Noninvasive evaluation of neural impairment in subjects with impaired glucose tolerance
Open accessAbstract
OBJECTIVE—To evaluate neural dysfunction in subjects with impaired glucose tolerance (IGT). RESEARCH DESIGN AND METHODS—For this study, 46 subjects with IGT and 45 healthy volunteers underwent detailed neurological assessment. Cardiovascular autonomic function was assessed by standard cardiovascular reflex tests, and heart rate variability was characterized by the triangle index. Sensory nerve function was assessed using Neurometer (for current perception threshold) and Medoc devices. Peak plantar pressure was measured by dynamic pedobarography, and symptoms were graded using the neuropathy total symptom score. RESULTS—Subjects with IGT had significantly greater abnormalities detected by four of five cardiovascular reflex tests and greater heart rate variability characterized by the triangle index. They had a higher frequency of both hyperesthesia and hypoesthesia as detected by current perception threshold testing at 5 Hz, as well as increased heat detection thresholds. CONCLUSIONS—This study provides evidence that subclinical neural dysfunction is present in subjects with IGT and can be detected noninvasively. Cardiovascular autonomic neuropathy may contribute to increased cardiovascular risk in IGT subjects.
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Prediabetes has been found to be associated with decreased heart rate variability, decreased postural changes in heart rate, increased prevalence of erectile dysfunction among men, and a worse profile in tests of sympathetic and parasympathetic function.
“Prediabetes has been found to be associated with decreased heart rate variability61 (HRV – a marker of parasympathetic function),62–65, decreased postural changes in heart rate,62 increased prevalence of erectile dysfunction among men,66 and a worse profile in tests of sympathetic and parasympathetic function.67”
From Prediabetes: a high-risk state for diabetes development (2012) · cites this paper as [67]
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Vascular risk factors and diabetic neuropathy
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Self-citationDiabetic cardiovascular autonomic neuropathy
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“While observational studies have shown an increased prevalence of IGT among subjects with idiopathic neuropathy (7), there are limited data concerning the prevalence of neuropathy in IGT.”
BackgroundEpidermal nerve innervation in impaired glucose tolerance and diabetes-associated neuropathy
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Prediabetes: a high-risk state for diabetes development
Tabák, A. G., Herder, C., Rathmann, W., Brunner, E. J., & Kivimäki, M. (2012) · The Lancet · doi:10.1016/s0140-6736(12)60283-9 · Cited by 2,958 · see citing works
Prediabetes diagnosis and treatment: A review
Bansal, N. (2015) · World Journal of Diabetes · doi:10.4239/wjd.v6.i2.296 · Cited by 579 · see citing works
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Cardiovascular autonomic neuropathy: A silent killer with long reach
Ang, L., Dillon, B., Mizokami-Stout, K., & Pop-Busui, R. (2020) · Autonomic Neuroscience · doi:10.1016/j.autneu.2020.102646 · Cited by 53 · see citing works
- Authors
- Putz, Z., Tabák, A. G., Tóth, N., Istenes, I., Németh, N., Gandhi, R. A., Hermányi, Z., Keresztes, K., Jermendy, G., Tesfaye, S., & Kempler, P.
- Affiliations
- Semmelweis University (HU)
- 1st Department of Medicine, Semmelweis University, Budapest, Hungary
- Royal Hallamshire Hospital (GB)
- 3rd Department of Internal Medicine, Bajcsy-Zsilinszky Hospital, Budapest, Hungary
- Corresponding author
- Putz, Zsuzsanna
- Venue
- Diabetes Care
- Publisher
- American Diabetes Association
- Published
- 2009-01-01
- Volume
- 32
- Issue
- 1
- Pages
- 181-183
- ISSN
- 0149-5992 (ISSN-L)
- 1935-5548
- PMC
- PMC2606810
- OpenAlex
- W2117357128
- Cited by
- 90
- References
- 11
- Citations by year
- 2026: 2 · 2025: 1 · 2024: 4 · 2023: 5 · 2022: 3 · 2021: 6 · 2020: 10 · 2019: 1 · 2018: 6 · 2017: 3 · 2016: 6 · 2015: 8 · 2014: 4 · 2013: 6 · 2012: 9
- FWCI
- 3.90
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- cc-by-nc-nd
- Locations
- Diabetes Care (publishedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- UCL Discovery (University College London) (submittedVersion)
- Semmelweis University Repository (Semmelweis University) (submittedVersion)
- Funders
- Magyar Diabetes Társaság
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Rate Variability and Autonomic Control
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Keywords
- impaired glucose tolerance, neural dysfunction, cardiac autonomic neuropathy, heart rate variability, current perception threshold, sensory nerve function, hyperesthesia, numbness, plantar pressure, cardiovascular risk
- MeSH terms
- Adult, Autonomic Nervous System, Autonomic Nervous System Diseases, Blood Pressure, Female, Glucose Tolerance Test, Heart Rate, Humans, Male, Nerve Fibers, Nervous System Diseases, Sensory Receptor Cells, Reference Values, Body Mass Index, Glucose Intolerance, Young Adult
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