IMPAIRED GLUCOSE TOLERANCE CAUSES NEUROPATHY

该子项目是利用 由NIH/NCRR资助的中心赠款提供的资源。子项目和 研究者（PI）可能从另一个NIH来源获得主要资金， 因此可以在其他CRISP条目中表示。列出的机构是 中心，不一定是研究者的机构。 感觉神经病，通常伴有疼痛，是一种常见的神经系统疾病。 在发达国家，II型（胰岛素抵抗）糖尿病是感觉神经病变最常见的明确原因。 我们发现，35-50%的前瞻性评估的原发性疼痛性周围神经病变患者有糖耐量受损（IGT），这是一种与胰岛素抵抗综合征相关的葡萄糖代谢中间缺陷，并已被证明具有心血管发病的独立风险。 这是一个显着更高的频率IGT比报告的大型流行病学研究的年龄匹配的一般人群（14%）。 我们推测，IGT所确定的餐后高血糖导致或促成了一种疼痛的小纤维神经病变，这种神经病变与早期坦率糖尿病中观察到的神经病变难以区分，并且早期积极治疗IGT患者以使高血糖正常化将减缓或预防神经病变的进展。 这项临床初步研究将为以后对IGT和神经病变患者进行的前瞻性双盲安慰剂对照试验奠定基础，以确定强化饮食和运动咨询或降糖药物治疗是否可以稳定或逆转神经病变。'

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Sensory neuropathy, often with pain, is a common neurologic problem. In developed countries, type II (insulin resistant) diabetes is the most frequent defined cause of sensory neuropathy. We have found that 35-50% of prospectively evaluated patients with otherwise idiopathic painful peripheral neuropathy have impaired glucose tolerance (IGT), an intermediate defect in glucose metabolism which correlates with insulin resistance syndrome, and has been shown to carry an independent risk for cardiovascular morbidity. This is a significantly greater frequency of IGT than reported in the large epidemiologic studies of age matched general population (14%). We hypothesize that the postprandial hyperglycemia identified by IGT causes or contributes to a painful, small fiber neuropathy that is indistinguishable from that observed in early frank diabetes, and that early, aggressive treatment of IGT patients to normalize hyperglycemia will slow or prevent progression of neuropathy. This clinical pilot study will lay the groundwork for a later prospective double blind placebo controlled trial of patients with IGT and neuropathy to determine if treatment with intensive diet and exercise counseling, or a glucose lowering agent can stabilize or reverse neuropathy.'