Diabetes Care, Vol 15, Issue 7 847-852, Copyright © 1992 by American Diabetes Association
Sensory function at diagnosis and in early stages of NIDDM in patients detected through screening
JM Sosenko, M Kato, R Soto and RB Goldberg
Department of Medicine, University of Miami School of Medicine, Florida 33101.
OBJECTIVE--We studied whether sensory function abnormalities are present at
diagnosis and whether they develop in the early stages of
non-insulin-dependent diabetes (NIDDM). RESEARCH DESIGN AND
METHODS--Quantitative assessments of vibration sensitivity at the hallux
and index fingers, and thermal sensitivity at the hallux were performed at
screening (2-h oral glucose tolerance tests) for diabetes in 364
individuals. Twenty-five subjects diagnosed with NIDDM and 25 matched
nondiabetic subjects were restudied after an interval of 12-41 mo.
RESULTS--When those with NIDDM (n = 41) or impaired glucose tolerance (IGT)
(n = 38) were compared with nondiabetic subjects, there were no significant
differences in sensory function indices. However, the vibration threshold
and HbA1c were related among those found to be hyperglycemic (IGT and NIDDM
combined P less than 0.05; NIDDM alone P less than 0.05). Among diabetic
subjects, the vibration threshold and interaction term of height and Hba1c
were positively related in a multiple regression analysis (P less than
0.01). There were increments in all sensory thresholds in diabetic patients
at follow-up (P less than 0.05 for all). Increments were smaller in control
subjects. CONCLUSIONS--These data suggest that although sensory function
tends to be normal at diagnosis in NIDDM patients, there appears to be a
diminution in sensory function as the disease progresses. An interaction
between metabolic factors and height may influence sensory function early
in the course of NIDDM.