Impaired glucose tolerance—does it cause neuropathy?

The publication of the Diabetes Control and Com-plications Trial (DCCT) laid to rest much of the controversy surrounding the role of hyperglycemia in diabetic neuropathy.11,12 This study showed that intensive insulin therapy, coupled with improved gly-cemic control, reduces the severity of diabetic com-plications and, more importantly, decreases the risk of developing these complications. This was the first large prospective study to show that careful regula-tion of blood glucose can prevent development of neuropathy in diabetic patients. Despite the evi-dence that hyperglycemia is coupled with neuropa-thy, it has been assumed that neuropathy results only from significant hyperglycemia and is not related to impaired glucose tolerance (IGT). In the presence