Cited by 708Peripheral Neuropathies and DisordersPain Mechanisms and TreatmentsHereditary Neurological Disorders

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The spectrum of neuropathy in diabetes and impaired glucose tolerance

Sumner, C.J., Sheth, S., Griffin, J.W., Cornblath, D.R., Polydefkis, M.·2003·Neurology

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Abstract

OBJECTIVE: To compare the neuropathy associated with impaired glucose tolerance (IGT) and diabetes mellitus (DM) determined by oral glucose tolerance testing (OGTT). METHODS: Patients with peripheral neuropathy of unknown cause were prescribed OGTT. Duration of neuropathic symptoms, neuropathic pain, neuropathy classification, nerve conduction test results, and intraepidermal nerve fiber densities (IENFD) were compared between IGT and DM groups. RESULTS: Seventy-three patients completed OGTT; 41 (56%) had abnormal results. Of these 41 patients, 26 had IGT and 15 had DM. Patients with IGT had less severe neuropathy than patients with diabetes, as measured by sural nerve amplitudes (p = 0.056), sural nerve conduction velocities (p = 0.03), and distal leg IENFD (p = 0.01). Patients with IGT had predominantly small fiber neuropathy, compared to patients with DM (p = 0.05), who had more involvement of large nerve fibers. CONCLUSIONS: The neuropathy associated with IGT is milder than the neuropathy associated with DM. Small nerve fibers are prominently affected and may be the earliest detectable sign of neuropathy in glucose dysmetabolism. OGTT is appropriate in patients with idiopathic neuropathy.

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“…via nerve conduction velocity tests mainly on large fibers such as motor and sensory ones (Hotta et al., 2006, 2008; Schemmel et al., 2010) in spite of diabetic neuropathy that usually commences in small fibers (Malik et al., 2005; Smith et al., 2001; Sumner et al., 2003) such as autonomic ones.”
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Authors: Sumner, C. J., Sheth, S., Griffin, J. W., Cornblath, D. R., & Polydefkis, M.
Affiliations: Johns Hopkins University (US)
ORCID: Sumner, C.J.
Cornblath, D.R.
Polydefkis, M.
Venue: Neurology
Publisher: Ovid Technologies (Wolters Kluwer Health)
Published: 2003-01-14
Volume: 60
Issue: 1
Pages: 108-111
ISSN: 0028-3878 (ISSN-L)
1526-632X
DOI: 10.1212/wnl.60.1.108
OpenAlex: W1978686107
Cited by: 708
References: 25
Citations by year: 2026: 9 · 2025: 18 · 2024: 11 · 2023: 13 · 2022: 19 · 2021: 21 · 2020: 30 · 2019: 26 · 2018: 27 · 2017: 35 · 2016: 37 · 2015: 42 · 2014: 53 · 2013: 43 · 2012: 40
FWCI: 21.43
Type: journal article
Language: en
Open access: closed
Locations: Neurology (publishedVersion)
PubMed (publishedVersion)
Funders: National Institutes of Health (5k23ns041374-04)
National Institute of Neurological Disorders and Stroke (K23NS41374-01)
Topics: Health Sciences › Medicine › Clinical Neurology › Peripheral Neuropathies and Disorders
Health Sciences › Medicine › Physiology (medical) › Pain Mechanisms and Treatments
Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Hereditary Neurological Disorders
Keywords: diabetic peripheral neuropathy, impaired glucose tolerance, oral glucose tolerance test, small fiber neuropathy, intraepidermal nerve fiber density, nerve conduction velocity, sural nerve, neuropathic pain, neuropathy classification
MeSH terms: Adult, Aged, Aged, 80 and over, Blood Glucose, Cell Count, Diabetic Nephropathies, Electrodiagnosis, Electromyography, Epidermis, Female, Glucose Tolerance Test, Humans, Male, Middle Aged, Nerve Fibers, Neural Conduction, Pain Measurement, Peripheral Nervous System Diseases, Sural Nerve, Cell Size

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The spectrum of neuropathy in diabetes and impaired glucose tolerance

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