This work happening with Arun Krishnan and coworkers from Sydney (courtesy of Erik Jensen and the Sydney Morning Herald).
Promising news for diabetics … Dr Arun Krishnan conducts nerve excitability testing on patient Salvatore Abela. Photo: Ben Rushton
DEBILITATING nerve damage that affects as many as half the country’s diabetes sufferers could be arrested with early detection, according to a world-first trial at the Prince of Wales Hospital.
Dr Arun Krishnan, a neurologist at the hospital and the study’s lead author, believes nerve excitability testing could be used to detect neuropathy in people before any outward signs of damage are exhibited.
He believes that treatments used only in more advanced cases of neuropathy could be effective in these early cases, although they are not used currently because the nerve damage is as yet undiagnosed.
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”Some treatments we think that might not be beneficial because they’re used in later disease may actually be helpful in earlier stages of the illness,” he said. ”But if you are going to give these trials to people who have obvious neuropathy, you’ve sort of missed the boat.”
The trial uses electrodes taped over a nerve or muscle to record activity while electrical pulses are delivered. The nerve response is then mapped against that for age-matched healthy controls in the hope of predicting neuropathy – the first testing of its kind.
Sal Abela, an early participant in the trial, has had type 2 diabetes for 17 years. He has shown obvious signs of neuropathy for the past four years – unable to feel his feet, no longer able to play golf.
”It’s just got worse and worse and worse,” he said. ”It’s got to a stage now where I can’t feel my feet. I can’t wait to get up in the morning to get some circulation through my feet.”
About 30 patients have participated in the trail – half showing changes to nerve excitability against aged-matched controls, suggesting they may develop neuropathy. The hospital hopes to recruit more than 100 patients to be tested twice yearly for three years as part of the study.