Nerve Conduction Studies of Peripheral Motor and Sensory Nerves in the Subjects With Prediabetes

Abstract

Background: Prediabetes is a condition in which the fasting blood glucose is elevated above normal levels but not high enough to be classified as diabetes mellitus. There is clear association between sensory polyneuropathy and diabetes mellitus. But association of neuropathy in prediabetes is still not clear. Forty years ago, Ellenberg suggested that neuropathy may indeed occur in prediabetes. Methods: In the present study, we attempted to study the changes in nerve conduction studies in the patients with glucose intolerance, i.e. impaired fasting blood glucose or impaired glucose tolerance in a tertiary care rural hospital. The study included 65 cases (prediabetic) and 65 controls. Nerve conduction studies were performed on right tibial nerve and right sural in lower limb, with surface recording, using the standardized technique. Results: The compound muscle action potential (CMAP) and nerve conduction velocity (NCV) of right tibial nerve were significantly reduced in the cases as compared to controls and were found to be statistically significant suggesting motor axonal neuropathy. The sensory nerve action potential (SNAP) and NCV of right sural nerve were significantly reduced in the cases as compared to controls which were found out to be statistically significant suggesting that cases had sensory axonal neuropathy. Conclusion: All the patients of prediabetes should also be screened for neuropathy. We conclude prediabetic stage is risk factor for development of neuropathy, with hyperglycemia being acting via same mechanism as in cases of diabetes. Prediabetes patients are at risk of developing full blown neuropathy. Early metabolic aberrations as seen in impaired glucose tolerance may lead to changes in the nerve conduction. J Endocrinol Metab. 2019;9(5):147-150 doi: https://doi.org/10.14740/jem602