Prediabetes and Peripheral Neuropathy

Summary: The association between peripheral neuropathy and prediabetes, although not well known by clinicians, is well established in the scientific literature. It is estimated that up to 15 million prediabetics in the US may have peripheral neuropathy–making prediabetes, one of the least recognized and most common causes of peripheral neuropathy in the US.

After performing a literature review and meta-analysis of 23 relevant studies (n=6494), the  prevalence of peripheral neuropathy in prediabetics was found to be 18%–as reported in 2018 in the JournalDiabetes.  If accurate, these findings suggest that there may be as many as 15 million prediabetics in the US with peripheral neuropathy. Canadian and Indian researchers have published studies that have found the prevalence to be even higher.

Unfortunately, the association between prediabetes and peripheral neuropathy is not well appreciated by many clinicians.  A 2008 paper found that 40% of all patients diagnosed with idiopathic neuropathy actually had prediabetes

Peripheral neuropathy is often the first clinical sign of prediabetes. Early diagnosis of prediabetes affords patients the opportunity to adopt lifestyle changes and therapies in the preliminary stages of the disease–when they have the greatest impact on preventing or delaying the progression of prediabetes to diabetes.

The neuropathy associated with prediabetes is clinically similar to early diabetic peripheral neuropathy, with preferential injury to small nerve fibers resulting in pain and autonomic dysfunction.  To aid in making the diagnosis, clinicians should consider performing a skin biopsy, to determine intraepidermal nerve fiber density, and blood work including HbA1c and/or 2hrPP.

A request from the author:
Have any of your patients who have taken NeuRemedy experienced any benefits in addition to improvement in their neuropathic symptoms? If so, I would like to know. Please contact me at or call me at 561-549-9099.

Dr. Mann bust-shot

Dr. Richard H Mann, DABPS, ret
Chief Scientific Officer & Founder, Realm Labs

If you would like to speak with Dr. Mann about how to improve your outcomes in the treatment of polyneuropathy call 866-634-2745 or email Dr. Mann at

Dr. Mann is the developer of the  NeuRemedy®line of benfotiamine nutritional supplements. NeuRemedy is a safe, proven, and effective nutritional formulation dispensed by physicians to their patients suffering from numbness, tingling, burning and/or shooting pains in the feet and legs.  Thiamine (vitamin B1) deficiency often accompanies and intensifies these symptoms. The reversal of thiamine deficiency is an important therapeutic goal in the management of these patients.*

The key ingredient in NeuRemedy, benfotiamine, is the most highly bioactive oral form of thiamine available. It rapidly and safely reverses thiamine deficiency, improving the functioning of the nerves in the feet and legs. Each capsule of NeuRemedy contains 150 mg of benfotiamine in a proprietary formulation. Because of its impressive success rate and high safety profile, NeuRemedy was recently licensed in Canada as an important factor in supporting healthy nerve function in individuals with polyneuropathy.*

NeuRemedy is the leader in the field with thousands of physicians and patients relying each day on its efficacy, purity, safety and rapid onset of action.*

For more information on NeuRemedy:
In the USA contact Realm Labs at 866-634-2745.
In Canada contact OHI at 855-561-4156.

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