Acute effects of blood glucose on chromatic visually evoked potentials in persons with diabetes and in normal persons.

PURPOSE To determine whether specific chromatic pathways are selectively affected by short-term variations in blood glucose levels in observers with and without diabetes. METHODS Ten subjects with diabetes, all with type 1 diabetes and no retinopathy, and eight age-similar normal subjects were tested. Cortical visually evoked potentials (VEPs) in response to stimuli designed to selectively activate the short-wavelength-sensitive (S) or long- and middle-wavelength-sensitive (LM) chromatic (isoluminant) pathways or the achromatic pathway were recorded over a period of several hours. Capillary blood glucose also was measured repeatedly over the same period. The relation between VEP latency and blood glucose was determined. RESULTS The S-pathway VEP latency was correlated significantly with blood glucose in a slight majority (6/10) of persons with diabetes; S-pathway latency was longer at higher blood glucose levels. This association between S-pathway latency and blood glucose was not dependent on the pattern of blood glucose variation over time (i.e., significant correlations between blood glucose and latency were observed in persons for whom blood glucose increased, decreased, or rose and then fell over time). No dependence on blood glucose was observed for LM- or achromatic-pathway VEP latency in subjects with diabetes. CONCLUSIONS Acute variations in blood glucose of subjects with diabetes over hours selectively affect the function of the short-wavelength-sensitive chromatic pathway. The findings are discussed within the context of known mechanisms by which elevated glucose affects cellular metabolism with a time course consistent with the transient nature of the effect observed.