Neuropathy in Prediabetes: Does the Clock Start Ticking Early?

Overview

Journal Nat Rev Endocrinol

Specialty Endocrinology

Date 2011 Jul 14

PMID 21750507

Citations 73

Authors

Nikolaos Papanas

Aaron I Vinik

Dan Ziegler

Affiliations

Soon will be listed here.

Abstract

Between 25% and 62% of patients with idiopathic peripheral neuropathy are reported to have prediabetes, and among individuals with prediabetes 11-25% are thought to have peripheral neuropathy, and 13-21% have neuropathic pain. Population-based studies suggest a gradient for the prevalence of neuropathy, being highest in patients with manifest diabetes mellitus, followed by individuals with impaired glucose tolerance then impaired fasting glucose and least in those with normoglycemia. The most sensitive test to assess glucose metabolism status is the oral glucose tolerance test. Pathogenesis involves hyperglycemia, microvascular abnormalities, dyslipidemia and the metabolic syndrome. Individuals with prediabetes have less severe neuropathy than those with manifest diabetes mellitus. Sensory modalities are more frequently affected than motor modalities, but impairment of small nerve fibers could be the earliest detectable sign. Diagnosis should rely on careful clinical examination, with emphasis on the evaluation of small fibers. An oral glucose tolerance test should be performed in patients with idiopathic neuropathy. The only treatment with any efficacy is lifestyle modification to improve control of hyperglycemia and cardiovascular risk factors, but long-term efficacy of this approach has not been established. This Review summarizes the current evidence on the association between prediabetes and neuropathy.

Citing Articles

Profiles of Peripheral Neuropathy and Risk Factors in People With Treatment-Naive Type 2 Diabetes Mellitus and Prediabetes.

Mairaj M, Pala N, Ismail M Cureus. 2024; 16(11):e73304.

PMID: 39655103 PMC: 11625967. DOI: 10.7759/cureus.73304.

Characteristics and risk factors associated with developing prediabetes in Saudi Arabia.

Tourkmani A, Alharbi T, Bin Rsheed A, Alotaibi A, AlEisaa M, Youzghadli I Ann Med. 2024; 56(1):2413922.

PMID: 39392033 PMC: 11486171. DOI: 10.1080/07853890.2024.2413922.

The Relationship Between Neighborhood Disadvantage and Markers of Chronic Pain Risk: Findings From the Oklahoma Study of Native American Pain Risk (OK-SNAP).

Kell P, Huber F, Lowe T, Shadlow J, Rhudy J J Pain. 2024; :104659.

PMID: 39182538 PMC: 11885637. DOI: 10.1016/j.jpain.2024.104659.

THE PREVALENCE OF POLYNEUROPATHY IN THE PRE-DIABETES PERIOD.

Kalyon S, Gumuskaya P, Ozsoy N, Pala A, Basmakci A, Ozcan M Acta Endocrinol (Buchar). 2024; 19(4):497-500.

PMID: 38933248 PMC: 11197838. DOI: 10.4183/aeb.2023.497.

Efficacy and safety of glucagon-like peptide-1 receptor agonists on prediabetes: a systematic review and meta-analysis of randomized controlled trials.

Salamah H, Marey A, Abugdida M, Abualkhair K, Elshenawy S, Elhassan W Diabetol Metab Syndr. 2024; 16(1):129.

PMID: 38877565 PMC: 11177512. DOI: 10.1186/s13098-024-01371-3.

References

Vinik A, Ziegler D . Diabetic cardiovascular autonomic neuropathy. Circulation. 2007; 115(3):387-97. DOI: 10.1161/CIRCULATIONAHA.106.634949. View

Pittenger G, Mehrabyan A, Simmons K, Amandarice , Dublin C, Barlow P . Small fiber neuropathy is associated with the metabolic syndrome. Metab Syndr Relat Disord. 2008; 3(2):113-21. DOI: 10.1089/met.2005.3.113. View

Harris M, Flegal K, Cowie C, Eberhardt M, Goldstein D, LITTLE R . Prevalence of diabetes, impaired fasting glucose, and impaired glucose tolerance in U.S. adults. The Third National Health and Nutrition Examination Survey, 1988-1994. Diabetes Care. 1998; 21(4):518-24. DOI: 10.2337/diacare.21.4.518. View

Caballero A, Arora S, Saouaf R, Lim S, Smakowski P, Park J . Microvascular and macrovascular reactivity is reduced in subjects at risk for type 2 diabetes. Diabetes. 1999; 48(9):1856-62. DOI: 10.2337/diabetes.48.9.1856. View

