态学和电生理学观察。这5组包括对照组、未经治疗的糖尿病大鼠，以及通过持续皮下胰岛素输注（CSII）疗法诱导出现持续性低血糖、中度低血糖或正常血糖的糖尿病动物。 teased纤维研究显示，严重低血糖和中度低血糖动物的胫神经中，正在经历轴突变性和再生的有髓纤维数量显著增加，但对照组、未经治疗的糖尿病组和正常血糖组中没有这种情况。低血糖发作（小于或等于2.0 mmol/l）与CSII治疗的糖尿病患者轴突变性和再生的发生率之间也存在显著相关性。与对照组相比，中度和重度低血糖组以及未经治疗的糖尿病动物的运动神经传导速度显著降低。然而，与未经治疗的糖尿病组和严重低血糖组相比，正常血糖组的运动神经传导速度显著改善。总之，本研究表明，严重甚至轻度低血糖对实验性糖尿病的周围神经结构和功能产生了有害影响。因此，在糖尿病管理中，即使是无症状低血糖也可能需要避免。
