Specific Assessments of Warm and Cool Sensitivities in Adult Diabetic Patients

Abstract

We have specifically examined warm and cool sensitivities in 60 diabetic and 43 nondiabetic individuals. Diabetic patients tended to have less warm and cool sensitivity than the control subjects (P < .001 for age <50 yr and P <.05 for age ≥50 yr). Both patients asymptomatic for neuropathy and patients with symptoms had impairment of warm and cool sensitivity (P < .05 for comparisons with control subjects). These differences persisted (P < .05) in covariance analyses with age included as a covariate. There was a nonlinear association between warm sensitivity and hemoglobin A1c. Warm-sensitivity values in the lowest and middle tertiles of the hemoglobin A1c distribution were similar; however, warm-sensitivity values of patientsin the highest tertile were markedly increased (P < .05 for the comparison of the highest tertile with the lowest and middle tertiles combined)There tended to be more warm insensitivity than cool insensitivity among the diabetic patients, and this difference increased with worsening glycemia. These data indicate that both warm and cool sensations are markedly impaired in asymptomatic adult diabetic patients. They also suggest that warm sensitivity is more impaired than cool sensitivity, and that this is the result of a stronger association between warm sensitivity and metabolic factors.