Metabolic risk factors, including prediabetes, could be related to neuropathy….
Brian C. Callaghan, MD, researcher at the University of Michigan, and colleagues addressed the clinical manifestation of distal symmetrical polyneuropathy (DSP) and the role it plays in the lives of patients with diabetes.
"Components of the metabolic syndrome, including prediabetes, are potential risk factors for neuropathy, and studies are needed to establish whether they are casually related to neuropathy. These lines of enquiry will have direct implications for the development of new treatments for diabetic neuropathy," the researchers said.
They searched the Cochrane Neuromuscular Disease Group Trials Specialized Register, The Cochrane Central Register of Controlled Trials (CENTRAL), Medline and Embase for randomized trials; and PubMed for articles about prediabetes, neuropathy and metabolic syndrome, using various keywords and phrases.
Callaghan and the research team said patients with DSP are two to three times more likely to fall than those with diabetes and no neuropathy, and those with severe DSP are at risk for ulcerations and lower-extremity amputations. As many as 15% of those with severe DSP develop an ulcer during the course of their disease.
"Unfortunately, few interventions are available for the remediation of non-painful symptoms, and glucose control is the only proven disease-modifying intervention for these patients," the researchers wrote. "Although pain is a common feature, it is often underreported and undertreated."
Callaghan and colleagues are currently conducting a study to review the discovery of modifiable risk factors for neuropathy.