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Glucose Tolerance Test Advised For Idiopathic Neuropathy

Oral glucose tolerance testing (OGTT) is appropriate in patients with idiopathic neuropathy, suggest researchers in the United States.

In a comparison study, they found neuropathy linked with impaired glucose tolerance (IGT) is milder than that associated with diabetes mellitus (DM).

The prominent involvement of small nerve fibres in glucose dysmetabolism may be the earliest detectable sign of neuropathy, report Dr C J Sumner and colleagues from the Department of Neurology, The Johns Hopkins University, Baltimore, Maryland.

Patients with peripheral neuropathy of unknown cause were given OGTT. The researchers then compared the duration of neuropathic symptoms, neuropathic pain, neuropathy classification, nerve conduction test results and intraepidermal nerve fibre densities (IENFD) between patients with IGT and patients with DM.

Overall, 73 patients completed OGTT, of whom 41 (56%) had abnormal results. Of these 41 patients, 26 had IGT, and 15 had DM.

The investigators found the patients with IGT had less severe neuropathy than did those with diabetes, as measured by sural nerve amplitudes, sural nerve conduction velocities and distal leg IENFD. Moreover, the IGT patients had predominantly small fibre neuropathy as compared with patients with DM, who tended to have involvement of large nerve fibres.
Neurology 2003;60:1:108-11. "The spectrum of neuropathy in diabetes and impaired glucose tolerance."

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