Examining how diabetic peripheral neuropathy and cholesterol are linked — and whether lowering cholesterol could cause peripheral neuropathy.
With the diagnosis of type 2 diabetes, there are conditions that become of increased concern. The patient becomes at an increased risk for various cardiovascular conditions and irreversible damage that can be done to the nerves of the body. One such cardiovascular condition of concern is heart disease. In order to prevent and manage heart disease, the cholesterol level of the patient must be managed and kept at therapeutic levels. For the nerves of the body, however, ways to prevent and manage the deterioration are difficult and unknown. According to recently published research, a relationship is suggested to exist between the development of Diabetic Neuropathy and the reduction of cholesterol in patients with established type 2 diabetes, writes author Lisa Jaffe.
Following 100 participants with type 2 diabetes, Felix Kurz, MD, and his team of researchers in Heidelberg, Germany, set out to establish whether a link between reduced levels of cholesterol and the development Diabetic Neuropathy exists, or if there may be a secondary cause unbeknownst to researchers. The 100 participants of the trial had varying degrees of peripheral neuropathy, some with neuropathy caused by uncontrolled diabetes and some who had not developed neuropathy yet. The patients underwent Magnetic Resonance Neurography to observe the nerves in the right leg of each patient.
Past trials have been conducted on this very topic, but many of them have conflicting reports. Many reports claim that reducing cholesterol can reduce the chance of having diabetic peripheral neuropathy, while other reports suggest that there is a link between the two, writes Jaffe. It was previously suggested that reducing the blood glucose, blood pressure, and the lipid panel can lead to a lower incidence of diabetic neuropathy. Through research referenced in the article, it is said that diabetic peripheral neuropathy does not improve with the reduction in blood sugar in type 2 diabetes patients as it does in those who have type 1 diabetes. Like other aspects of our body, healthy levels of cholesterol show great benefits to the heart and nerves of the body. Cholesterol becomes an issue when there is an overabundance circulating through the body, potentially, clotting arteries and veins.
According to Felix Kurz and his researchers, while looking through the Magnetic Resonance Neurography results, they found that an inversely proportional relationship exists between the lipid load (total cholesterol, HDL, LDL) and the length of the lesion found on the nerve. Individuals who had lowered cholesterol (n=64) also had diabetic peripheral neuropathy, when compared to their counterparts (n=36). The trial was cross-sectional in nature, however, meaning that causality cannot be established through this means alone. Future studies and analysis must be performed and considered before a final clinical recommendation is issued. A study population of 100 is small in nature and may not be taking all variables into account, as noted by Lisa Jaffe. With a study population so small, data may not be a reliable representation of the population at large. Kurz believes that there may be a certain clinical level that patients with type 2 diabetes should achieve, to decrease their diabetic neuropathy, while maintaining a healthy level of circulating cholesterol.
- Through the trials conducted by Kurz and his research team, there seems to be an inverse relationship between Diabetic Neuropathy and a lowered cholesterol level
- Further studies must be conducted to confirm the relationship between decreased cholesterol and increased neuropathy. Future studies with larger population sizes should be considered to give a more revealing and representative population
- Future studies should be conducted to confirm or establish causality between the two conditions. With that establishment, patients who suffer from Diabetic Peripheral Neuropathy may finally be given a treatment plan to prevent that complication.
Jaffe, Lisa. “Sorting Out the Relationship between Cholesterol and Neuropathy in T2D.” EndocrineWeb, 18 June 2019, www.endocrineweb.com/news/diabetes/62064-sorting-out-relationship-between-cholesterol-neuropathy-t2d.
Usif Darwish, PharmD Candidate, Florida A&M University, College of Pharmacy & Pharmaceutical Sciences