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Impaired glucose tolerance and neuropathy
A Gordon Smith1, J Robinson Singleton
1Department of Neurology, University of Utah, Salt Lake City, Utah 84132, USA. gordon.smith@hsc.utah.edu
The Neurologist
|January 16, 2008
Summary
Impaired glucose tolerance (IGT), or prediabetes, is common in peripheral neuropathy patients. Evidence suggests IGT may directly cause nerve damage, and lifestyle changes may improve symptoms.
Area of Science:
- Neurology
- Endocrinology
- Metabolic Syndrome
Background:
- Peripheral neuropathy is a common condition, with diabetes as the leading cause.
- A significant portion of neuropathy cases lack a clear cause, with impaired glucose tolerance (IGT) frequently observed in these patients.
- The precise relationship between IGT and neuropathy remains under investigation.
Purpose of the Study:
- To review the evidence linking impaired glucose tolerance (IGT) to peripheral neuropathy.
- To explore the clinical presentation and underlying mechanisms of IGT-associated neuropathy.
- To assess the potential therapeutic benefits of lifestyle interventions for IGT and neuropathy.
Main Methods:
- Review of existing literature on IGT and peripheral neuropathy.
- Clinical comparison of neuropathy in IGT and diabetic patients.
- Analysis of microvascular function in affected patient groups.
Main Results:
- IGT is prevalent in patients with peripheral neuropathy, particularly those without diabetes.
- Neuropathy associated with IGT shares clinical and pathophysiological features with early diabetic neuropathy, including small fiber damage, pain, and autonomic dysfunction.
- Microvascular endothelial dysfunction is a common finding in both IGT and diabetic neuropathy.
- Lifestyle interventions (diet and exercise) in IGT individuals may reduce diabetes progression and improve neuropathy symptoms, including pain and small fiber function.
Conclusions:
- IGT is frequently identified in individuals with peripheral neuropathy.
- While IGT is associated with neuropathy, its direct causal role versus its association with other metabolic factors requires further elucidation.
- Diet and exercise counseling show promise as a management strategy for IGT-related peripheral neuropathy.
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