Clinical studies investigating the benefit of glucose control on the progression of diabetic neuropathy (DN) have come to controversial results in patients with type 2 diabetes (T2D). This study aimed to assess associations of HbA1c levels with parameters of nerve perfusion in T2D patients with and without DN using dynamic contrast enhanced (DCE) magnetic resonance neurography (MRN) at 3 Tesla.

58 T2D patients (20 with DN and 38 without DN) took part in this cross-sectional single center study. Groups were matched for age, BMI, HbA1c, duration of T2D and renal function. All patients underwent DCE magnetic resonance neurography with subsequent electrophysiologic and serologic testing. The extended Tofts model was used to quantify the sciatic nerve's microvascular permeability (Ktrans), extravascular extracellular volume fraction (ve), and plasma volume fraction (vp). As a main result, we found that Ktrans correlated positively with HbA1c in patients with DN, while a negative correlation between the two parameters was found in patients without DN.

Our results indicate that the effect of glucose control on the capillary permeability of peripheral nerves differs between T2D patients with and without DN.

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