Summary: Recent studies indicate that type 2 diabetics with peripheral neuropathy are at increased risk of undergoing cognitive decline and earlier mortality than type 2 diabetics who do not have peripheral neuropathy.
Investigators at the Nanjing University Medical School in China, recently published, in the journal Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy, the results of a study in which they compared and evaluated cognitive function in type 2 diabetics with peripheral neuropathy (PN) vs. cognitive function in type 2 diabetics without PN. The investigators found that patients with type 2 diabetes and PN had decreased cognitive abilities when compared to patients with type 2 diabetes without PN. This is believed to be the first study to compare cognition in type 2 diabetics with and without PN.
In a recent prospective cohort study previously reviewed here, investigators from Johns Hopkins and the University of Mississippi Medical Center compared the incidence rate of all-cause mortality in type 2 diabetics without PN versus type 2 diabetics with PN–as measured by decreased ability to sense a standardized monofilament (5.07 Semmes-Weinstein/10-gram). They found that having PN more than doubled the mortality rate of type 2 diabetics. PN was also found to increase the mortality rate of nondiabetics as well. This study is believed to be the first to evaluate the association between nondiabetic PN and mortality.
Many of the harmful effects of PN in type 2 diabetes are well documented and include increased incidence of wounds, infections, and lower extremity amputations, among others. As shown in these and other studies, the consequences of PN in type 2 diabetes appear to be even more pernicious than previously believed.
Whether the early treatment of PN in type 2 diabetics can inhibit the progression of this pathology remains to be seen and certainly warrants further study. In light of these new findings, physicians may want to act even more aggressively in treating type 2 diabetics with PN by counseling patients on lifestyle changes including improved diet, exercise, nutrition, and appropriate vitamin supplementation.