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Prediabetes & Obesity: Growing Problem of Peripheral Neuropathy


 Studies Reveal Peripheral Nerve Damage Begins with Pre-diabetes and Obesity

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 — more than one in three U.S. adults — 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

“We 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,” said J. Rob Singleton, MD, who is a professor of neurology at the University of Utah in Salt Lake City. “We think it is more obesity and dysfunction of lipids (fats) that is causing the problem.”

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.

“We 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,” Singleton said in an interview with Endocrinology Advisor. “You need to improve lipid (cholesterol) function and glucose levels. So, lifestyle issues have to be addressed.”

Relationship Between Peripheral Neuropathy, Prediabetes

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 ‘new-onset’ 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.

 

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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

References

  1. Callaghan BC, Xia R, Reynolds E, et al.Association between metabolic syndrome components and polyneuropathy in an obese populationJAMA Neurol. 2016; doi:10.1001/jamaneurol.2016.3745[LS1]
  2. Callaghan BC, Little AA, Feldman EL, Hughes RA. Enhanced glucose control for preventing and treating diabetic neuropathy.Cochrane Database Syst Rev. 2012;6(6):CD007543
  3. Novella SP, Inzucchi SE, Goldstein JM. The frequency of undiagnosed diabetes and impaired glucose tolerance in patients with idiopathic sensory neuropathy.Muscle Nerve. 2001;24(9):1229-1231
  4. Singleton JR, Smith AG, Bromberg MB. Increased prevalence of impaired glucose tolerance in patients with painful sensory neuropathy. Diabetes Care. 2001;24(8):1448-1453
  5. Dyck PJ, Clark VM, Overland CJ, et al. Impaired glycemia and diabetic polyneuropathy: the OC IG Survey.Diabetes Care. 2012;35(3):584-591

Sourced through Scoop.it from: www.endocrinologyadvisor.com

Peripheral 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. This is something that we have known for years and have written about in our book: Defeat Neuropathy Now…In Spite of Your Doctor.  It is fantastic to find more and more research being published on the issue to enlighten more doctors and the public.

Although it is important to strive for maintaining fasting glucose levels between 70 – 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.

Dr. Alexander Jimenez ♛
Chiropractor💡 Author • Researcher • Injury & Trauma Clinician • Wellness Educator • 915-850-0900 📞
We Welcome You 👊🏻.
Purpose & Passions: I am a Doctor of Chiropractic specializing in progressive cutting-edge therapies and functional rehabilitation procedures focused on clinical physiology, total health, functional strength training and complete conditioning. We focus on restoring normal body functions after neck, back, spinal and soft tissue injuries.

We use Specialized Chiropractic Techniques, Balanced Diet Plans, Agility Training programs, Cross-Fit techniques, the PUSH-Rx Rehabilitation System and a highly specialized program for our Veterans.

We’ve been blessed to use our methods with thousand of El Pasoans over the last 27 years. This has allowed us to improve health and restore true fitness through researched non-surgical methods and wellness programs. These programs are natural and use the body’s own ability to achieve goals of improvement, rather than introducing harmful chemicals, controversial hormone replacement, surgery, or addictive drugs. We want you to live a life that is fulfilled with more energy, positive attitude, better sleep, less pain, proper body weight and informed on how to maintain this way of life.

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God Bless

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By: Dr. Alex Jimenez D.C.,C.C.S.T

El Paso Spinal Trauma Specialist

 
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