Nerve Injury Can Develop Before Diabetes

Peripheral neuropathy most commonly develops in patients who’ve been previously diagnosed with pre-diabetes. According to researchers from the University of Utah, early interventions can allow people to maintain their overall health and wellness. Further research studies have revealed that peripheral nerve damage begins with pre-diabetes and obesity.

Approximately more than one in three adults in the United States, about 86 million people, have pre-diabetes. Without the proper body weight and moderate physical activity, 15 to 30 percent of these individuals could develop type 2 diabetes within 5 years.

“We now know a lot more than we did 3 to 5 years ago about neuropathic pain in patients with pre-diabetes. Neuropathy affects patients with pre-diabetes in a continuum,” stated Dr. Rob Singleton, MD, and professor of neurology at the University of Utah in Salt Lake City. “We think obesity and the dysfunction of lips or fats are what’s actually causing the issues.”

During another research study conducted and published by researchers from the University of Michigan in JAMA Neurology, peripheral neuropathy was also commonly diagnosed in patients with obesity, regardless if they had normal blood sugar levels when compared with lean, control patient participants. This same study additionally confirmed that the rate of neuropathy increased in individuals with pre-diabetes and diabetes, leading the researchers to conclude that pre-diabetes, diabetes and obesity are possible metabolic drivers of peripheral neuropathy.

Dr. Singleton and his team of researchers have been studying peripheral neuropathy associated with pre-diabetes and metabolic syndrome as well as which forms of treatment may work best for the condition. Metabolic syndrome is characterized as the group of risk factors which increases the chance of experiencing heart disease, diabetes and stroke. Risk factors include: high blood pressure; elevated blood glucose, high cholesterol and abdominal fat. Throughout their research, they discovered that many patients with metabolic syndrome had pre-diabetes and peripheral neuropathy.

“We have demonstrated that in pre-diabetics with neuropathic pain, exercise can reduce neuropathic pain and can increase the intradermal nerve fibers in the thigh and ankle. We are in the process now of replicating that study,” Dr. Rob Singleton explained in an interview with an endocrinology advisor. “You need to improve lipid, or cholesterol, function and glucose levels. Lifestyle issues have to be addressed.”

The Relation Between Pre-Diabetes & Peripheral Neuropathy

New research studies have evaluated the relationship between pre-diabetes and peripheral neuropathy. In a study published in Diabetes Care, Dr. Christine Lee, PhD, of the University of Toronto, determined that pre-diabetes created similar risks towards nerve damage and dysfunction, which often lead to the development of peripheral neuropathy, as those caused by diabetes.

Evidence suggests that peripheral neuropathy begins in the early stages of the diabetes pathogenesis. Dr. Lee and other researchers evaluated 467 individuals. The researchers found that peripheral neuropathy was common in 29 percent of adults with normal glucose levels as compared to 49 percent in adults diagnosed with pre-diabetes and 50 percent in adults diagnosed with diabetes. The researchers also established that pre-diabetes, or a progression of elevated glucose levels in the course of 3 years concluded an increased risk of developing peripheral neuropathy and nerve damage or dysfunction.

“Early interventions such as lifestyle changes involving proper diet and exercise, could be ultimately essential towards preventing severe nerve complications,” stated Dr. Christine Lee. Another study published in Diabetes Care by Dr. Rob Singleton in 2006, supported this statement. Dr. Singleton and other researchers concluded that dietary changes and physical activity can result in cutaneous reinnervation as well as improved symptoms in patients with pre-diabetes.

Peripheral Nerve Damage Before Diabetes

Its fundamental to acknowledge that the nerve injury which occurs with peripheral neuropathy can occur before diabetes develops. As a matter of fact, current research studies have shown that obesity, even with normal blood sugar levels, has been associated with causing peripheral neuropathy as well as pre-diabetes.

Fortunately, more and more research studies and evidence on the issue has been published to help enlighten doctors and the public. Although it is essential to maintain fasting glucose levels between 70 to 80 mg/dL, it is equally important to manage a healthy weight, LDL cholesterol and triglycerides. All of this can be achieved without the use of medication or bariatric procedures. Natural treatments and holistic care options are also available to help control the symptoms of the disease.

For more information, please feel free to ask Dr. Jimenez or contact us at 915-850-0900 . 

By Dr. Alex Jimenez

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