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Glycemic control is related to the severity of impaired thermal sensations in type 2 diabetes.
Diabetes Metab Res Rev. 2007 Nov; 23(8):612-20.DM

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, HbA(1C) 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 HbA(1C).

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.

Authors+Show Affiliations

Department of Neurology, National Taiwan University Hospital, Taipei 100, Taiwan.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

17354257

Citation

Chao, Chi-Chao, et al. "Glycemic Control Is Related to the Severity of Impaired Thermal Sensations in Type 2 Diabetes." Diabetes/metabolism Research and Reviews, vol. 23, no. 8, 2007, pp. 612-20.
Chao CC, Hsieh SC, Yang WS, et al. Glycemic control is related to the severity of impaired thermal sensations in type 2 diabetes. Diabetes Metab Res Rev. 2007;23(8):612-20.
Chao, C. C., Hsieh, S. C., Yang, W. S., Lin, Y. H., Lin, W. M., Tai, T. Y., & Hsieh, S. T. (2007). Glycemic control is related to the severity of impaired thermal sensations in type 2 diabetes. Diabetes/metabolism Research and Reviews, 23(8), 612-20.
Chao CC, et al. Glycemic Control Is Related to the Severity of Impaired Thermal Sensations in Type 2 Diabetes. Diabetes Metab Res Rev. 2007;23(8):612-20. PubMed PMID: 17354257.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Glycemic control is related to the severity of impaired thermal sensations in type 2 diabetes. AU - Chao,Chi-Chao, AU - Hsieh,Song-Chou, AU - Yang,Wei-Shiung, AU - Lin,Yea-Hui, AU - Lin,Whei-Min, AU - Tai,Tong-Yuan, AU - Hsieh,Sung-Tsang, PY - 2007/3/14/pubmed PY - 2008/1/8/medline PY - 2007/3/14/entrez SP - 612 EP - 20 JF - Diabetes/metabolism research and reviews JO - Diabetes Metab Res Rev VL - 23 IS - 8 N2 - 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, HbA(1C) 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 HbA(1C). 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. SN - 1520-7552 UR - https://www.unboundmedicine.com/medline/citation/17354257/Glycemic_control_is_related_to_the_severity_of_impaired_thermal_sensations_in_type_2_diabetes_ L2 - https://doi.org/10.1002/dmrr.734 DB - PRIME DP - Unbound Medicine ER -