期刊
NEUROLOGIST
卷 14, 期 1, 页码 23-29出版社
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/NRL.0b013e31815a3956
关键词
impaired glucose tolerance; peripheral neuropathy; metabolic syndrome
资金
- NATIONAL CENTER FOR RESEARCH RESOURCES [M01RR000064] Funding Source: NIH RePORTER
- NCRR NIH HHS [M01 RR0064] Funding Source: Medline
Background: Peripheral neuropathy is common. Diabetes is the most common cause, accounting for approximately half of cases, but up to 1/3rd of neuropathy patients have no identifiable etiology. Among this population, impaired glucose tolerance (IGT or prediabetes) is observed in approximately 40%. The exact nature of the relationship between IGT and neuropathy is debated. Review Summary: A variety of evidence suggests IGT causes neuropathy. Neuropathy may occur early in diabetes. The neuropathy associated with IGT is clinically similar to early diabetic neuropathy, with preferential injury to small nerve fibers resulting in pain and autonomic dysfunction. IGT and diabetic neuropathy patients share abnormal microvascular endothelial dysfunction. Treatment of IGT subjects with diet and exercise. reduces risk of progression to diabetes, and those with neuropathy experience a short-term improvement in small fiber function with sustained benefit for pain. An evolving literature links other aspects of the metabolic syndrome to peripheral neuropathy. Conclusions: IGT is common in peripheral neuropathy patients. The extent to which IGT directly causes nerve injury as opposed to being a covariant with other equally or more important features (eg, obesity, metabolic syndrome) remains to be determined. Preliminary data suggest diet and exercise counseling may be a useful treatment strategy.
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