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Peripheral somatic nerve function in relation to glucose tolerance in an elderly Caucasian population: the Hoorn
J N de Neeling1, P J Beks, F W Bertelsmann
1Institute for Research in Extramural Medicine, Amsterdam, The Netherlands.
Diabetic Medicine : a Journal of the British Diabetic Association
|November 1, 1996
Summary
Glucose intolerance is linked to impaired peripheral nerve function, even in individuals without diabetes. Higher insulin levels correlate with better small-fiber nerve function, suggesting a complex relationship between glucose metabolism and nerve health.
Area of Science:
- Neurology
- Endocrinology
- Metabolic Health
Background:
- Limited data exists on peripheral nerve function across the full spectrum of glucose tolerance.
- Understanding this relationship is crucial for early detection and management of diabetic neuropathy.
Purpose of the Study:
- To investigate the association between varying degrees of glucose tolerance and peripheral nerve function.
- To examine both large-fiber and small-fiber nerve function in relation to glucose metabolism.
Main Methods:
- A population-based sample (n=267 normal glucose tolerance, 167 impaired glucose tolerance, 90 newly diagnosed diabetes, 73 known diabetes) aged 50-74 years was assessed.
- Large-fiber function was measured via reflexes, vibration sense, and vibratory perception threshold (VPT).
- Small-fiber function was assessed using the thermal discrimination threshold (TDT).
Main Results:
- Known diabetes mellitus (KDM) showed the highest prevalence of large-fiber nerve dysfunction.
- Large-fiber function generally declined with decreasing glucose tolerance, from normal glucose tolerance (NGT) to newly diagnosed diabetes mellitus (NDM).
- Thermal discrimination threshold (TDT) decreased with increased fasting and post-load insulin levels, while higher insulin levels correlated with better small-fiber function.
Conclusions:
- Glucose intolerance is associated with impaired peripheral large-fiber nerve function, extending even to the non-diabetic range.
- This suggests that nerve damage may begin before a formal diabetes diagnosis.
- Higher insulin levels appear to be protective for small-fiber nerve function.
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