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In 10 years,36 patients with NIDDM and 8 control subjects died;86 patients and 121 control subjects completed the study.When the study ended,18 percent of the patients were being treated only with diet,59 percent with oral hypoglycemic drugs alone,12 percent with insulin alone,and 11 percent with both insulin and oral hypoglycemic agents.A base line the prevalence of definite or probable polyneuropathy among the patients with NIDDM was 8.3 percent,as compared with 2.1 percent among the control subjects.These values 10 years later were 41.9 percent and 5.8 percent,respectively.The number of patients with NIDDM who had nerve-conduction abnormalities in the legs and feet increased from 8.3 percent at base line to 16.7 percent after 5 years and to 41.9 percent after 10 years.The decrease in sensory and motor amplitudes,indicating axonal destruction,was more pronounced than the slowing of the nerve conduction velocities,which indicates demyelination.Among the patients with NIDDM,those with polyneuropathy had poorer glycemic control than those without.Low serum insulin concentrations before and after the oral administration of glucose were associated with the development of polyneuropathy,regardless of the degree of glycemia.The prevalence of polyneuropathy among patients with NIDDM increases with time,and the increase may be greater in patients with hypoinsulinemia. |
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diabetes mellitus
diabetes mellitus,neurologic manifestations of
neuropathy
neuropathy,diabetic
neuropathy,peripheral
neuropathy,peripheral,treatment
prevention of neurologic disorders
prognosis
treatment of neurologic disorder
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