Rob Singleton, MD

Rob Singleton

I am a neuromuscular specialist with expertise in clinical investigation of metabolic nerve and muscle disease. My research has focused on the relationship between early hyperglycemia, dyslipidemia, obesity and length dependent nerve injury. Our research group established an epidemiological link between otherwise idiopathic sensory predominant neuropathy and prediabetes, identified obesity and hypertriglyceridemia as risk factors for diabetic neuropathy independent of glucose control, and showed that small fiber aspects of prediabetic neuropathy improve with diet and exercise. We developed and validated a clinical exam scale for sensory predominant neuropathy, the Utah Early Neuropathy Scale, and showed that skin biopsy for intraepidermal nerve fiber density (IENFD) determination is a sensitive measure of the painful, small fiber predominant neuropathy that is among the most common early complications of type I diabetes. We have shown that reduced IENFD predicts progression to clinical neuropathy symptoms in patients with diabetes. We have adapted IENFD following capsaicin axotomy to demonstrate that metabolic syndrome inhibits cutaneous reinnervation, and that intensive diet counseling and observed exercise improves reinnervation rate in these patients. We have received NIH funds to study lifestyle intervention to prevent neuropathy in patients with diabetes. I have had continuous NIH funding for 15 years, and have used the Utah GCRC and CCTS as an Investigator since 2001. As Director of the Utah CCTS Clinical Services Core I oversee the 140 adult and pediatric human study protocols currently using the CSC. In this role I have developed a predictive and tracking instrument for nursing effort and protocol acuity, integrated the CCTS protocol and IRB applications, and expanded CCTS outreach to the Intermountain Health Care affiliated Primary Children's Medical Center and non-medical University departments that conduct human subject research.