Sensory Neuropathy Associated with Glucose Intolerance: A 35 Patients Study

Abstract

Problem statement: Peripheral neuropathy due to diabetes has been studied for several decades. Until recently, we associate the involvement of peripheral nerves with an inappropriate glycemic control in the most advanced stages of the disease. Currently, it is considered that the onset of the neural injury can occur in the initial phase of this metabolic abnormality, during the period of glucose intolerance. Approach: The clinical aspects of the sensory neuropathy associated to the impaired glucose tolerance were analyzed in 35 Brazilian patients. All patients met the American Diabetes Association (ADA) and the World Health Organization (WHO) criteria for glucose intolerance. Results: We studied 20 male and 15 female, with a mean age of 62.5, ranging from 30-83 years. A distal symmetrical lower limb involvement with positive (neuropathic pain) and/or negative (reduced temperature and pinprick sensations) symptoms and clinical signs of autonomic neuropathy were seen in most patients. The glycemic levels were not related to the severity of the symptoms or to the presence of any specific symptom. Conclusion: The Impaired Glucose Tolerance (IGT) neuropathy can be included in the chronic axonal polyneuropathy and usually the patients suffer from chronic pain and disability before the diagnosis. The determination of the prevalence of symptoms is essential to recognize this disease. The early diagnosis and the aggressive treatment can be crucial for the control, development and progression of the small fiber neuropathy in glucose intolerant patients.