June 14, 2012

Aggressive Glucose Control Prevents Neuropathy in Diabetics

(Ivanhoe Newswire) — In the first systematic review of its kind, new research shows that strictly monitoring blood glucose levels (enhanced glucose control) with the right target levels can prevent diabetic neuropathy.

Diabetic neuropathy is a disabling condition that develops in up to half of people with diabetes. It affects the nerves in the feet and legs, making them feel painful, weak, tingly, or numb. It is possible to prevent neuropathy by strictly controlling the blood sugar levels with different insulin regimens and diet modification.

Researchers reviewed six studies that investigated the risk of neuropathy in people who received enhanced glucose control treatments like extra insulin injections, anti-diabetic drugs, and diet changes. The review analyzed evidence in type-1 and type-2 diabetes separately. In two studies involving 1,228 people with type-1 diabetes, there were significantly fewer people that developed neuropathy each year with enhanced glucose control treatment compared with routine care. In four studies involving 6,669 people with type-2 diabetes, the reduction of neuropathy in those who used enhanced glucose control was small and not statistically significant.

“Overall, this evidence suggests that a more aggressive approach to controlling sugar levels can be effective in delaying the onset of neuropathy in diabetes,” lead author of the review, Brian Callaghan, M.D., Assistant Professor in the Department of Neurology at the University of Michigan in Ann Arbor, Michigan, US, was quoted as saying. “The results also highlight the differences between type-1 and type-2 diabetes. The less dramatic effect of enhanced glucose control in type-2 diabetes may indicate that other factors, besides high glucose levels, may be important in causing nerve damage in these patients.”

Despite the positive effects, enhanced glucose control also put patients at a higher risk of adverse effects such as hypoglycemia. Researchers need to continue testing to determine the optimal level for safe treatments that will prevent neuropathy and minimize these side effects.

“Although these results show clear benefits for preventing neuropathy in people with diabetes, they should be weighed against potential adverse effects,” Callaghan was quoted as saying. “Future studies must establish target levels for glucose control that will balance benefits and side effects.”

Source: Cochrane Library, June 2012