Glycemic control is related to the severity of impaired thermal sensations in type 2 diabetes
Journal
Diabetes/Metabolism Research and Reviews
Journal Volume
23
Journal Issue
8
Pages
612-620
Date Issued
2007
Author(s)
Abstract
Background: Small-fibre sensory neuropathy of diabetes presenting as impaired thermal sensations is associated with ominous consequences, such as foot ulcer and amputation, but there is a lack of systematic studies on its occurrence in large cohorts. We investigated (1) the impact of glycemic control on thermal thresholds, (2) the frequencies and patterns of sensory deficits, and (3) the contribution of sensory nerve abnormalities to neuropathic symptoms. Methods: Quantitative sensory testing and nerve conduction studies were performed to measure warm and cold thresholds of extremities, and amplitudes of nerve action potentials on 498 type 2 diabetic patients and 434 control subjects with similar age and gender distributions, enrolled during the same period. Results: The diabetic patients had higher thermal thresholds than control subjects (p < 0.0001). Thermal thresholds of the lower and upper extremities were linearly correlated with HbA1C on multiple linear regression analysis (p < 0.01). By the multivariate logistic regression analysis, HbA1C and age were the most important risk factors independently associated with elevated thermal thresholds (p < 0.01). Elevated warm threshold in the big toe was the most frequent abnormality (60.2%) compared to abnormal cold threshold in the big toe (39.6%) and abnormal sural nerves on nerve conduction studies (12.9%). Elevated thermal thresholds were risk factors for neuropathic symptoms independent of HbA1C. Conclusion: Small-fibre neuropathy with the impairment of thermal sensations is the most frequent sensory deficit in diabetes, and HbA1C is significantly associated with the elevated thermal thresholds. Copyright ? 2007 John Wiley & Sons, Ltd.
SDGs
Other Subjects
glucose; hemoglobin A1c; abnormal sensation; adult; age distribution; aged; arm disease; article; cold sensation; controlled study; correlation analysis; diabetic neuropathy; diagnostic value; disease severity; female; foot disease; glycemic control; heat sensation; human; major clinical study; male; multiple regression; multivariate logistic regression analysis; nerve cell membrane potential; nerve conduction; non insulin dependent diabetes mellitus; perceptive threshold; priority journal; quantitative analysis; risk assessment; risk factor; sensory analysis; sensory nerve; sex difference; sural nerve; Adult; Aged; Aged, 80 and over; Blood Glucose; Diabetes Mellitus, Type 2; Diabetic Neuropathies; Fingers; Foot; Heat; Hemoglobin A, Glycosylated; Humans; Median Nerve; Middle Aged; Neural Conduction; Peroneal Nerve; Reference Values; Sensory Thresholds; Sural Nerve; Toes
Type
journal article