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Early sensory neurophysiological changes in prediabetes.

Yi-Chen Lin1,2, Cindy Shin-Yi Lin3,4, Tsui-San Chang1,2,5

  • 1Department of Neurology, Taipei Municipal Wanfang Hospital, Taipei Medical University, Taipei, Taiwan.

Journal of Diabetes Investigation
|September 29, 2019
PubMed
Summary
This summary is machine-generated.

Early axonal changes occur in prediabetes, detectable through nerve excitability tests. Superexcitability and prolonged latencies indicate preclinical neurophysiological dysfunction, suggesting early monitoring for polyneuropathy is crucial.

Keywords:
Diabetic polyneuropathiesPrediabetic stateSensory nerve excitability

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Area of Science:

  • Neurology
  • Diabetology
  • Physiology

Background:

  • Prediabetes is a precursor to type 2 diabetes, characterized by elevated blood glucose levels.
  • Early detection of neurophysiological changes is vital for preventing diabetic neuropathy.
  • Axonal dysfunction may manifest prior to overt diabetes diagnosis.

Purpose of the Study:

  • To determine if axonal changes are present in the prediabetic state.
  • To identify a biomarker for the early detection of neurophysiological alterations.
  • To investigate the correlation between nerve excitability and clinical profiles.

Main Methods:

  • Recruitment of asymptomatic diabetes patients, prediabetic individuals, and normoglycemic controls.
  • Assessment of sensory nerve excitability using standardized tests.
  • Analysis of nerve excitability findings and their correlation with clinical parameters like fasting plasma glucose and glycated hemoglobin.

Main Results:

  • Increased sensory superexcitability was observed progressively from normoglycemic to prediabetic and diabetic cohorts (P=0.002).
  • Prolonged distal sensory latency in the median nerve was noted in prediabetes and diabetes groups compared to normoglycemic individuals (P=0.019).
  • Superexcitability showed a positive correlation with fasting plasma glucose (r=0.291) and glycated hemoglobin (r=0.331).

Conclusions:

  • Sensory superexcitability and prolonged latencies are sensitive indicators of preclinical neurophysiological dysfunction in prediabetes.
  • These nerve excitability changes correlate with glycemic control markers, specifically glycated hemoglobin.
  • Early axonal changes commence in the prediabetic stage, necessitating polyneuropathy monitoring from this phase onwards.