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Early peripheral nerve abnormalities in impaired glucose tolerance
A Cappellari1, L Airaghi, R Capra
1Service of Clinical Neurophysiology, Dino Ferrari Centre, Department of Neurological Sciences, IRCCS Ospedale Maggiore di Milano and University of Milan, Milan, Italy. albertocapp@yahoo.it
Electromyography and Clinical Neurophysiology
|August 9, 2005
Summary
Impaired glucose tolerance (IGT) shows early nerve abnormalities, specifically myelin dysfunction in distal sensory fibers. This suggests IGT precedes more advanced nerve damage seen in type 2 diabetes.
Area of Science:
- Neurology
- Endocrinology
- Metabolic Disorders
Background:
- Impaired glucose tolerance (IGT) is increasingly linked to sensory neuropathy.
- Early nerve dysfunction detection in IGT is crucial for understanding disease progression.
Purpose of the Study:
- To investigate subclinical nerve abnormalities in individuals with impaired glucose tolerance.
- To compare nerve conduction study (NCS) findings in IGT, type 2 diabetes (DM), and healthy controls.
Main Methods:
- Nerve conduction studies (NCS) of the sural nerve were performed on 12 IGT subjects without neuropathy.
- Results were compared to 12 asymptomatic type 2 diabetes patients and 12 healthy controls.
- Distal and proximal sural nerve segments were analyzed for conduction velocity and action potential amplitude.
Main Results:
- IGT subjects exhibited increased distal sural nerve conduction velocity compared to controls and DM patients.
- No significant difference in proximal sural nerve conduction velocity was observed among groups.
- DM patients showed reduced distal and proximal sural nerve action potential amplitudes, indicating axonal degeneration.
Conclusions:
- Increased distal sural nerve conduction velocity in IGT suggests early myelin dysfunction in sensory fibers due to hyperglycemia.
- This myelin dysfunction in IGT represents the earliest detectable nerve alteration.
- Reduced nerve action potential amplitude in DM patients signifies axonal degeneration, a more advanced stage of neuropathy.