Dysmetabolism-related early sensory Deficits and their Relationship with peripheral Neuropathy Development

Aim To investigate the association of early peripheral sensory dysfunction (EPSD) identified through quantitative sensory testing (QST) with factors related to a dysmetabolic status in individuals with and without type 2 diabetes (T2DM) without peripheral neuropathy (PN), and the impact of those factors on PN development. Methods 225 individuals (117 and 108 without and with T2DM, respectively) without PN based on clinical and electrophysiological criteria were analyzed. Comparative analysis was conducted between those identified as “healthy” and those with EPSD based on a standardized QST protocol. 196 were followed-up over a mean of 2.64 years for PN occurrence. Results Among those without T2DM, apart from male gender, height, higher fat and lower lean mass, only higher insulin resistance (IR, HOMA-R: OR 1.70, p=0.009, McAuley index OR: 0.62, p=0.008), was independently associated with EPSD. In T2DM, metabolic syndrome (MetS, OR 18.32, p Conclusion We demonstrate for the first time the utility of a standardized QST-based approach in identifying early sensory deficits in individuals with and without T2DM. These are associated with a dysmetabolic status signified by IR markers, MetS and higher AGEs which in turn are shown to influence PN development.