Cited by 364Peripheral Neuropathies and DisordersPain Mechanisms and TreatmentsHereditary Neurological Disorders

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Increased Prevalence of Impaired Glucose Tolerance in Patients With Painful Sensory Neuropathy

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Singleton, J. Robinson, Smith, A. Gordon, Bromberg, Mark B.·2001·Diabetes Care

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Abstract

OBJECTIVE—To characterize a cohort of patients with neuropathy and impaired glucose tolerance (IGT) but no other identifiable cause of neuropathy. Of patients with diabetes, 10% have peripheral neuropathy at the time of their diagnosis, suggesting that axonal injury may occur early in the course of glucose intolerance. The American Diabetes Association (ADA) revised diagnostic criteria to recognize IGT (a serum glucose between 140 and 200 mg/dl in a 2-h oral glucose tolerance test [OGTT]) as a risk factor for cardiovascular disease independent of development of diabetes. RESEARCH DESIGN AND METHODS—Using revised ADA criteria for diabetes and IGT, we prospectively evaluated 107 sequential patients with idiopathic neuropathy. RESULTS—A total of 13 of the 107 patients had diabetes, whereas 36 (34%) had IGT, nearly three times the prevalence in age-matched control subjects (P < 0.01). OGTT was often elevated, whereas both fasting plasma glucose and HbA1c were normal. Comparing patients with diabetes, IGT, or normal OGTT, age and BMI were similar. However, painful sensory symptoms were more common in patients with IGT and diabetes, and family history of neuropathy was significantly more common in normoglycemic patients. Electrodiagnostic findings of axonal injury were less severe in patients with IGT and were more likely to be confined to sensory fibers than in patients with diabetes. CONCLUSIONS—Our results suggest that IGT may cause or contribute to small-fiber neuropathy, which is similar in phenotype to the painful sensory neuropathy commonly encountered in diabetes. Two-hour OGTT is more sensitive than other measures of glucose handling in screening these patients.

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Background
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Background
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Authors: Singleton, J. R., Smith, A. G., & Bromberg, M. B.
Affiliations: University of Utah (US)
ORCID: Singleton, J. Robinson
Bromberg, Mark B.
Venue: Diabetes Care
Publisher: American Diabetes Association
Published: 2001-08-01
Volume: 24
Issue: 8
Pages: 1448-1453
ISSN: 0149-5992 (ISSN-L)
1935-5548
DOI: 10.2337/diacare.24.8.1448
OpenAlex: W2095995150
Cited by: 364
References: 32
Citations by year: 2026: 4 · 2025: 4 · 2024: 9 · 2023: 7 · 2022: 12 · 2021: 7 · 2020: 21 · 2019: 9 · 2018: 17 · 2017: 20 · 2016: 14 · 2015: 22 · 2014: 28 · 2013: 25 · 2012: 21
FWCI: 4.72
Type: journal article
Language: en
Open access: bronze
doi.org
Locations: Diabetes Care (publishedVersion)
PubMed (publishedVersion)
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: impaired glucose tolerance, small fiber neuropathy, peripheral neuropathy, diabetes mellitus, oral glucose tolerance test, axonal injury, electrodiagnostic findings
MeSH terms: Adult, Aged, Arsenic, Blood Glucose, Cardiovascular Diseases, Diabetic Neuropathies, Electromyography, Glucose Tolerance Test, Glycated Hemoglobin, Humans, Lead, Mercury, Middle Aged, Neural Conduction, Neuralgia, Peripheral Nervous System Diseases, Prospective Studies, Risk Factors, Body Mass Index, Prevalence, Glucose Intolerance

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Increased Prevalence of Impaired Glucose Tolerance in Patients With Painful Sensory Neuropathy

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