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Researchers find ways to spot early diabetic neuropathy
Researchers find ways to spot early diabetic neuropathy -- Posted by Gumbo on 11-04-04 17:26
Researchers find ways to spot early diabetic neuropathy
Sep 12 (HeartCenterOnline) - Researchers at The Johns Hopkins Hospital
(Baltimore) are investigating the differences in neuropathy associated with
both early diabetes or impaired glucose tolerance. Their report is published
in the September 10 issue of The Journal of the American Medical
Association.
A glucose test is primarily used to screen for, diagnose or monitor patients
with diabetes by measuring the level of blood sugar (glucose) in the liquid
part of the blood (serum). Glucose is a key source of energy. During
digestion in the stomach and intestines, carbohydrates from food are broken
down into glucose, which is directly absorbed into the bloodstream. This
leads to higher glucose levels, which signals the pancreas (located next to
the stomach) to secrete insulin - a hormone necessary for body tissues to
absorb glucose. In a properly functioning pancreas, the amount of insulin
produced is relative to amounts and types of foods eaten and the body's
overall energy needs. If not enough insulin is produced, or insulin is
produced but is not effective in helping the body use the glucose, then this
could be a sign of undiagnosed or poorly controlled diabetes.
A glucose tolerance test is the most sensitive method of testing available
for blood glucose levels. It is also the longest, most complicated and most
expensive method of glucose testing. It is rarely used in patients who have
abnormal results from either the fasting glucose test or the two-hour
postprandial glucose test. If patients have borderline or normal glucose
levels in these tests, but physicians still suspect diabetes based on other
factors, then the glucose tolerance test may be done.
In the current report, Dr. Michael Polydefkis and colleagues write that the
oral glucose tolerance test can be a "sensitive measure" of disorders in
glucose metabolism, particularly for those individuals who first see a
physician with neuropathic symptoms, complaining of "numbness, tingling, and
dysesthesias [abnormal sensations] in the toes and feet." This is because
"neuropathy can be the presenting symptom of either diabetes or impaired
glucose tolerance."
One of the historic challenges in diagnosis and treatment, says Dr.
Polydefkis, is the difficulty in evaluating small nerve fibers after a skin
biopsy is taken to help diagnose neuropathy. Ongoing research, he writes, is
focusing on new diagnostic methods toward an early, more accurate assessment
of neuropathy which, in turn, may enhance the development of effective
therapies to reverse the condition.
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