PRE-DIABETES CAUSES NERVE DAMAGE

It is well understood that, over time, diabetes causes nerve damage in the extremities, a condition known as peripheral neuropathy.  Damage to the nerves results in sensations of tingling, "pins & needles", and pain, especially in the hands, lower legs, and feet and eventually results in a deficit of sensations altogether, impairing balance and awareness of injuries.  While it has been appreciated that high blood sugar damages small nerves, it has not been well understood if the modest elevations in blood sugar characteristic of pre-diabetes also cause nerve damage.  A new study suggests that pre-diabetes does result in significant damage of peripheral nerves.   

This study included 52 participants with tingling and pain in their hands and feet as well as 10 individuals with no nerve pain (controls).  The participants were an equal mix of male and female and ranged in age from their mid-40s to late 60s. Of those with neuropathy, 13 participants had pre-diabetes, 14 had type 2 diabetes and 24 had no blood sugar related health problems.  To measure nerve damage progression, the research team compared the density of nerves in skin samples taken at the start of the study and 3-years later.   Unlike those with healthy blood sugar, those with pre-diabetes and diabetes saw similar declines, about 10% each year, in nerve density at all sites sampled.

What to do:  It is increasingly being recognized that the co-morbidities of diabetes including damage to the kidneys, cardiovascular system, and nervous system starts during pre-diabetes.  These findings illustrate the importance of catching pre-diabetes early and making lifestyle changes that can return blood sugar to healthy levels and prevent diabetes.  The American Diabetes Association defines pre-diabetes as having a fasting blood sugar of 100-125 mg/dL and/or a hemoglobin A1c of 5.7-6.4%.   Research shows that moderate cardiovascular exercise such as brisk walking for 30 minutes five times per week and a 5-7% reduction in bodyweight can prevent or delay diabetes in those with pre-diabetes.  If you have excess weight or other risk factors for diabetes, make sure your provider is checking your hemoglobin A1c blood level which often indicates pre-diabetes before fasting blood sugar levels become elevated.

Source:

Khoshnoodi MA, Truelove, S, Burakgazi A, et al.  Longitudinal assessment of small fiber neuropathy: Evidence of a non–length-dependent distal axonopathy. JAMA Neurology, April 2016 DOI:10.1001/jamaneurol.2016.0057

Adapted from articles available at:

http://www.hopkinsmedicine.org/news/media/releases/small_nerve_fibers_defy_neuropathy_conventions

http://www.sciencedaily.com/releases/2016/04/160411112554.htm>.

http://consumer.healthday.com/diabetes-information-10/misc-diabetes-news-181/prediabetes-may-damage-nerves-more-than-believed-709885.html