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Prim Care Diabetes. 2013 Dec;7(4):269-73. doi: 10.1016/j.pcd.2013.08.001. Epub 2013 Sep 27.

Assessment of small fiber neuropathy to predict future risk of type 2 diabetes.

Author information

1
Institute for Medical Informatics and Biometry, Medical Faculty at the Technical University Dresden, Germany.

Abstract

OBJECTIVE:

Sudomotor dysfunction due to small fiber neuropathy can be observed very early in pre-diabetes. The aim of this study was to assess the predictive power of EZSCAN, a non invasive, quick and simple measurement of sudomotor function to identify glucose impairment.

RESEARCH DESIGN AND METHODS:

The study was performed in 76 German subjects at risk of diabetes. Glucose metabolism was assessed by using, oral glucose tolerance test (OGTT) at baseline and after 2 year follow-up. Sudomotor function was evaluated by measuring hand and foot electrochemical sweat conductances to calculate a risk score.

RESULTS:

At baseline, 38 patients had normal glucose tolerance (NGT), 34 had pre-diabetes (impaired fasting glucose, IFG and/or impaired glucose tolerance, IGT) and 4 had newly diagnosed type 2 diabetes. The AUC values for FPG, 2h-OGTT glucose, 1h-OGTT glucose, HbA1C and EZSCAN score to predict pre-diabetes were 0.50, 0.65, 0.64, 0.72 and 0.76, respectively. Subjects having a moderate or high EZSCAN score (>50) at baseline had a substantially increased risk for having IFG and/or IGT at follow-up visit presented by an odds ratio of 12.0 [1.4-100.5], the OR for having 1h-OGTT ≥ 8.6mmol/L at follow-up was 9.8 [1.0-92.8] and for having HbA1C ≥ 5.7% was 15.7 [1.9-131.5] compared to subjects with low EZSCAN risk.

CONCLUSIONS:

This preliminary study, which must be confirmed in a larger population, shows that EZSCAN risk score is associated with diabetes progression which have implications for prevention and disease management.

KEYWORDS:

Diabetes progression; Diabetes risk; Prediction of type 2 diabetes; Small fiber neuropathy

PMID:
24076379
DOI:
10.1016/j.pcd.2013.08.001
[Indexed for MEDLINE]

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