A group of investigators from the UK recently performed an extensive review of the scientific literature in an attempt to better determine the prevalence of peripheral neuropathy in patients with prediabetes. Twenty-nine studies (9351 participants) were analyzed. Their findings were published on May 18, 2021 in the BMJ Open Diabetes Research & Care.
The researchers found that, although there was a wide range of estimates in the literature that they reviewed, the majority of studies reported a prevalence ≥10%. This agrees with prior work on the topic as was previously discussed.
According to the CDC, approximately 88 million American adults—more than 1 in 3—have prediabetes. This new research would suggest that there are ≥8.8 million Americans with peripheral neuropathy secondary to prediabetes–making it one of leading causes of peripheral neuropathy in the US.
It is also one of the least appreciated causes of peripheral neuropathy. The diagnosis of peripheral neuropathy secondary to prediabetes is often missed. A 2008 paper found that 40% of all patients diagnosed with idiopathic neuropathy actually had prediabetes. The high rate at which this diagnosis is missed is consistent with the fact that 84% of people with prediabetes are unaware that they have it.
The mechanism of peripheral neuropathy in prediabetics is likely the same as in diabetics–in that they are both caused by glucose dysmetabolism–with the former being a prodrome of the latter.
Treatment considerations, as with diabetic peripheral neuropathy, should include early adoption of life style changes including diet and exercise modification, vitamin supplementation, medications, physical therapy, and other appropriate therapies.