Watcho P, Stavniichuk R, Ribnicky D, Raskin I, Obrosova I . High-fat diet-induced neuropathy of prediabetes and obesity: effect of PMI-5011, an ethanolic extract of Artemisia dracunculus L. Mediators Inflamm. 2010; 2010:268547. PMC: 2852597. DOI: 10.1155/2010/268547. View

Haanpaa M, Backonja M, Bennett M, Bouhassira D, Cruccu G, Hansson P . Assessment of neuropathic pain in primary care. Am J Med. 2009; 122(10 Suppl):S13-21. DOI: 10.1016/j.amjmed.2009.04.006. View

de Neeling J, Beks P, Bertelsmann F, Heine R, Bouter L . Peripheral somatic nerve function in relation to glucose tolerance in an elderly Caucasian population: the Hoorn study. Diabet Med. 1996; 13(11):960-6. DOI: 10.1002/(SICI)1096-9136(199611)13:11<960::AID-DIA268>3.0.CO;2-Z. View

Thrainsdottir S, Malik R, Dahlin L, Wiksell P, Eriksson K, Rosen I . Endoneurial capillary abnormalities presage deterioration of glucose tolerance and accompany peripheral neuropathy in man. Diabetes. 2003; 52(10):2615-22. DOI: 10.2337/diabetes.52.10.2615. View

Qiao Q, Pyorala K, Pyorala M, Nissinen A, Lindstrom J, Tilvis R . Two-hour glucose is a better risk predictor for incident coronary heart disease and cardiovascular mortality than fasting glucose. Eur Heart J. 2002; 23(16):1267-75. DOI: 10.1053/euhj.2001.3113. View

10.

Grandinetti A, Chow D, Sletten D, Oyama J, Theriault A, Schatz I . Impaired glucose tolerance is associated with postganglionic sudomotor impairment. Clin Auton Res. 2007; 17(4):231-3. DOI: 10.1007/s10286-007-0426-z. View

11.

Gong Q, Gregg E, Wang J, An Y, Zhang P, Yang W . Long-term effects of a randomised trial of a 6-year lifestyle intervention in impaired glucose tolerance on diabetes-related microvascular complications: the China Da Qing Diabetes Prevention Outcome Study. Diabetologia. 2010; 54(2):300-7. DOI: 10.1007/s00125-010-1948-9. View

12.

Schroeder E, Chambless L, Liao D, Prineas R, Evans G, Rosamond W . Diabetes, glucose, insulin, and heart rate variability: the Atherosclerosis Risk in Communities (ARIC) study. Diabetes Care. 2005; 28(3):668-74. DOI: 10.2337/diacare.28.3.668. View

13.

. International Expert Committee report on the role of the A1C assay in the diagnosis of diabetes. Diabetes Care. 2009; 32(7):1327-34. PMC: 2699715. DOI: 10.2337/dc09-9033. View

14.

Elming M, Hornum M, Feldt-Rasmussen B, Mathiesen E . Cardiac autonomic neuropathy in patients with uraemia is not related to pre-diabetes. Dan Med Bull. 2011; 58(3):A4244. View

15.

Kissel J . Peripheral neuropathy with impaired glucose tolerance: a sweet smell of success?. Arch Neurol. 2006; 63(8):1055-6. DOI: 10.1001/archneur.63.8.1055. View

16.

Rota E, Quadri R, Fanti E, Poglio F, Paolasso I, Ciaramitaro P . Clinical and electrophysiological correlations in type 2 diabetes mellitus at diagnosis. Diabetes Res Clin Pract. 2006; 76(1):152-4. DOI: 10.1016/j.diabres.2006.07.027. View

17.

Smith A, Singleton J . Impaired glucose tolerance and neuropathy. Neurologist. 2008; 14(1):23-9. DOI: 10.1097/NRL.0b013e31815a3956. View

18.

Singleton J, Smith A, Bromberg M . Increased prevalence of impaired glucose tolerance in patients with painful sensory neuropathy. Diabetes Care. 2001; 24(8):1448-53. DOI: 10.2337/diacare.24.8.1448. View

19.

Borch-Johnsen K, Colagiuri S, Balkau B, Glumer C, Carstensen B, Ramachandran A . Creating a pandemic of prediabetes: the proposed new diagnostic criteria for impaired fasting glycaemia. Diabetologia. 2004; 47(8):1396-402. DOI: 10.1007/s00125-004-1468-6. View

20.

Stavniichuk R, Drel V, Shevalye H, Vareniuk I, Stevens M, Nadler J . Role of 12/15-lipoxygenase in nitrosative stress and peripheral prediabetic and diabetic neuropathies. Free Radic Biol Med. 2010; 49(6):1036-45. PMC: 3056543. DOI: 10.1016/j.freeradbiomed.2010.06.016. View