Impact of impaired glucose regulation on the functions of large and small fibers of peripheral nerves

Amaç & Hipotez:Background/aim: This article analyzes the incidence and characteristics of peripheral neuropathy in patients with impaired glucoseregulation (IGR).Materials and methods: A total of 120 IGR patients and 60 healthy controls were enrolled.

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Temel Bulgular & Veri:IGR patients were evaluated using the Michigan Neuropathy ScreeningInstrument (MNSI).Results: The abnormal rates (MNSI >2) in IGR patients and NCS and SSR evaluations were 18.3%, 22.5%, and 39.2%, respectively.

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Sonuç & Katkı:CHEP can detect small fiber damage earlier than SSR and NCS.

🔬Tür:Araştırma Makalesi

📍Kapsam:Genişletilmiş Akademik Örneklem

⚙️Değişkenler:Alan Parametreleri

Abstract

Background/aim: This article analyzes the incidence and characteristics of peripheral neuropathy in patients with impaired glucoseregulation (IGR).Materials and methods: A total of 120 IGR patients and 60 healthy controls were enrolled. All subjects underwent nerve conductionstudy (NCS) of large fibers and skin sympathetic response (SSR) and contact heat pain evoked potential (CHEP) testing of small fiberswith a Medtronic Keypoint machine (Medoc Ltd., Israel). IGR patients were evaluated using the Michigan Neuropathy ScreeningInstrument (MNSI).Results: The abnormal rates (MNSI >2) in IGR patients and NCS and SSR evaluations were 18.3%, 22.5%, and 39.2%, respectively. Allabnormal NCS findings were accompanied with abnormal SSR findings. Compared with the control group, the sensory nerve actionpotential wave of the posterior tibial and sural nerve was decreased in the IGR group (P = 0.01, P = 0.00), the SSR wave was reduced inthe upper and lower limbs (P = 0.002, P = 0.00), and the CHEP wave was decreased in opisthenar and shank (P = 0.00). Compared withthe control group, the CHEP wave was decreased in the shank in the normal SSR group (P < 0.05) and in the opisthenar and shank inthe normal NCS group (P < 0.05).Conclusion: : IGR patients have peripheral neuropathy characterized by impaired functions of large and small fibers focused on smallfiber and lower limb sensory nerves. CHEP can detect small fiber damage earlier than SSR and NCS.

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Bu Makaleye Atıf Yap

ZHANG, Z., ZHANG, J., ZHU, J., TIAN, L., LI, Q., ZENG, X., LIU, N. (2022). Impact of impaired glucose regulation on the functions of large and small fibers of peripheral nerves. Turkish Journal of Medical Sciences, Cilt: 48 - Sayı: 6, 1207–1213. https://ajindex.com/articles/610242

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Bansal N. Prediabetes diagnosis and treatment: A review. World J Diabetes 2015; 6: 296-303.
Yang WY, Lu JM, Weng JP, Jia WP, Ji LN, Xiao JZ, Shan ZY, Liu J, Tian HM, Ji QH. Prevalence of diabetes among men and women in China. N Engl J Med 2010; 362: 2425. Singleton JR, Smith AG, Bromberg MB. Increased prevalence of impaired glucose tolerance in patients with painful sensory neuropathy. Diabetes Care 2001; 24: 1448-1453.
Smith AG, Ramachandran P, Tripp S, Singleton JR. Epidermal nerve innervation in impaired glucose tolerance and diabetesassociated neuropathy. Neurology 2001; 57: 1701-1704. World Health Organization. Definition and Diagnosis of Diabetes Mellitus and Intermediate Hyperglycemia. Geneva, Switzerland: World Health Organization; 2006.
Chinese Medical Association, Neurology Branch. Electromyogram standardized detection and clinical application consensus. I. Chin J Neurol 2008; 41: 279-283 (in Chinese). Chinese Medical Association, Neurology Branch. Electromyogram standardized detection and clinical application consensus. II. Chin J Neurol 2008; 41: 353-357 (in Chinese). Zhang Z, Liu N, Xing G. Evaluation of the effect of contact heat-induced evoked potential on diabetic small fibrosis. Chin J Neurol 2008; 41: 653-656 (in Chinese). Novella S, Inzucchi S, Goldstein J. The frequency of undiagnosed diabetes and impaired glucose tolerance in patients with idiopathic sensory neuropathy. Muscle Nerve 2001; 24: 1229-1231.
Kannan MA, Sarva S, Kandadai RM, Paturi VR, Jabeen SA, Borgohain R. Prevalence of neuropathy in patients with impaired glucose tolerance using various electrophysiological tests. Neurol India 2014; 62: 656. Callaghan BC, Cheng HT, Stables CL, Smith AL, Feldman EL. Diabetic neuropathy: clinical manifestations and current treatments. Lancet Neurol 2012; 11: 521-534.
Ziegler D, Rathmann W, Dickhaus T, Meisinger C, Mielck A. Prevalence of polyneuropathy in pre-diabetes and diabetes is associated with abdominal obesity and macroangiopathy: the MONICA/KORA Augsburg Surveys S2 and S3. Diabetes Care 2008; 31: 464-469.
Shen Q, Jia W, Bao Y, Lu J. A cross-sectional study of peripheral neuropathy in diabetic and sugar-regulated people in Shanghai community. Shanghai Med J 2009; 32: 374-378 (in Chinese). Green AQ, Krishnan S, Finucane FM, Rayman G. Altered c-fiber function as an indicator of early peripheral neuropathy in individuals with impaired glucose tolerance. Diabetes Care 2010; 33: 174-176.
Isak B, Oflazo B, Tanridag T, Yitmen I, Us O. Eval