NEUROPATHY ASSOCIATED WITH IMPAIRED GLUCOSE TOLERANCE

与葡萄糖耐量受损相关的神经病

• 批准号: 7376473
• 负责人: John Robinson Singleton
• 金额: $ 5.27万
• 依托单位: UNIVERSITY OF UTAH
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-04-01 至 2007-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7376473
• 关键词: aging; blood glucose; counseling; diabetic neuropathy; diet; exercise; fasting; glucose; glucose tolerance; glucose tolerance test; hyperglycemia; noninsulin dependent diabetes mellitus; pain; phenotype; plasma; prevention; sensory neuropathy

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Sensory neuropathy, often with pain, is a common neurologic problem. In developed countries, type 2 diabetes is the most frequent defined cause of sensory neuropathy. In approximately 40% of patients with neuropathy, no cause can be defined (?idiopathic neuropathy?). We and others have shown that 35-50% of patients with otherwise idiopathic neuropathy have impaired glucose tolerance (IGT), compared to 14% of the age matched general population. IGT is defined as a glucose level after a 2 hour oral glucose tolerance test (OGTT) between 140 and 200 mg/dL and a fasting plasma glucose less than 126 mg/dL. Patients with IGT almost uniformly have a painful sensory neuropathy, linking them to the phenotype of early diabetic neuropathy. The Diabetes Control and Complications Trial (DCCT) clearly showed that neuropathy onset and severity correlates with glycemic control in type I diabetes. In the DCCT, aggressive treatment of hyperglycemia prevented or slowed the progression of neuropathy, while the Diabetes Prevention Program (DPP) shows that intensive diet and exercise modification can prevent progression from IGT to diabetes and sets a standard of care for IGT patients. We hypothesize that episodic hyperglycemia contributes to a neuropathy that is clinically indistinguishable from that observed in patients with frank diabetes, and that aggressive treatment to normalize blood glucose levels will be necessary to slow progression of neuropathy in these patients. To test this hypothesis, we propose a prospective controlled trial to determine if treatment with intensive diet and exercise counseling can stabilize or reverse neuropathy in IGT patients

该子项目是利用NIH/NCRR资助的中心赠款提供的资源的许多研究子项目之一。子弹和调查员（PI）可能已经从其他NIH来源获得了主要资金，因此可以在其他清晰的条目中代表。列出的机构适用于该中心，这不一定是调查员的机构。感觉神经病通常疼痛，是一个常见的神经系统问题。在发达国家，2型糖尿病是感觉神经病的最常见原因。 在大约40％的神经病患者中，无法定义原因（？特发神经病？）。我们和其他人已经表明，有35-50％的特发性神经病患者降低了葡萄糖耐受性（IGT），而年龄匹配的一般人群中有14％。在140至200 mg/dL之间进行了2小时口服葡萄糖耐受性测试（OGTT）和小于126 mg/dl的禁食血浆葡萄糖之间的2小时口服葡萄糖耐受性测试（OGTT）后，IGT定义为葡萄糖水平。 IGT患者几乎均匀地患有疼痛的感觉神经病，将其与早期糖尿病神经病的表型联系起来。 糖尿病控制和并发症试验（DCCT）清楚地表明，神经病的发作和严重程度与I型糖尿病的血糖控制相关。在DCCT中，对高血糖的积极治疗可以预防或减慢神经病的发展，而糖尿病预防计划（DPP）表明，强化饮食和运动改性可以防止IGT从IGT发展到糖尿病，并为IGT患者提供标准的护理。我们假设发作性高血糖有助于神经病，而神经病变与F型糖尿病患者的临床上没有区别，并且对血糖水平归一化的积极治疗对于减慢这些患者的神经病进展是必要的。为了检验这一假设，我们提出了一项前瞻性对照试验，以确定IGT患者的强化饮食和运动咨询治疗是否可以稳定或逆转神经病