Association between HbA<sub>1c</sub>
 and peripheral neuropathy in a 10-year follow-up study of people with normal glucose tolerance, impaired glucose tolerance and Type 2 diabetes

Peterson, Magnus; Pingel, Ronnie; Lagali, Neil; Dahlin, Lars B.; Rolandsson, Olov

doi:10.1111/dme.13514

Cited by 21 publications

(20 citation statements)

References 29 publications

(65 reference statements)

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“… a Data already published (29) . b Data missing in one patient . *p < 0.05; 2004 vs. 2014, Wilcoxon . € p < 0.05, comparison between groups, Kruskal–Wallis adjusted by the Bonferroni correction for multiple tests. The significant differences were found between NGT and T2D .…”

Section: Resultsmentioning

confidence: 99%

Autonomic Neuropathy—a Prospective Cohort Study of Symptoms and E/I Ratio in Normal Glucose Tolerance, Impaired Glucose Tolerance, and Type 2 Diabetes

et al. 2018

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BackgroundAutonomic neuropathy in diabetes, in addition to causing a range of symptoms originating from the autonomic nervous system, may increase cardiovascular morbidity. Our aim was to study the progression of autonomic neuropathy, based on symptom score and evaluation of an autonomic test, in persons with normal and impaired glucose tolerance and in patients with type 2 diabetes (T2D).MethodsParticipants were recruited in 2003/2004 with a follow-up in 2014. The participants’ glucose tolerance was categorized using oral glucose tolerance tests. Symptoms were evaluated using an autonomic symptom score (ASS), ECG was used to test cardiac autonomic function based on the expiration/inspiration ratio (E/I ratio), and blood samples were taken on both occasions.ResultsASSs were higher at follow-up in the T2D patients than in the normal glucose tolerance group (mean 1.21 ± 1.30 vs. 0.79 ± 0.7; p < 0.05). E/I ratio did not deteriorate more than could be expected as an aging effect in well-controlled T2D. No relationship was found between E/I ratio and HbA1c or ASS.ConclusionThe presence of autonomic symptoms increased over time in T2D patients, but the symptoms did not correlate with the E/I ratio in this metabolically well-controlled cohort. ASSs can be a useful clinical tool when assessing the progression of autonomic dysfunction in patients with abnormal glucose metabolism.

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Section: Resultsmentioning

confidence: 99%

Autonomic Neuropathy—a Prospective Cohort Study of Symptoms and E/I Ratio in Normal Glucose Tolerance, Impaired Glucose Tolerance, and Type 2 Diabetes

et al. 2018

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“…We were interested in the recent publication by Peterson et al . who reported a progressive reduction in sural nerve amplitude from 10.9 to 7.0μV during a 10‐year follow‐up of 87 people with varying degrees of glucose intolerance. This reduction was more pronounced for people whose glucose tolerance deteriorated during the follow‐up period, and paralleled their increasing HbA 1c concentration.…”

Section: Results Of Nerve Conduction Studies In People With Reduced Vmentioning

confidence: 99%

“…The modest decline in sural nerve conduction velocities in the study by Peterson et al . may be partly attributable to the immediate slowing of conduction with hyperglycaemia, which was more pronounced after 10 years of follow‐up. Our results show that this effect is also present in people with altered sensation; this is an important issue because Tesfaye et al .…”

Section: Results Of Nerve Conduction Studies In People With Reduced Vmentioning

confidence: 99%

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Nerve action potential amplitude, a robust marker of diabetic peripheral neuropathy

Monlun¹,

Hugo²,

Blanco³

et al. 2018

Diabet. Med.

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“…In contrast, the correlation was generally weak between conduction velocity of the sural nerve and both vibration perception and thermal thresholds. This is likely due to the fact that demyelination of nerves is less apparent than the loss of nerve fibers in early stages of neuropathy[47]. Previous results suggest an association between blood glucose level and the severity of peripheral neuropathy, measured as amplitude of the sural nerve [18].…”

Section: Discussionmentioning

confidence: 99%

Vibrotactile perception in the sole of the foot in people with normal glucose tolerance and type 2 diabetes

Peterson

Pingel²,

Rolandsson

et al. 2019

Preprint

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AimTo evaluate vibrotactile perception thresholds in people with normal glucose tolerance (NGT) and type 2 diabetes (T2DM) in relation to other sensory tests.MethodsNerve function was evaluated in 36 and 42 participants with NGT and T2DM, respectively [mean age 70.0 (1.2) years; males n=40, females n=38]. The mean duration of T2DM was 12.3 (7.3) years. Vibration perception thresholds were measured at four frequencies (8, 16, 32 and 125 Hz) bilaterally on the sole of the foot at first and fifth metatarsal heads using Multifrequency vibrametry and compared to vibration perception thresholds using Biothesiometer (128 Hz) bilaterally (medial malleolus and distal dorsal bony surface of great toes), touch sensation with Semmes-Weinstein monofilament bilaterally (10 g) at three sites on the sole of foot (distal great toe and 1st and 5th metatarsal heads), electrophysiology (amplitude and conduction velocity of sural nerve; right side) and thermal sensory testing (i.e. small diameter nerve fibers; method of limits using Thermotest®).ResultsVibration perception and temperature thresholds in the foot and sural nerve function were different between the NGT and T2DM categories. Measuring vibration perception thresholds at lower frequencies with Multifrequency vibrametry, compared to Biothesiometer, both provided similar correlations to the amplitude of the sural nerve. Temperature thresholds did also correlate with vibration perception thresholds and with sural nerve function. Only 4/42 participants with T2DM showed pathology by monofilament test, none with NGT.ConclusionsVibration perception thresholds have a fair correlation to amplitude of the sural nerve, even when measured at a non-tactile surface. Thus in the present study, measuring vibration perception threshold at a tactile surface does not seem to provide any clear advantage over the traditional way of measuring vibration perception on the medial malleolus. In people with T2DM, both large and small diameter nerve fibers seem to be affected.

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Association between HbA_1c and peripheral neuropathy in a 10-year follow-up study of people with normal glucose tolerance, impaired glucose tolerance and Type 2 diabetes

Cited by 21 publications

References 29 publications

Autonomic Neuropathy—a Prospective Cohort Study of Symptoms and E/I Ratio in Normal Glucose Tolerance, Impaired Glucose Tolerance, and Type 2 Diabetes

Autonomic Neuropathy—a Prospective Cohort Study of Symptoms and E/I Ratio in Normal Glucose Tolerance, Impaired Glucose Tolerance, and Type 2 Diabetes

Nerve action potential amplitude, a robust marker of diabetic peripheral neuropathy

Vibrotactile perception in the sole of the foot in people with normal glucose tolerance and type 2 diabetes

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Association between HbA1c and peripheral neuropathy in a 10-year follow-up study of people with normal glucose tolerance, impaired glucose tolerance and Type 2 diabetes

Cited by 21 publications

References 29 publications

Autonomic Neuropathy—a Prospective Cohort Study of Symptoms and E/I Ratio in Normal Glucose Tolerance, Impaired Glucose Tolerance, and Type 2 Diabetes

Autonomic Neuropathy—a Prospective Cohort Study of Symptoms and E/I Ratio in Normal Glucose Tolerance, Impaired Glucose Tolerance, and Type 2 Diabetes

Nerve action potential amplitude, a robust marker of diabetic peripheral neuropathy

Vibrotactile perception in the sole of the foot in people with normal glucose tolerance and type 2 diabetes

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Product

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Association between HbA_1c and peripheral neuropathy in a 10-year follow-up study of people with normal glucose tolerance, impaired glucose tolerance and Type 2 diabetes