Idiopathic neuropathy, prediabetes and the metabolic syndrome

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J Neurol Sci. 2006 Jan 27;

Idiopathic neuropathy, prediabetes and the metabolic syndrome.

Gordon A, Singleton J.

Neurology and Pathology, University of Utah School of Medicine, 30

North 1900 East, SOM 3R152, Salt Lake City, UT 84132, USA.

Peripheral neuropathy is a common problem encountered by neurologists

and primary care physicians. While there are many causes for

peripheral neuropathy, none can be identified in a large percentage

of patients ( " idiopathic neuropathy " ). Despite its high prevalence,

idiopathic neuropathy is poorly studied and understood. There is

evolving evidence that impaired glucose tolerance (prediabetes) is

associated with idiopathic neuropathy. Preliminary data from a

multicenter study of diet and exercise in prediabetes (the Impaired

Glucose Tolerance Neuropathy Study) suggests a diet and exercise

counseling regimen based on the Diabetes Prevention Program results

in improved metabolic measures and small fiber function. Prediabetes

is part of the Metabolic Syndrome, which also includes hypertension,

hyperlipidemia and obesity. Individual aspects of the Metabolic

Syndrome influence risk and progression of diabetic neuropathy and

may play a causative role in neuropathy both for those with

prediabetes, and those with otherwise idiopathic neuropathy. Thus, a

multifactorial treatment approach to individual components of

Metabolic Syndrome may slow prediabetic neuropathy progression or

result in improvement.