Related Experiment Videos
Lifestyle intervention for pre-diabetic neuropathy.
A Gordon Smith1, James Russell, Eva L Feldman
1Department of Neurology, University of Utah School of Medicine, 50 N. Medical Drive, SOM 3R152, Salt Lake City, UT 84132, USA. gordon.smith@hsc.utah.edu
Diabetes Care
|May 30, 2006
Summary
Lifestyle intervention improved nerve fiber density and reduced pain in individuals with impaired glucose tolerance (IGT). Skin biopsy measuring intraepidermal nerve fiber density (IENFD) proved a sensitive indicator of neuropathy changes over one year.
Area of Science:
- Neurology
- Metabolic Disorders
- Clinical Trials
Background:
- Impaired glucose tolerance (IGT) can lead to neuropathy.
- Lifestyle interventions, like those in the Diabetes Prevention Program, are crucial for managing prediabetes.
- Intraepidermal nerve fiber density (IENFD) is a potential biomarker for neuropathy.
Purpose of the Study:
- To assess IENFD as a sensitive measure of neuropathy changes in IGT patients undergoing lifestyle intervention.
- To evaluate the impact of diet and exercise counseling on neuropathy in IGT individuals.
Main Methods:
- 32 IGT subjects underwent skin biopsies for IENFD measurement at baseline and 1 year.
- Standard care included individualized diet and exercise counseling.
- Nerve conduction studies, sensory testing, sudomotor testing, and neuropathy scoring were performed.
Main Results:
- Baseline distal IENFD correlated with fasting glucose and OGTT results.
- After 1 year, significant improvements in both distal and proximal IENFD were observed.
- Changes in proximal IENFD correlated with reduced neuropathic pain and improved nerve conduction.
Conclusions:
- Diet and exercise counseling for IGT promotes cutaneous reinnervation and alleviates neuropathic pain.
- Skin biopsy for IENFD measurement is a highly sensitive method for detecting neuropathy changes.
- IENFD should be considered a key endpoint in future neuropathy clinical trials.