New Insights into Peripheral Neuropathy
Is Prediabetes a Risk Factor for Neuropathy?

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by Richard Mann, DPM, Chief Scientific Officer and Founder, Realm Labs®, sole U.S. distributor of the NeuRemedy® line of benfotiamine products for the healthy function of the nerves in the feet and legs*

According to the American Diabetes Association, before people develop type 2 diabetes, they almost always have “prediabetes” — blood glucose levels that are higher than normal but not yet high enough to be diagnosed as diabetes.  Also known as impaired glucose tolerance, prediabetes is a hidden epidemic by any definition.  In 2015, according to the CDC, 84 million people in the US were prediabetic and 90% of those were unaware that they had it.  Since its pathogenesis is a consequence of early glucose dysregulation, it would be reasonable to expect that the earliest and most common complication of diabetes, polyneuropathy, would be more frequent in prediabetics than in non-diabetics…and that, in fact, turns out to be the case.

 

Surprisingly, many clinicians are unaware that prediabetes is an independent risk factor for polyneuropathy.  A recent study found that 40% of all patients diagnosed with idiopathic neuropathy actually had prediabetes.  After a comprehensive literature review, a research group in the UK, recently published a paper in the journal Diabetes reporting an estimated 18% prevalence of peripheral neuropathy in prediabetics. A Canadian study found the prevalence of peripheral neuropathy in prediabetics to be about the same as in newly diagnosed diabetics. The neuropathy associated with prediabetesis clinically similar to early diabetic neuropathy, with preferential injury to small nerve fibers resulting in pain and autonomic dysfunction.

A recent study found that 40% of all patients diagnosed with idiopathic neuropathy actually had prediabetes.

The treatment for prediabetic and diabetic polyneuropathy are basically the same - lifestyle changes including improved diet and exercise, protecting the feet and legs from injury, appropriate nutrients such as benfotiamine, vitamins B6, 9 and 12, essential fatty acids, Alpha Lipoic Acid, etc., physical therapy, topical analgesics and, if necessary, the use of antidepressants and anticonvulsants to manage extreme symptoms.

Many clinicians in the U.S. and Canada have reported significant success with the use of benfotiamine, a high potency form of thiamine (vitamin B1), in the treatment of polyneuropathy in prediabetic patients.  This suggests that thiamine deficiency, which is endemic in diabetics, may also be common in prediabetics. This would help to explain the impressive results reported by these clinicians and represents an interesting avenue for future research.

*This statement has not been evaluated by the Food and Drug Administration.

This product is not intended to diagnose, treat, cure or prevent any disease.