Getting a prediabetes diagnosis leaves one often wondering if prediabetics face the same issues as diabetics. One of these issues is neuropathy, and we've encountered the question, "Can you get neuropathy if you have prediabetes?" more often in recent times.

One thing we know for a fact is that prediabetes is the forerunner of type 2 diabetes. Most people with uncontrolled or unmanaged prediabetes go on to develop type 2 diabetes after some years, and about 50% of people with diabete s suffer from peripheral neuropathy in their lifetime. And Yes, indeed, studies have also linked prediabetes to cardiovascular disease and neuropathy.

The question, however, is, how serious can prediabetic neuropathy get? Let's dive into the facts.

Key Facts

  • According to reports, about 98 million people (38% of the entire population) in the United States aged 45 and above had prediabetes in 2021.
  • It is estimated that without weight loss and moderate physical activity, 15% to 30% of people with prediabetes will develop full-blown type 2 diabetes within five years.
  • While prediabetes primarily garners attention due to its association with diabetes, emerging research suggests a potential link between prediabetes and neuropathy.
  • Prolonged high blood sugar levels, even those in the prediabetes range, can cause neuropathy, which can lead to numbness, tingling, burning, or pain in the feet, toes, and hands.
  • Insulin resistance, a key feature of prediabetes, has been implicated in the pathogenesis of neuropathy. This further showcases the strong connection between metabolic dysfunction and nerve health.
  • Losing a small amount of weight as an overweight prediabetic and getting regular physical activity can lower your risk of developing type 2 diabetes.
  • Studies found that diet and exercise can boost cutaneous reinnervation and reduce pain in patients with prediabetes.

What is Prediabetes?

When you have prediabetes, your blood sugar level is higher than normal but not high enough to be called type 2 diabetes. In this condition, the body's production of insulin, which helps regulate your blood sugar, isn't working optimally. Unmanaged or poorly managed prediabetes will lead to full-blown diabetes after some years.

Prediabetes mostly presents no symptoms, but where it does, it may be similar to that of diabetes. Hence, it's possible to experience increased thirst and urination, tiredness, blurry vision, and, in some cases, symptoms related to cardiovascular issues and peripheral neuropathy.

People who eat unhealthy, unbalanced, and high-carb diets, who are inactive, overweight, and who are over 45 years old are at a higher risk of developing prediabetes and type 2 diabetes mellitus. Having a family history of prediabetes or a history of gestational diabetes also increases your risk.

The good news, however, is that lifestyle changes, including a healthier diet and exercise, can prevent prediabetes or stall its progression into type 2 diabetes.

What is Peripheral Neuropathy?

Peripheral neuropathy occurs due to nerve damage outside the brain and spinal cord. This condition is a commonly known complication of type 2 diabetes that leads to foot sores and amputation; however, emerging studies have shown this can also happen to people with prediabetes.

Peripheral neuropathy comes with symptoms like pain or numbness in the hands and feet, burning or freezing sensations in the hands and feet, balance issues, abnormal blood pressure, and difficulty with movement.

Apart from prediabetes and type 2 diabetes, other risk factors of peripheral neuropathy are alcoholism, vitamin and nutrient deficiencies, chemotherapy, certain medications, tumors, and genetic conditions like amyloidosis, Fabry disease, and Charcot-Marie-Tooth disease.

What is the Connection Between Neuropathy and Prediabetes?

The common link between prediabetes and neuropathy is that prediabetes increases blood sugar to abnormal levels, which, if not controlled, can lead to diabetes.

Untreated or poorly managed diabetes may cause peripheral neuropathy at some point. However, some people who have prediabetes with uncontrolled sugar levels for many months may develop neuropathy, even when they don't have diabetes - Although prediabetic neuropathy presents milder symptoms than diabetic neuropathy.

But then, in a study published in Diabetes Care, the University of Toronto's C. Christine Lee and colleagues suggested that prediabetes was associated with similar risks for peripheral neuropathy and severity of nerve dysfunction as new-onset diabetes. The study also found an independent connection between prediabetes and both peripheral neuropathy and the severity of nerve dysfunction.

The bottom line is that uncontrolled, prolonged abnormal sugar levels increase the risk of neuropathy, whether in prediabetes or diabetes. However, the chances and severity may increase in full-blown diabetes that has lingered for years.

Preventing Prediabetes, Diabetes, and Peripheral Neuropathy

Since prediabetes, diabetes, and neuropathy are closely related, preventing one will always help avoid the other.

The primary step to curb prediabetes is to adopt lifestyle changes like healthy dieting and exercising, which will drastically reduce the chances of prediabetes, diabetes, and neuropathy.

For overweight or obese prediabetic people, the goal of exercise and healthy diet choices is to lose some pounds. This can go a long way to prevent type 2 diabetes and complications like cardiovascular disease and neuropathy.

NOTE: Losing weight in this context could mean 5% to 7% of your body weight, just 12.5 to 17.5 pounds for a 250-pound person. Regular physical activity typically means getting at least 2 hours and 30 minutes (150 minutes) of brisk walking or jogging weekly. That's just 30 minutes daily and five days weekly.

What is the Way Forward if I Have Prediabetic Neuropathy?

Suppose you suspect that you have neuropathic pain. In that case, it's crucial to seek prompt medical attention from a chiropractic neurologist, as that could be the very first sign of type 2 diabetes or prediabetes in some cases. The doctor is best positioned to offer expert insight and appropriate next steps to manage your neuropathy.

Remember, early detection is critical to preventing complications related to prediabetes and type 2 diabetes - Complications like amputation, cardiovascular disease, and stroke.

Conclusion

Prediabetes increases the risk of neuropathy, even before diabetes onset, due to prolonged exposure to abnormal glucose levels. Symptoms may be milder in prediabetic neuropathy but still impactful. Hence, a comprehensive health approach, including lifestyle changes, glycemic control, and collaborative care between patients and doctors, is essential to manage prediabetes better, stall its progression, or even prevent complications like neuropathy.

Frequently Asked Questions

Is Prediabetic Neuropathy Reversible?

Any significant damage done to the nerves as a result of neuropathy is irreversible, whether as a diabetic or as a prediabetic. This is because the body can't naturally repair damaged nerve tissues. Successful measures, however, can be taken to stop the progression of neuropathy and alleviate the symptoms.

At What Stage of Diabetes do you get Neuropathy?

People with diabetes can develop neuropathy at any time. In fact, in some cases, the first neuropathic pain you feel might be the very first symptom of diabetes. However, you can develop significant nerve problems within ten years of being diagnosed with diabetes. The longer you have diabetes, the more chances you may develop neuropathy.

Sources

At Diabetic Me, we are committed to delivering information that is precise, accurate, and pertinent. Our articles are supported by verified data from research papers, prestigious organizations, academic institutions, and medical associations to guarantee the integrity and relevance of the information we provide. You can learn more about our process and team on the about us page.

  1. PubMed Prediabetic neuropathy: does it exist?
  2. CDC Prevalence of Prediabetes Among Adults
  3. CDC Prediabetes – Your Chance to Prevent Type 2 Diabetes
  4. PubMed Neuropathy in prediabetes: does the clock start ticking early?
  5. Johns Hopkins Medicine What is diabetic neuropathy?

About the Author

Ely Fornoville

Hi, I'm Ely Fornoville, and I am the founder of Diabetic Me. Being a type 1 diabetic since 1996, I developed a passion to help people learn more about diabetes. I write about diabetes and share stories from other diabetics around the world. I currently use a Medtronic Guardian 4 CGM and a MiniMed 780G insulin pump with Humalog insulin.

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