Peripheral neuropathy may be more common in patients with pre-diabetes than previously thought, and early interventions may be warranted in this patient population, according to researchers from the University of Utah.
Currently, 86 million adults â€” more than one in three U.S. adults â€” have prediabetes, according to CDC estimates. Without weight loss and moderate physical activity, 15% to 30% of these people will develop full-blown type 2 diabetes within 5 years.1
â€œWe know now a lot more than we did 3 or 5 years ago about neuropathic pain in patients with prediabetes. Neuropathy affects patients with prediabetes in a continuum,â€ said J. Rob Singleton, MD, who is a professor of neurology at the University of Utah in Salt Lake City. â€œWe think it is more obesity and dysfunction of lipids (fats) that is causing the problem.â€
Research Shows the Link between Obesity, Pre-diabetes and Neuropathy
In another study conducted by researchers from the University of Michigan, peripheral neuropathy was also common in obese patients, even if they had normal blood sugar levels, when compared with lean control participants. This same study also confirmed that rates of neuropathy were increased in participants with prediabetes and diabetes, leading the researchers to conclude that diabetes, prediabetes, and obesity are likely metabolic drivers of peripheral neuropathy. The findings were published in JAMA Neurology.1
Dr. Singleton and his team have been studying peripheral neuropathy associated with prediabetes and metabolic syndrome as well as what treatments may work best. Metabolic syndrome is the name for a group of risk factors that raise the risk for heart disease, diabetes and stroke. Risk factors include high blood pressure, elevated blood glucose, elevated cholesterol, and abdominal fat. Through their research, they have found that many patients with metabolic syndrome have pre-diabetes and peripheral neuropathy. Therefore, a multi-pronged approach to managing these patients is essential.
â€œWe have shown that, in pre-diabetics with neuropathic pain, exercise reduces neuropathic pain and increases the intradermal nerve fibers in the thigh and ankle. We are in the process now of replicating that study,â€ Singleton said in an interview with Endocrinology Advisor. â€œYou need to improve lipid (cholesterol) function and glucose levels. So, lifestyle issues have to be addressed.â€
New studies evaluating the link between prediabetes and peripheral neuropathy are filling in some of the gaps in knowledge.
In a study recently published in Diabetes Care, C. Christine Lee, PhD, of the University of Toronto, and colleagues reported that prediabetes was associated with similar risks for nerve dysfunction and damage leading to peripheral neuropathy as one develops with â€˜new-onsetâ€™ diabetes.2
While the exact mechanisms behind these associations are unclear, a growing body of evidence suggests that peripheral neuropathy begins in the early stages of diabetes pathogenesis, the researchers noted.
Lee and colleagues analyzed data on 467 individuals. The researchers found that the prevalence of peripheral neuropathy was 29% in adults with normal glucose levels, as compared with 49% in adults with prediabetes and 50% in adults with new-onset diabetes.
The researchers also found that progression of elevated glucose (pre-diabetes) over 3 years predicted a higher risk for peripheral neuropathy and nerve dysfunction.
Early intervention with lifestyle changes involving diet and exercise may be vital to preventing the severity of nerve damage, Dr. Lee stated. This had previously been backed up by another study published in 2006 in Diabetes Care, by Dr. Singleton. Singleton and his colleagues found that dietary changes and exercise can result in cutaneous reinnervation and improved pain in patients with prediabetes.3
Nerve Damage Occurs Long Before Diabetes
It is imperative to realize that the nerve damage seen in peripheral neuropathy can actually occur long before diabetes sets in. In fact the most current research has shown that obesity, even with normal glucose (blood sugar) levels has been linked with causing peripheral neuropathy as well as pre-diabetes. Although it is important to strive for maintaining fasting glucose levels between 70 â€“ 80 mg/dL, it is equally important to keep your weight down, lower LDL cholesterol and triglycerides. All of this can be accomplished without the use of medication or bariatric procedures.
For more information, please feel free to ask Dr. Jimenez or contact us at 915-850-0900 .
Additional Topics: Neck Pain and Auto Injury
Neck pain is characterized as the most prevalent symptom after being involved in an automobile accident. During an auto collision, the body is exposed to a sheer amount of force due to the high speed impact, causing the head and neck to jolt abruptly back-and-forth as the rest of the body remains in place. This often results in the damage or injury of the cervical spine and its surrounding tissues, leading to neck pain and other common symptoms associated with whiplash-related disorders.
.video-containerposition: relative; padding-bottom: 63%; padding-top: 35px; height: 0; overflow: hidden;.video-container iframeposition: absolute; top:0; left: 0; width: 100%; height: 100%; border: none; max-width:100%!important;
The information herein on "Obesity & Pre-Diabetes Can Still Cause Neuropathy" is not intended to replace a one-on-one relationship with a qualified health care professional, or licensed physician, and is not medical advice. We encourage you to make your own healthcare decisions based on your research and partnership with a qualified healthcare professional.
Our information scope is limited to Chiropractic, musculoskeletal, physical medicines, wellness, contributing etiological viscerosomatic disturbances within clinical presentations, associated somatovisceral reflex clinical dynamics, subluxation complexes, sensitive health issues, and/or functional medicine articles, topics, and discussions.
We provide and present clinical collaboration with specialists from a wide array of disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the injuries or disorders of the musculoskeletal system.
Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and support, directly or indirectly, our clinical scope of practice.*
Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. We provide copies of supporting research studies available to regulatory boards and the public upon request.
We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez DC or contact us at 915-850-0900.
We are here to help you and your family.
Dr. Alex Jimenez DC, MSACP, CIFM*, IFMCP*, ATN*, CCST
My Digital Business Card