Small-Fiber Neuropathy in Prediabetes Less Benign Than Believed

In a new study of patients with small-fiber neuropathy, analyses of the density of nerve fibers in skin biopsies from the leg, taken 3 years apart, revealed that, contrary to what is taught in medical school, the longest nerves did not degrade first.

Instead, the rate of deterioration of small nerve fibers was similar in the ankle, midleg, and upper leg, Mohammad A Khoshnoodi, MD, from Johns Hopkins University, Baltimore, Maryland, and colleagues report, in the study that was published online April 11 in JAMA Neurology.

Moreover, the rate of nerve deterioration was similar whether the small-fiber neuropathy was idiopathic or associated with diabetes or with impaired glucose tolerance (prediabetes) — which suggests that prediabetes may be more damaging to motor nerves than once believed.

"We anticipated that people with diabetes would have greater progression than people with prediabetes, but that was not the case," senior author Michael Polydefkis, MD, also from Johns Hopkins University, told Medscape Medical News.

http://www.medscape.com/viewarticle/862431