Pre-diabetes and peripheral neuropathy

[ShellyBeee]

Hi all
Hubby has a family history of T2 diabetes and although his BS results were above normal he was reassured that he was fine and wasn't pre-diabetic. He has suffered with increasingly numb feet over the last couple of years and this has worried him a lot and they've not been able to get to the bottom of the reason.
Well a new consultant has confirmed he is indeed pre-diabetic (have the ranges changed?) and his new GP says he has peripheral neuropathy that may have been caused by the pre-diabetes.
I've looked at good old Google and read a couple of articles that say they are beginning to realise this is more widespread than they thought.
My questions:- is there anyone else here who is in the same position?
If so did your PN improve at all once your BS levels started to improve?
Thanks
ShellyBeee

 

[rebrascora]

Hi.
Do you know what his readings were. You are entitled to know them.
I would be quite surprised if pre diabetic levels would cause peripheral neuropathy unless it was over a very long period but it is certainly possible (but not guaranteed) that it may be reversible if diabetes is the cause and glucose levels are reduced. I would say that gentle exercise like walking would probably be beneficial both for BG levels and the neuropathy if he is able.

 

[Eddy Edson]

Hi all
Hubby has a family history of T2 diabetes and although his BS results were above normal he was reassured that he was fine and wasn't pre-diabetic. He has suffered with increasingly numb feet over the last couple of years and this has worried him a lot and they've not been able to get to the bottom of the reason.
Well a new consultant has confirmed he is indeed pre-diabetic (have the ranges changed?) and his new GP says he has peripheral neuropathy that may have been caused by the pre-diabetes.
I've looked at good old Google and read a couple of articles that say they are beginning to realise this is more widespread than they thought.
My questions:- is there anyone else here who is in the same position?
If so did your PN improve at all once your BS levels started to improve?
Thanks
ShellyBeee

Hi Shelly - Pre-diabetes is certainly a risk factor for neuropathy. Science-stuff in this 2017 review paper: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5583955/#!po=2.72727

A growing literature links obesity and metabolic syndrome (MetS) to neuropathy risk in type 1 diabetes and type 2 diabetes, although this relationship might be particularly robust in the latter. Furthermore, several studies show that patients with MetS and prediabetes have an elevated risk of cryptogenic sensory polyneuropathy (CSPN) before the onset of frank diabetes, and that CSPN patients have an elevated risk of MetS and its component metabolic abnormalities.

"CSPN" is a condition which is identified as distinct from full-blown diapetc polyneuropathy ("DPN"), but they're pretty much the same thing from a patient's point of view ...

MetS-CSPN [CSPN due to MetS] and early DPN share clinical features, and it is probable that they also share disease mechanisms, and that promising therapies could work for both.

If hubby is pre-diabetic then it's extremely likely he has "metabolic syndrome" (MetS - some mixture of excess fat around the wasit, high blood pressure, higher than normal blood sugar, high triglycerides; not necessarily all of these.) MetS can lead to pre-diabetes and then to diabetes, but it doesn't have to.

Research doesn't support the notion that reducing BG levels by itself is effective for reducing neuropathy - people's actual experiences may differ, but that's what the research data says. A combination of exercise, quitting smoking, weight reduction is much more effective, according to the data.

Although no pharmacological agent has been found to alter the natural history of DPN or CSPN‐MetS, exercise‐based lifestyle modification regiments have consistently shown promising results, likely because of enhanced peripheral nerve regenerative capacity. Although this approach might not be sustainable for many patients, integrating strategies to reduce sedentary behavior represent a promising alternative approach, as does pharmacological treatment aimed at weight loss and improved insulin sensitivity.

Presonally, FWIW: I started to develop neuropathy in the feet a long time before being diagnosed with diabetes (because being a male I didn't go to a doctor until my optometrist told me I was at risk of going blind, didn't get diagnosed until well along, so don't actually know if I was still at the pre-diabetic stage when the neuropathy started happening). I pretty quickly got my BG down to "normal" levels but subjectively it was really only with increased exercise, weight loss, quitting smoking all together than I noticed any real improvement. So just as flagged in this review paper. Nowdays it's much improved - from a fairly frequent annoyance, reduced to an occasional annoyance.

