Carbohyrate tolerance in patients with tropical ataxic neuropathy — A human model of chronic cyanide intoxication

Abstract

Patients with tropical ataxic neuropathy (TAN) have been shown to have chronic cyanide intoxication. Glucose tolerance test data in a group of 88 patients with TAN and 88 matched controls who were studied several years ago were analysed. A standard glucose tolerance test (SGTT) with 50 gm dextrose preceded by 50 mgs cortisone acetate orally 8l/ 2 and 2 hours before the tests were performed. The SGTT was considered abnormal if the capillary bUxxl glucose at 0.60 and 120 were greater than 120, 200 and 140 ing/100 ml (6.6, 11.1, 7.8 mmol/1) respectively. Capillary blood glucose considered abnormal for CGTT were 205 and 155 mg/100 ml at 60 and 120 (113 and 8.6 mmol/1) respectively. The SGTT was abnormal in 1 of the TAN patients and 2 controls while CGTT was abnormal in 9 TAN patients and 7 controls. However, all controls with abnormal CGTT were older than 50 years while only 1 TAN patient was older than 50 and 6 were 30 years or younger (p = 0.0105), Fischer's probability test. The results suggest a greater statistical risk for subjects with TAN 30 years or younger to have an abnormal CGTT. While this does not predict the future development of diabetes, our observation indicates the need for better designed prospective studies among such patients in developing countries.