Aims: To study the prevalence and correlate the autonomic function tests in peripheral neuropathy in patients with diabetes and impaired glucose tolerance comparing with normal controls Settings and Design: Cross Sectional Study done during January 2016 to November 2017 in three groups of patients randomly selected from the Department of Medicine, Government Dharmapuri Medical College. Material and Methods: History, clinical examination, blood sugar estimation, HbA1c, Oral Glucose Tolerance Tests, blood pressure, screening for macrovascular and microvascular complications of diabetes, bed side autonomic function tests and nerve conduction studies were done. Statistical Analysis: SPSS software analysis. Results: 67.2% of Diabetic Peripheral Neuropathy (DPN) patients,20% of Impaired Glucose Tolerance (IGT) patients and 2% of controls had sensory symptoms at presentation. 60% of DPN patients and 16% of IGT patients had sensory signs on clinical examination. Symptoms of autonomic dysfunction was observed in 6 0% D PN patients and 16% I GT patients. Signs of autonomic dysfunction was present in 78.6% of DPN patients and 24% IGT patients. Conclusions: Peripheral neuropathy occurs in impaired glucose tolerance patients before diabetes develops.IGT peripheral neuropathy is primarily a painful small fiber neuropathy with dys-autonomia. Severe autonomic dysfunction occurs early in diabetes .A discordance between neuropathic symptoms and electrophysiological studies was found to occur
