Peripheral polyneuropathy in type 2 diabetes mellitus and impaired glucose tolerance. Correlations between morphology, neurophysiology, and clinical findings
type: CreativeWork
description: Diabetic peripheral polyneuropathy (PN) is a common and serious complication of diabetes. The prevalence of PN is rising with the global burden of type 2 diabetes. The causal mechanisms of PN are not fully understood, but both vascular and metabolic factors play a role. New methods of investigating PN need to be correlated with standard methods in well-defined, population-based cohorts. Objectives: The overall aim was to investigate endoneurial microvascular abnormalities of the sural nerve and intraepidermal nerve fiber loss in type 2 diabetes and impaired glucose tolerance (IGT), in relation to glucose dysmetabolism, and clinical and neurophysiological measures of PN. Methods: Subjects were recruited from a prospective, population-based study of males from Malmö, Sweden (6956 responders). From this cohort, 182 individuals in three groups were identified, [69 with type 2 diabetes, 51 IGT, and 62 normal glucose tolerance (NGT)], matched for age, height, and body mass index (BMI). Endoneurial microangiopathy and myelinated nerve fiber density (MNFD) were assessed in 30 sural nerve biopsies (from 10 men with type 2 diabetes, 10 IGT, and 10 NGT). Intraepidermal nerve fibers (IENF) were assessed in skin biopsies from the distal leg in 86 subjects (50 men with type 2 diabetes, 15 IGT, and 21 NGT) and graded as absent IENF, low (1–3 IENF/section), or high (> 4 IENF/section) counts of IENF. The subjects underwent oral glucose tolerance test, clinical examination (Total Neuropathy Score; combined Neuropathy Symptom Score and Neuropathy Disability Score), and neurophysiological tests (nerve conduction and quantitative sensory testing) at baseline and at follow-up (6–10 years later). Vibrotactile sense of the index (median nerve) and little fingers (ulnar nerve) was assessed in 58 subjects (23 type 2 diabetes, 7 IGT, 28 NGT) with persistent glucose tolerance for 15 years. Results: Increased endoneurial capillary density was linked to current diabetes and future progression fr…
abstract: Diabetic peripheral polyneuropathy (PN) is a common and serious complication of diabetes. The prevalence of PN is rising with the global burden of type 2 diabetes. The causal mechanisms of PN are not fully understood, but both vascular and metabolic factors play a role. New methods of investigating PN need to be correlated with standard methods in well-defined, population-based cohorts. Objectives: The overall aim was to investigate endoneurial microvascular abnormalities of the sural nerve and intraepidermal nerve fiber loss in type 2 diabetes and impaired glucose tolerance (IGT), in relation to glucose dysmetabolism, and clinical and neurophysiological measures of PN. Methods: Subjects were recruited from a prospective, population-based study of males from Malmö, Sweden (6956 responders). From this cohort, 182 individuals in three groups were identified, [69 with type 2 diabetes, 51 IGT, and 62 normal glucose tolerance (NGT)], matched for age, height, and body mass index (BMI). Endoneurial microangiopathy and myelinated nerve fiber density (MNFD) were assessed in 30 sural nerve biopsies (from 10 men with type 2 diabetes, 10 IGT, and 10 NGT). Intraepidermal nerve fibers (IENF) were assessed in skin biopsies from the distal leg in 86 subjects (50 men with type 2 diabetes, 15 IGT, and 21 NGT) and graded as absent IENF, low (1–3 IENF/section), or high (> 4 IENF/section) counts of IENF. The subjects underwent oral glucose tolerance test, clinical examination (Total Neuropathy Score; combined Neuropathy Symptom Score and Neuropathy Disability Score), and neurophysiological tests (nerve conduction and quantitative sensory testing) at baseline and at follow-up (6–10 years later). Vibrotactile sense of the index (median nerve) and little fingers (ulnar nerve) was assessed in 58 subjects (23 type 2 diabetes, 7 IGT, 28 NGT) with persistent glucose tolerance for 15 years. Results: Increased endoneurial capillary density was linked to current diabetes and future progression fr…
author: Thrainsdottir, Soley
language: eng
keywords: Clinical Medicine, nerve conduction studies, skin biopsy, intraepidermal nerve fibers, Diabetic neuropathy, sural nerve pathology, body mass index, quantitative sensory testing, vibrotactile sense
date published: 2009
date modified: 2026-07-24T02:59:36Z
provider: University of Lund
publisher: Networked Digital Library of Theses and Dissertations
type: WebPage
source organization: Department of Clinical Sciences, Lund University