Harvard's Joslin Diabetes Center says 20 million people in the U.S. have Impaired Glucose Tolerance, and 1% - 10% of them will be diagnosed with diabetes every year. I'm sure a good hunk of them don't know they have it, as was the case with me.

http://www.joslin.org/info/diagnosin...rance_IGT.html

I posted a link to this report before on another thread, but I think it's worth posting again because of what it says about neuropathy. The case studies referenced ring very familiar and are worth a read, but I'll copy and paste the most relevant and summarizing areas of the report.

Peripheral Neuropathy and “Borderline” Diabetes

http://www.jabfm.org/content/17/2/127.full

"There is increasing evidence that patients with milder degrees of abnormal glucose metabolism, including impaired glucose tolerance (IGT) and impaired fasting glucose (formerly referred to as “borderline” diabetes), are also at risk for developing symptomatic polyneuropathy . We have personally observed patients for several years with “idiopathic” painful sensory neuropathy who subsequently develop overt diabetes; in retrospect, it seems likely that their symptoms were related to longstanding impaired glucose metabolism."

"DISCUSSION:

The cause of polyneuropathy remains unknown in more than 20% of cases despite extensive laboratory testing. The incidence of idiopathic cases is believed to be even higher among patients presenting with painful sensory neuropathy. However, some patients with “idiopathic” painful sensory neuropathy have ultimately developed overt diabetes mellitus after many years of follow-up, suggesting that occult impairment of glucose metabolism may have been the cause of their symptoms all along. There have been a number of recent series suggesting than more than 50% of the patients referred to neuromuscular clinics with a diagnosis of “idiopathic” painful sensory neuropathy have abnormal glucose metabolism when they are evaluated using the 2-hour glucose tolerance test (Table 3). Of these, more than 50% have impaired glucose tolerance, so the fasting glucose and glycohemoglobin are frequently normal despite an abnormal glucose tolerance test. These incidences of occult diabetes and impaired glucose tolerance are significantly higher than those reported for the general population, suggesting a causal relationship.

"CONCLUSION

Based on the data available in the current medical literature, we suggest that patients presenting with unexplained painful sensory neuropathy should be evaluated for impaired glucose metabolism with a 2-hour OGTT; if the results of the test are abnormal, they should be referred for lifestyle interventions and/or initiation of oral hypoglycemic agents in addition to management of neuropathy symptoms. Improved glycemic control can prevent the
development of overt diabetes mellitus and may have some impact on progression of neuropathy in these cases. The association between “idiopathic” painful sensory neuropathy and impaired glucose metabolism argues very strongly for prospective studies in larger populations looking at the cost effectiveness of this approach."


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