Sensory function and albumin excretion according to diagnostic criteria for diabetes

Abstract

OBJECTIVE - The purpose of this study was to examine sensory function and albumin excretion according to categories of glucose tolerance in individuals undergoing screening for diabetes. RESEARCH DESIGN AND METHODS - Sensory function and albumin excretion measurements were obtained in 636 individuals at the time of screening for diabetes according to American Diabetes Association glucose tolerance criteria. Sensory thresholds were measured by forced-choice techniques. Albumin-to-creatinine ratios were calculated from spot urine samples. RESULTS - Of 90 individuals whose glucose levels were in the range for diabetes, 65 had fasting glucose values ≥126 mg/dl, whereas 25 had 2-h glucose values ≥200 mg/dl, with fasting glucose values <126 mg/dl. In covariance analyses, those with fasting glucose levels ≥126 mg/dl had higher vibration (P < 0.01) and thermal (P < 0.05 for cool and warm) thresholds than those with normal glucose tolerance. This pattern was also evident for albumin-to-creatinine ratios (P < 0.001). In contrast, those with 2-h glucose values ≥200 mg/dl and fasting glucose values <126 mg/dl had sensory threshold and albumin-to-creatinine ratio values similar to those of the normal group. Individuals with fasting glucose levels ≥126 mg/dl had higher vibration threshold and albumin-to-creatinine ratio values (<0.05 and <0.01, respectively) than those with levels <126 mg/dl. CONCLUSIONS - Sensory threshold and albumin excretion values already tend to be greater than normal at screening in individuals with fasting glucose levels ≥126 mg/dl, but not in those with levels <126 mg/dl. A reliance on fasting glucose levels ≥126 mg/dl for screening might not be sufficient for early intervention and the optimal prevention of diabetes complications.