Prediabetes, diabetes, metabolic syndrome, and small fiber neuropathy

Pariwat Thaisetthawatkul, Elizabeth Lyden, J. Americo Fernandes, David N. Herrmann

Research output: Contribution to journalArticlepeer-review

3 Scopus citations


Introduction: This study was conducted to evaluate the association between prediabetes (PD), elements of the metabolic syndrome (MetS), and small fiber neuropathy (SFN). Methods: A total of 268 patients with SFN symptoms and normal electrophysiology underwent tests to assess small fibers. SFN was diagnosed based on abnormality of at least two among intraepidermal nerve fiber density (IEFND), quantitative sensory testing, and quantitative sudomotor axon reflex testing. Results: There was no difference in IENFD or abnormal skin biopsy frequency between PD and normoglycemia (NG). However, IENFD was lower in people with diabetes mellitus (DM) than in those with NG. An association between HbA1C and IENFD was observed only if DM patients were included. Attributes of the MetS were more common in those with an abnormal skin biopsy but not among those with autonomic dysfunction or meeting SFN criteria. Discussion: DM, but not PD alone, is associated with SFN. Other MetS elements appear to preferentially impact small fiber structure over function.

Original languageEnglish (US)
Pages (from-to)475-479
Number of pages5
JournalMuscle and Nerve
Issue number4
StatePublished - Apr 1 2020


  • autonomic neuropathy
  • diabetes mellitus
  • metabolic syndrome
  • peripheral neuropathy
  • prediabetes
  • small fiber neuropathy

ASJC Scopus subject areas

  • Physiology
  • Clinical Neurology
  • Cellular and Molecular Neuroscience
  • Physiology (medical)


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