Issue 41 March 2012
3. Impaired Glycemia Not a Risk Factor for Diabetic Polyneuropathy
According to the findings of a population-matched prospective study Impaired glycemia (IG) is not a risk factor for typical or atypical diabetic polyneuropathy. Matched IG and non-IG volunteers were randomly identified from population-based diagnostic and laboratory registries, restudied, and reclassified as non-IG (n = 150), IG (n = 174), or new diabetes (n = 218).

In population studies of Olmsted County, Minnesota, inhabitants, prevalence of typical DPN, retinopathy, and nephropathy was significantly increased only in subjects with new diabetes—not in subjects with IG as defined by American Diabetes Association (ADA) criteria of abnormality of Impaired Fasting Glucose(IFG), Impaired Glucose Tolerance(IGT), or Impaired A1C (IA1C). For atypical DPN, such an increase was not observed even in subjects with new diabetes.

The authors mention that their findings might have several implications. "By showing that IG alone does not cause diabetic microvessel complications, our results support present [American Diabetes Association] criteria for the diagnosis of diabetes, based on the idea that the lowest level of chronic hyperglycaemia that induces micro vessel complications should be the minimal criteria for the diagnosis of diabetes."

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JDC Gems Editor’s note:
It should be recalled that there are several previous observations and studies on the concrete evidence of the link between pre-diabetes and associated macro vascular and micro vascular complications of diabetes. There is evidence that both glucose-related and glucose-independent mechanisms contribute to these vascular complications. Hence IGT, IFG and IA1C should be regarded as potentially significant stages in disease progression.
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