Does Prediabetic Impaired Glucose Tolerance Cause Neuropathy?

In many patients who present with new-onset distal symmetric polyneuropathy (DSP), an underlying cause is not initially evident. Clinicians certainly should consider overt diabetes, but whether prediabetic impaired glucose tolerance also causes clinical neuropathy is controversial. In a survey study, investigators sought to determine what tests internists and neurologists would order in the evaluation of patients with DSP. Although most in either specialty would order fasting blood glucose levels, significantly more neurologists than internists would order an oral glucose tolerance test (OGTT) both initially (17% vs. 2%) and in a second-level work-up if initial testing is unrevealing (29% vs. 4%).

Another study addressed whether impaired gly…