Mohseni S, Hildebrand C
Department of Biomedicine and Surgery, Faculty of Health Sciences, University of Linköping, Sweden.
Acta Neuropathol. 1998 Aug;96(2):144-50. doi: 10.1007/s004010050874.
To elucidate the pathophysiology of diabetic neuropathy many workers have examined nerve specimens from diabetic rats. While most workers found that animals with high blood glucose levels develop neuropathy, some researchers report that the peripheral nerves are normal in hyperglycaemic rats. Hypoglycaemia may also cause neuropathy. Some workers suggest that neuropathy is linked to fluctuations of the blood glucose level. In the present study we examine plantar nerves of diabetic BB/Wor rats maintained on an eu-/hyperglycaemic or an eu-/hypoglycaemic regime with insulin implants. Treatment with implants worked well. Light microscopic examination of nerve fibres in non-diabetic control rats and in eu-/hyperglycaemic diabetic rats showed a normal picture. Preparations from eu-/hypoglycemic rats showed irregular myelin sheaths and signs of Wallerian degeneration. The lengths and diameters of the largest internodes were significantly subnormal. We conclude, that periodic moderate hypoglycaemia, but not periodic moderate hyperglycaemia, elicits neuropathy in diabetic BB/Wor rats treated with insulin implants.
为阐明糖尿病性神经病变的病理生理学,许多研究人员检查了糖尿病大鼠的神经标本。虽然大多数研究人员发现血糖水平高的动物会发生神经病变,但一些研究人员报告说,高血糖大鼠的周围神经是正常的。低血糖也可能导致神经病变。一些研究人员认为神经病变与血糖水平的波动有关。在本研究中,我们检查了通过胰岛素植入维持在正常/高血糖或正常/低血糖状态下的糖尿病BB/Wor大鼠的足底神经。植入治疗效果良好。对非糖尿病对照大鼠和正常/高血糖糖尿病大鼠的神经纤维进行光镜检查显示情况正常。正常/低血糖大鼠的标本显示髓鞘不规则和沃勒变性的迹象。最大节间的长度和直径明显低于正常水平。我们得出结论,对于接受胰岛素植入治疗的糖尿病BB/Wor大鼠,周期性中度低血糖而非周期性中度高血糖会引发神经病变。