Reduced Ia-afferent-mediated Hoffman reflex in streptozotocin-induced diabetic rats

The size of motoneurons of the gastrocnemius muscle in rats with diabetes

Alterations in the number and size of motoneurons were studied in the medial gastrocnemius (MG) motor nucleus of diabetic rats (12 or 22 weeks after injection of storeptozotocin) and age-matched controls. Each group contained 6 animals. MG motoneurons were retrogradely labeled by dextran-fluorescein and the number and size of cell bodies were examined. Significantly fewer labeled MG motoneurons were found in the 22-week diabetic rats as compared with age-matched control animals. The mean soma diameter of MG motoneurons was significantly smaller in the 12- and 22-week diabetic animals. Furthermore the soma size for 22-week diabetic animals was smaller than for 12-week diabetic animals. The distribution of average soma diameters in the MG nucleus of control animals was bimodal; cells with larger average diameter were presumed to be alpha-motoneurons and those with smaller diameters were presumed to be gamma. Compared to control animals, the number of smaller MG motoneurons was reduced in 12 week diabetic animals. By 22 weeks, diabetic animals had no small MG motoneurons and the size distribution became unimodal. We conclude that there is a significant decrease in the absolute number and size of MG motoneurons in diabetic rats, with the possibility that the decrease occurred predominantly among the smaller gamma-motoneurons.

Update on diabetic neuropathy

PURPOSE OF REVIEW

This review will focus on recent advances in the field of diabetic neuropathy, with an emphasis on distal symmetric sensory and sensorimotor polyneuropathy. Some new information in the areas of diabetic amyotrophy and diabetic autonomic neuropathy will also be reviewed.

RECENT FINDINGS

The pathogenesis of diabetic neuropathy is multifactorial. There is increasing evidence to link abnormalities in the polyol pathway to the pathogenesis of diabetic neuropathy. In addition, there appear to be abnormalities of nerve regeneration and of sodium and calcium channels. Aldose reductase inhibitors have shown promise in animal models for reversing neuropathy if started early and used for a sufficient time, but those used to date in human trials are probably not of sufficient potency. Neurotrophic factors and vascular endothelial growth factor both also show promise. Specific recommendations and pathways for diabetic foot care have been devised. Lamotrigine and bupropion represent new treatments for neuropathic pain. The role of impaired glucose tolerance is being explored as it relates to polyneuropathy.

SUMMARY

An increasing understanding of the pathogenetic mechanisms holds out promise for the effective treatment of diabetic neuropathy. The early detection of abnormal glucose metabolism is particularly important, as treatments will probably be most effective if administered early in the course of the neuropathy, when abnormalities of peripheral nerves are more likely to be reversible.