title: Altered C-fiber function as an indicator of early peripheral neuropathy in individuals with impaired glucose tolerance.
abstract: OBJECTIVE
  This study explored the importance of glycemic burden compared with features of the metabolic syndrome in the pathogenesis of diabetic neuropathy by comparing C-fiber function in people with type 1 diabetes to that in people with impaired glucose tolerance (IGT).
  
  
  METHODS
  The axon reflex-elicited flare areas (LDIflares) were measured with a laser Doppler imager (LDI) in age-, height-, and BMI-matched groups with IGT (n = 14) and type 1 diabetes (n = 16) and in healthy control subjects (n = 16).
  
  
  RESULTS
  The flare area was reduced in the IGT group compared with the control (2.78 +/- 1.1 vs. 5.23 +/- 1.7 cm(2), P = 0.0001) and type 1 diabetic (5.16 +/- 2.3 cm(2), P = 0.002) groups, whereas the flare area was similar in the type 1 diabetic and control groups.
  
  
  CONCLUSIONS
  This technique suggests that small-fiber neuropathy is a feature of IGT. The absence of similar small-fiber neuropathy in those with longstanding type 1 diabetes suggests that glycemia may not be the major determinant of small-fiber neuropathy in IGT.
authors.affiliation: The Diabetes Research Centre, Ipswich Hospital National Health Service Trust, Suffolk, UK.
authors.forename: Alistair Q
authors.initials: AQ
authors.lastname: Green
authors.forename: Singhan
authors.initials: S
authors.lastname: Krishnan
authors.forename: Francis M
authors.initials: FM
authors.lastname: Finucane
authors.forename: Gerry
authors.initials: G
authors.lastname: Rayman
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D003929:Diabetic Neuropathies / Q000503:physiopathology*; D003943:Diagnostic Techniques, Neurological; D005260:Female; D018149:Glucose Intolerance / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D036421:Nerve Fibers, Unmyelinated / Q000469:parasitology* / Q000473:pathology; D010523:Peripheral Nervous System Diseases / Q000503:physiopathology*