FREE NEJM E-TOC    HOME   |   SUBSCRIBE   |   CURRENT ISSUE   |   PAST ISSUES   |   COLLECTIONS   |   Search Term  Advanced Search

Sign in | Get NEJM's E-Mail Table of Contents — Free | Subscribe

Previous Volume 309:1546-1550 December 22, 1983 Number 25 Next

	Add to Personal Archive Add to Citation Manager Notify a Friend E-mail When Cited PubMed Citation

Abstract

We studied the relation between the control of blood glucose and the width of skeletal-muscle capillary basement membrane in 23 insulin-dependent (Type I) diabetic patients. After initial measurement of levels of glycosylated hemoglobin and width of skeletal-muscle capillary basement membrane, the patients were divided into two groups: an experimental group of 13 patients who were treated with continuous subcutaneous insulin infusion, and a control group of 10 patients who continued to receive conventional treatment--usually two injections of insulin daily. After two years, the experimental group had a significant decrease in glycosylated hemoglobin levels as compared with base-line values (mean +/- S.E.M., 7.6 +/- 0.4 vs 10.2 +/- 0.7 per cent; P less than 0.001), reflecting improved control of blood glucose, and a significant reduction in the width of skeletal-muscle capillary basement membrane (1293 +/- 68 vs. 1717 +/- 182 A; P less than 0.05). The control group of patients had no significant change in their levels of glycosylated hemoglobin or in the width of their skeletal-muscle capillary basement membranes. If changes in the capillaries in skeletal muscle parallel those in the capillaries in retinal or renal tissue, then meticulous control of blood glucose may be beneficial over time in preventing the microvascular complications of diabetes.

This article has been cited by other articles:

• Greer, D. M., Cagliero, E., Krakauer, E. L., Gonzalez, R. G., Hedley-Whyte, E. T. (2007). Case 21-2007 -- A 58-Year-Old Woman with Headaches, Weakness, and Strokelike Episodes. NEJM 357: 164-173 [Full Text]  
• Schramm, J. C., Dinh, T., Veves, A. (2006). Microvascular changes in the diabetic foot.. INT J LOW EXTREM WOUNDS 5: 149-159 [Abstract]  
• Christopher, J., Velarde, V., Zhang, D., Mayfield, D., Mayfield, R. K., Jaffa, A. A. (2001). Regulation of B2-kinin receptors by glucose in vascular smooth muscle cells. Am. J. Physiol. Heart Circ. Physiol. 280: H1537-H1546 [Abstract] [Full Text]  
• Clark, C. M., Lee, D. A. (1995). Prevention and Treatment of the Complications of Diabetes Mellitus. NEJM 332: 1210-1217 [Full Text]  
• Strowig, S. M. (1993). Initiation and Management of Insulin Pump Therapy. The Diabetes Educator 19: 50-58  
• Strumph, P. S., Odoroff, C. L., Amatruda, J. M. (1988). The Accuracy of Blood Glucose Testing by Children. CLIN PEDIATR 27: 188-194 [Abstract]  
• Wigg, D. S., Shapiro, J., Perley, M. J., Charles, M. A. (1986). Patient and Spouse Expectations of and Reactions to Continuous Subcutaneous Insulin Infusion (CSII) Therapy: Case Report. The Diabetes Educator 12: 141-144