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Patients with early-stage type 1 diabetic neuropathy who received C-peptide treatment for 6 months experienced improved sensory nerve function, according to a study published in the January 2007 issue of Diabetes Care. In an exploratory, double-blinded, randomized, placebo-controlled study of 3 groups at 5 centers in Sweden, C-peptide was given as a replacement dose (1.5 mg/day, divided into 4 subcutaneous doses) or a dose 3 times higher (4.5 mg/day) during 6 months.


Neurologic examinations and neurophysiologic measurements were performed on the 139 patients in the study before and after 6 months of treatment with C-peptide or placebo. At baseline, clinical neurologic impairment of the lower extremities was present in 86% of patients. The sensory nerve conduction velocity (SCV) was 2.6 +/- 0.08 standard deviation (SD) below body height-corrected normal values at baseline; this improved similarly within the 2 C-peptide groups (P < .007). More patients experienced SCV peak potential improvement with C-peptide treatments than with placebo. Clinical neurologic impairment scores and vibration perception both improved within the C-peptide-treated groups (P < .011 and P < .002)


Source: Ekberg K, Brismar T, Johansson BL, Lindstrom P, et al. C-Peptide replacement therapy and sensory nerve function in type 1 diabetic neuropathy. Diabetes Care 2007;30:71-6.


Venous Ulcers

Results of a study to assess the clinical usefulness of surface swabs versus tissue biopsies for clinically noninfected leg wounds were published in the January/February 2007 issue of Wound Repair and Regeneration. The study also evaluated whether comprehensive microbiologic analysis offered real predictive value in terms of healing outcome. After sampling by swabbing and biopsy, the researchers quantified the wound microflora of 70 patients with chronic venous leg ulcers. A significant association was demonstrated between healing and bacterial diversity in the swab-assessed wound (P = .023). The researchers reported that the microbiologic analysis of biopsies did not provide additional prognostic data when compared with analysis of the surface microflora (P = .27).


Based on these outcomes, the researchers concluded that the use of biopsies should be discouraged in clinically noninfected wounds, unless the biopsies significantly contribute to patient management. In addition, wound surface microbial diversity and density could help identify patients who are likely to have an unfavorable outcome.


Source: Davies CE, Hill KE, Newcombe RG, et al. A prospective study of the microbiology of chronic venous leg ulcers to reevaluate the clinical predictive value of tissue biopsies and swabs. Wound Repair Regen 2007;15:17-22.