Monofilament insensitivity and small and large nerve fiber symptoms in impaired fasting glucose

Abstract

Aims: To determine if diabetes or pre-diabetes is associated with monofilament insensitivity and peripheral neuropathy symptoms.

Methods: The 10-g Semmes-Weinstein monofilament test and Michigan Neuropathy Screening Instrument symptom questionnaire were administered to participants in the Study of Women's Health Across the Nation - Michigan site (n=396). We determined the concordance of monofilament insensitivity and symptoms and used chi-square tests, ANOVA, and logistic regression to quantify the relationships among diabetes status, monofilament insensitivity and symptoms.

Results: The prevalence of monofilament insensitivity was 14.3% and 19.4% of women reported symptoms of peripheral neuropathy. With monofilament testing, 11.7% of women with normal fasting glucose, 14.4% of women with impaired fasting glucose (IFG) and 18.3% of women with diabetes had monofilament insensitivity (p-value=0.33). For symptoms, 14.0% of women with normal fasting glucose, 16.5% of women with IFG and 31.2% of women with diabetes reported symptoms of peripheral neuropathy. Women who reported symptoms of small fiber nerve dysfunction alone were unlikely to have monofilament insensitivity. Compared to women with normal fasting glucose, women with diabetes were more likely to report peripheral neuropathy symptoms [OR 2.8 (95% CI: 1.5, 5.1)]. Women with diabetes were also more likely to report symptoms than women with IFG (p=0.02). There was no difference in the frequency of symptoms between women with normal fasting glucose and IFG.

Conclusions: Women with diabetes were more likely to report peripheral neuropathy symptoms. The prevalence of monofilament insensitivity and peripheral neuropathy symptoms did not differ between women with normal fasting glucose and IFG.

Keywords: Monofilament testing; Peripheral neuropathy; Symptoms.

Figure 1

Counts of coinciding peripheral nerve dysfunction assessments using three measures, Peripheral Neuropathy Substudy, Michigan SWAN, 2008. Abbreviations: SWAN, Study of Women’s Health Across the Nation