 

[ShellyBeee]

Hi.
Do you know what his readings were. You are entitled to know them.
I would be quite surprised if pre diabetic levels would cause peripheral neuropathy unless it was over a very long period but it is certainly possible (but not guaranteed) that it may be reversible if diabetes is the cause and glucose levels are reduced. I would say that gentle exercise like walking would probably be beneficial both for BG levels and the neuropathy if he is able.

Thank you for your reply Barbara,
No, he doesn't know his readings, I'll register for online results so he can keep an eye on them.
It was mentioned to him a couple of years ago that his BS was high so we think it has been getting worse over quite a long period of time. He does walk regularly as we have a dog but I'm wondering if he's actually doing too much (he walks for a couple of hours at least every day) and aggravating the PN? I'll suggests he goes a bit more gently at it to see if that makes any difference.
ShellyBeee 🙂

 

[ShellyBeee]

Hi Shelly - Pre-diabetes is certainly a risk factor for neuropathy. Science-stuff in this 2017 review paper: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5583955/#!po=2.72727

A growing literature links obesity and metabolic syndrome (MetS) to neuropathy risk in type 1 diabetes and type 2 diabetes, although this relationship might be particularly robust in the latter. Furthermore, several studies show that patients with MetS and prediabetes have an elevated risk of cryptogenic sensory polyneuropathy (CSPN) before the onset of frank diabetes, and that CSPN patients have an elevated risk of MetS and its component metabolic abnormalities.

"CSPN" is a condition which is identified as distinct from full-blown diapetc polyneuropathy ("DPN"), but they're pretty much the same thing from a patient's point of view ...

MetS-CSPN [CSPN due to MetS] and early DPN share clinical features, and it is probable that they also share disease mechanisms, and that promising therapies could work for both.

If hubby is pre-diabetic then it's extremely likely he has "metabolic syndrome" (MetS - some mixture of excess fat around the wasit, high blood pressure, higher than normal blood sugar, high triglycerides; not necessarily all of these.) MetS can lead to pre-diabetes and then to diabetes, but it doesn't have to.

Research doesn't support the notion that reducing BG levels by itself is effective for reducing neuropathy - people's actual experiences may differ, but that's what the research data says. A combination of exercise, quitting smoking, weight reduction is much more effective, according to the data.

Although no pharmacological agent has been found to alter the natural history of DPN or CSPN‐MetS, exercise‐based lifestyle modification regiments have consistently shown promising results, likely because of enhanced peripheral nerve regenerative capacity. Although this approach might not be sustainable for many patients, integrating strategies to reduce sedentary behavior represent a promising alternative approach, as does pharmacological treatment aimed at weight loss and improved insulin sensitivity.

Presonally, FWIW: I started to develop neuropathy in the feet a long time before being diagnosed with diabetes (because being a male I didn't go to a doctor until my optometrist told me I was at risk of going blind, didn't get diagnosed until well along, so don't actually know if I was still at the pre-diabetic stage when the neuropathy started happening). I pretty quickly got my BG down to "normal" levels but subjectively it was really only with increased exercise, weight loss, quitting smoking all together than I noticed any real improvement. So just as flagged in this review paper. Nowdays it's much improved - from a fairly frequent annoyance, reduced to an occasional annoyance.

Thank you so much for the links Eddy, this makes interesting reading and the conditions making up metabolic syndrome pretty much apply to him (although he isn't obese his waist measurement is more than it should be).
He hasn't smoked for many years but he can look at his exercise and he has cut right back his alcohol to well below the weekly units so fingers crossed this will make a difference!
ShellyBeee 🙂

 

[everydayupsanddowns]

Best wishes to you and your husband @ShellyBeee

Hope the effort you are putting in to managing his BG levels slows any progress of the neuropathy, and that some increased activity that @Eddy Edson’s post mentions helps.

 

[ShellyBeee]

Best wishes to you and your husband @ShellyBeee

Hope the effort you are putting in to managing his BG levels slows any progress of the neuropathy, and that some increased activity that @Eddy Edson’s post mentions helps.

Thank you @everydayupsanddowns
Hubby is throwing himself into it, I am hoping he keeps it up because he is so worried about his feet. If it doesn't help his PN and his BG levels it won't be for lack of trying 🙂
My mum has her review in a couple of weeks and I'm hoping the tweaks she has made to her diet has helped her stave off full diabetes. At 90 and with gall bladder removed and a very sensitive stomach she may find it harder to adapt.
ShellyBeee