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Related Experiment Videos

Small nerve fiber dysfunction in diabetic neuropathy.

X Navarro1, W R Kennedy, T J Fries

  • 1Department of Neurology, University of Minnesota, Minneapolis 55455.

Muscle & Nerve
|June 1, 1989
PubMed
Summary

Diabetic neuropathy affects small nerve fibers, with thermal sensitivity (TS) being the most sensitive indicator of dysfunction in type 1 diabetes patients. Sweat gland (SG) activity and pain thresholds were also impaired, showing variable nerve fiber involvement.

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Area of Science:

  • Neurology
  • Diabetology
  • Autonomic Neuroscience

Background:

  • Diabetic neuropathy is a common complication of type 1 diabetes.
  • Small nerve fiber dysfunction contributes significantly to diabetic neuropathy symptoms.
  • Objective quantification of sensory and autonomic function is crucial for understanding neuropathy progression.

Purpose of the Study:

  • To investigate sensory and autonomic small nerve fiber function in type 1 diabetic patients.
  • To compare the sensitivity of different functional tests in detecting diabetic neuropathy.
  • To correlate nerve fiber function with clinical findings and diabetes duration.

Main Methods:

  • Studied 142 type 1 diabetics and 45 controls.
  • Quantitated thermal sensitivity (TS), hot pain threshold, and sweat gland (SG) activity on hand and foot.

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  • Utilized physical examination for temperature and pinprick sensation scores.

    • Main Results:

    • Abnormal TS detected in 86% of feet and 66% of hands.
    • TS was more sensitive than pain or SG tests.
    • Abnormalities correlated with clinical sensory scores but not diabetes duration.
    • TS correlated with nerve conduction parameters, SG number did not.

    Conclusions:

    • Diabetic neuropathy presents variably across different nerve fiber types.
    • Thermal sensitivity testing is a sensitive indicator of small fiber dysfunction in diabetic neuropathy.
    • Autonomic and sensory nerve fiber involvement in diabetic neuropathy is complex and requires comprehensive assessment.