A cross sectional study of insulin resistance as a predictor of sensory neuropathy in patients with prediabetes

 

 

Abstract              Background: Prediabetes represents the earliest stage of glucose dysregulation, and precedes the development of overt type 2 diabetes. Insulin resistance is defined as a state of decreased responsiveness of target tissues to normal circulating levels of insulin and is the central feature of type 2 diabetes and Metabolic Syndrome. Present study was aimed to study insulin resistance as a predictor of sensory neuropathy in prediabetes. Material and Methods: Present study was hospital based, prospective, observational study conducted in patients of age of 40–60 years, with prediabetic status as defined by the American Diabetes Association (Fasting plasma glucose between 100 and 125 mg/dL or 2‑h postprandial plasma glucose between 140 and 199 mg/dL or glycated hemoglobin 5.7%–6.4%). We measured fasting serum Insulin levels and vibration perception thresholds (using Digital Biothesiometer). Results: In present study, 50 prediabetic cases were studied. According to VPTs, 7 cases had peripheral neuropathy (14 %). Majority of neuropathy cases were from 51-60 years age (12 %). Age and gender were comparable among total cases and cases with peripheral neuropathy and difference was not statistically significant (p>0.05). Raised values of Serum insulin (mIU/L) and HOMA IR (Homeostatic model assessment of insulin resistance) were noted among cases with peripheral neuropathy as compared with total cases and difference was statistically significant (p<0.05). VPTs were found to have statistically significant positive correlation with fasting serum insulin levels and HOMA-IR in both feet. Conclusion: VPTs were found to have statistically significant positive correlation with fasting serum insulin levels and HOMA-IR and thus insulin resistance can be used as a predictor of sensory neuropathy in patients with prediabetes.

Keywords: sensory neuropathy, prediabetes, diabetes, Insulin resistance.