Nerve glucose, fructose, sorbitol, myo-inositol, and fiber degeneration and regeneration in diabetic neuropathy

Peter J Dyck, B. R. Zimmerman, T. H. Vilen, S. R. Minnerath, J. L. Karnes, J. K. Yao, J. F. Poduslo

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Abstract

We measured the alochol sugars in sural nerves from 11 controls, 21 conventionally treated patients with diabetes and neuropathy, and 4 diabetics without neuropathy. The results were related to metabolic control and to clinical, neuropathological, and morphometric abnormalities in the nerves. The mean endoneurial glucose, fructose, and sorbitol values were higher in diabetic patients in controls. Linear regression analysis revealed that nerve sorbitol content in the diabetics was inversely related to the number of myelinated fibers (P = 0.003). Mean nerve levels of myo-inositol were not decreased in the diabetic patients, with or without neuropathy, and were not associated with any of the neuropathological end points of diabetes. Our results indicate that myo-inositol deficiency is not part of the pathogenesis of human diabetic neuropathy, as had been hypothesized. Other accumulated alcohol sugars, however, were increased in diabetes and were associated with the severity of neuropathy. On repeat biopsy, six diabetics, treated for a year with the aldose reductase inhibitor sorbinil, had decreased endoneurial levels of sorbitol (P < 0.01) and fructose (0.05 < P < 0.1), but unchaged levels of myo-inositol.

Original languageEnglish (US)
Pages (from-to)542-548
Number of pages7
JournalNew England Journal of Medicine
Volume319
Issue number9
StatePublished - 1988

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Sorbitol
Diabetic Neuropathies
Inositol
Fructose
Regeneration
Glucose
Sugar Alcohols
Aldehyde Reductase
Sural Nerve
Linear Models
Regression Analysis
Biopsy

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Dyck, P. J., Zimmerman, B. R., Vilen, T. H., Minnerath, S. R., Karnes, J. L., Yao, J. K., & Poduslo, J. F. (1988). Nerve glucose, fructose, sorbitol, myo-inositol, and fiber degeneration and regeneration in diabetic neuropathy. New England Journal of Medicine, 319(9), 542-548.

Nerve glucose, fructose, sorbitol, myo-inositol, and fiber degeneration and regeneration in diabetic neuropathy. / Dyck, Peter J; Zimmerman, B. R.; Vilen, T. H.; Minnerath, S. R.; Karnes, J. L.; Yao, J. K.; Poduslo, J. F.

In: New England Journal of Medicine, Vol. 319, No. 9, 1988, p. 542-548.

Research output: Contribution to journalArticle

Dyck, PJ, Zimmerman, BR, Vilen, TH, Minnerath, SR, Karnes, JL, Yao, JK & Poduslo, JF 1988, 'Nerve glucose, fructose, sorbitol, myo-inositol, and fiber degeneration and regeneration in diabetic neuropathy', New England Journal of Medicine, vol. 319, no. 9, pp. 542-548.
Dyck, Peter J ; Zimmerman, B. R. ; Vilen, T. H. ; Minnerath, S. R. ; Karnes, J. L. ; Yao, J. K. ; Poduslo, J. F. / Nerve glucose, fructose, sorbitol, myo-inositol, and fiber degeneration and regeneration in diabetic neuropathy. In: New England Journal of Medicine. 1988 ; Vol. 319, No. 9. pp. 542-548.
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