Ziegler O, Guerci B, Algan M, Lonchamp P, Weber M, Drouin P
Département de Nutrition, Centre Hospitalo-Universitaire, Nancy, France.
Diabetes Care. 1994 Oct;17(10):1141-7. doi: 10.2337/diacare.17.10.1141.
To determine whether short-term strict control of blood glucose can improve abnormal visual evoked potentials (VEPs) in poorly controlled diabetic patients with no overt diabetic complications.
VEPs (P100 wave latencies) were recorded in 12 poorly controlled diabetic patients (7 with insulin-dependent diabetes mellitus and 5 with non-insulin-dependent diabetes mellitus) before and after at least 3 days of near normoglycemia obtained by continuous subcutaneous insulin infusion (CSII). Exclusion criteria were overt diabetic neuropathy or retinopathy. The control subjects were 12 healthy subjects matched for age and sex. Fifty-two other subjects formed a reference control population. The intra-individual coefficient of variation for P100 latency was < 3%.
The P100 latencies were longer in diabetic patients than in control subjects (means of both eyes +/- SD: 116.8 +/- 10.1 vs. 106.2 +/- 4.5 ms, P < 0.01), and 4 of the 12 diabetic patients had abnormal VEPs. After 3 days of close blood glucose control (mean blood glucose profile fell from 13.7 +/- 2.2 mmol/l to 6.8 +/- 1.2 mmol/l, P < 0.01), the mean P100 latencies were significantly shorter (112.5 +/- 7.6 ms, P < 0.01) but were still significantly longer than control values. The longer the initial P100 latency, the greater the decrease after CSII. There was no correlation between the fall in blood glucose and improvement in VEPs.
Short-term blood glucose normalization is associated with improved P100 wave latency in uncomplicated diabetic patients. These data suggest that abnormal VEPs are partly reversible and include functional disturbances related to glucose metabolism.
确定短期严格控制血糖是否能改善血糖控制不佳且无明显糖尿病并发症的糖尿病患者异常的视觉诱发电位（VEP）。
对12例血糖控制不佳的糖尿病患者（7例胰岛素依赖型糖尿病和5例非胰岛素依赖型糖尿病）进行视觉诱发电位（P100波潜伏期）记录，这些患者通过持续皮下胰岛素输注（CSII）实现至少3天的接近正常血糖水平前后各进行一次记录。排除标准为明显的糖尿病神经病变或视网膜病变。对照组为12名年龄和性别匹配的健康受试者。另有52名受试者组成参考对照人群。P100潜伏期的个体内变异系数<3%。
糖尿病患者的P100潜伏期比对照组更长（双眼平均值±标准差：116.8±10.1 vs. 106.2±4.5毫秒，P<0.01），12例糖尿病患者中有4例VEP异常。经过3天的严格血糖控制（平均血糖水平从13.7±2.2毫摩尔/升降至6.8±1.2毫摩尔/升，P<0.01）后，平均P100潜伏期显著缩短（112.5±7.6毫秒，P<0.01），但仍显著长于对照值。初始P100潜伏期越长，CSII后下降幅度越大。血糖下降与VEP改善之间无相关性。
短期血糖正常化与无并发症糖尿病患者P100波潜伏期改善相关。这些数据表明，异常的VEP部分是可逆的，且包括与葡萄糖代谢相关的功能障碍。
