Dr. Ahmed Prediabetic neuropathy is a condition that manifests as tingling, numbness, paraesthesias, and heaviness of the hands and feet with or without muscle weakness.
The rising prevalence of prediabetes has also raised the occurrence of diabetic complications. The micro- and macrovascular complications that are linked with diabetes can also be found in the prediabetic stage.
Because as diabetes itself develops at that stage, the factors that contribute to diabetes also contribute to its complications.
Peripheral neuropathy affects about 50% of the diabetic population. This is because diabetes causes high blood glucose levels, and these high levels cause nerve damage,e which is called diabetic neuropathy.
People with prediabetes have an equal risk of developing peripheral neuropathy because of the developing insulin resistance and occasional spikes in glucose levels.
Even if it is small and barely noticeable, nerve damage exists in the majority of the prediabetic population.
The relationship between peripheral neuropathy and prediabetes:
It might be difficult to accept the fact that prediabetes is associated with almost the same risks of peripheral neuropathy as newly developed diabetes. Peripheral neuropathy begins eventually after the insulin resistance starts.
Although many questions remain, new research examining the relationship between prediabetes and peripheral neuropathy is filling in some of the knowledge gaps.
Christine Lee, Ph.D., of the University of Toronto, and colleagues reported in Diabetes Care that prediabetes was associated with the same risks for peripheral neuropathy and severity of nerve dysfunction as new-onset diabetes.
They also discovered an independent link between prediabetes and peripheral neuropathy as well as the severity of nerve dysfunction.
One study that looked into the prevalence of peripheral neuropathy and nerve dysfunction in relation to prediabetes is given below.
“Both conditions are associated with glucose tolerance and the presence of the metabolic syndrome.”
The study showed that the overall prevalence of peripheral neuropathy ranged from about 29% in normal people to 49% and 50% in prediabetic and diabetic people. [Ref].
Researchers currently believe that microvascular abnormalities, dyslipidemia, and metabolic syndrome may play a role in the pathogenesis of peripheral neuropathy in patients with prediabetes.
Why is early intervention necessary in prediabetic neuropathy?
Although it isn’t possible to reverse nerve damage, early intervention is necessary to prevent any further damage.
At the prediabetes stage, only the thin nerve fibers are exposed to injury, but the more it goes neglected, the more difficult it becomes to prevent the severity of nerve damage.
Early interventions with changes to lifestyle, such as diet and exercise,e can prevent the occurrence of severe nerve damage.
Research suggests that diet and exercise counseling can result in cutaneous reinnervation and improved pain in prediabetic patients with neuropathy.
Treatment of Diabetes and Prediabetic Neuropathy:
Unfortunately, there are no available treatments to reverse the nerve fiber damage associated with diabetic neuropathy once it has occurred.
Currently, only the symptoms of neuropathy can be treated, such as pain. The commonly prescribed medications include:
- Gabapentin
- Pregabalin
- Fluoxetine
- Amitriptyline
Despite the fact that the FDA has only approved three agents in the United States to treat neuropathic pain in diabetes, including pregabalin, duloxetine, and tapentadol, a narcotic.
There are other agents that we know work as well and have high effectiveness in treating neuropathic pain.
Along with these medications, physicians often prescribe and patients prefer taking OTC vitamin B12 instead of medications.
Vitamin B12 or cobalamine is one of the essential factors required for the regeneration of nerve fibers. In addition, people who are on a vegetarian diet and those taking metformin may be deficient in Vitamin B12.
Although not approved as a treatment, most people respond to Vitamin B12 supplements. Furthermore, medications for diabetic neuropathy are helpful in those with painful neuropathy. Vitamin B 12 may also help in relieving symptoms of numbness and loss of sensation.
Lifestyle Interventions for Prediabetes Neuropathy:
Here are some lifestyle changes that can act as remedies and slow the progression of nerve damage and help in managing symptoms.
Dietary interventions:
Fresh fruits and vegetables are high in fiber, vitamins, minerals, and antioxidants. These can improve overall health and help keep blood sugar levels stable.
Choosing healthy fats:
Nuts, avocados, oily fish, vegetable oils, low-fat dairy products, lean meats, and poultry products all contain healthy fats.
High levels of triglycerides, a type of fat, in the bloodstream, on the other hand, can increase the risk of nerve damage.
Manufactured or added fats, particularly trans fats, can raise triglyceride levels and increase the risk of high cholesterol and obesity.
Excess sugars should be avoided.
Highly refined carbohydrates and sugars, including fructose sweeteners, can cause sharp, sudden spikes and dips in blood glucose.
Avoiding these highs and lows is critical for managing blood sugar and preventing diabetes.
Vitamin B-12 rich foods:
Since the intake of vitamin B12 supplements is associated with relief in the symptoms of prediabetic neuropathy, it is best to take food items that are rich in Vitamin B12.
Vitamin B12-rich foods include:
- Liver
- Meat
- Fish
- Milk
- Cheese
- Eggs, and
- cereals fortified with Vitamin B12
Maintaining a healthy body weight:
Obesity is greatly linked to diabetes and its complications. So, working on your weight and losing some pounds to get back in the ideal range can also be helpful.
Obesity is associated with prediabetes neuropathy in several ways:
- Inactivity and reduced blood supply to the peripheral parts of the body
- Uncontrolled and fluctuating blood glucose
- High requirements of essential nutrients, and
- Entrapment neuropathies (the nerves get pressed at the extremities), such as CTS (carpal tunnel syndrome).
Exercise
Exercise can reduce the pain caused by peripheral neuropathy. Some moderate-intensity exercises, such as aerobics and resistance training, are safe.
You can experience pain, but if you have any joint stiffness, visit your doctor right away.
Exercise can relieve the symptoms of diabetes and prediabetic neuropathy in several ways:
- Exercise enhances blood circulation to the peripheral parts of the body, where most neuropathic symptoms are felt
- Exercise results in the release of endorphins, which are mood-elevating hormones and relieve the symptoms of prediabetic neuropathy
- Exercise may help nerve regeneration.
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