Prediabetes can significantly impact (ing) quality of life

The term prediabetes refers to a glycemic state not yet exceeding the diagnostic threshold for diabetes and, thus, not yet considered ‘diabetic’. Nevertheless, a person with prediabetes already shows signs of impaired glucose tolerance (IGT) and blood glucose levels slightly above normoglycemia.

1. Prediabetes usually progresses to diabetes but can fully resolve with appropriate lifestyle interventions.
2. Often, people with prediabetes do not have clear signs or symptoms and are therefore often not aware of their condition. However, severe complications such as nerve damage, leading to a disease called peripheral neuropathy (PN), can also develop within these patients already. Symptoms of peripheral neuropathy include numbness, tingling, prickling, and burning sensations in the hands and feet.  Besides prediabetes, diabetes mellitus and B vitamins deficiencies are other high-risk factors leading to peripheral nerve damage, this risk is growing with increasing age. Further, B vitamins deficiency is highly prevalent in Diabetes patients (B1: 98 per cent; B6: 63 per cent; B12: up to 19 per cent) 

Global prevalence

Even though prediabetes is a leading risk factor for diabetes and may predict cardiovascular disease and increased mortality, the degree of unawareness is very high with up to 85 per cent not being aware of their condition. Additionally, the low awareness of peripheral neuropathy leads to a high number of patients suffering in silence. Published studies across different countries confirm that up to 80 per cent of patients with peripheral neuropathy remain undiagnosed and untreated. Early diagnoses can help enable better treatment outcomes, better quality of life, and damaged nerves can be regenerated if nerve care damage has not progressed too far. 

Growing burden requires more attention

Prediabetes can—in the absence of clinical signs—already lead to nerve damage. PN, which is characterised by symptoms such as tingling, numbness, burning, etc. in hands and feet, is one of the most common neurological complications in diabetes and prediabetes. Although early signs are often mild and misinterpreted, untreated PN progresses and can significantly impact quality of life, affecting not only social but also working life with economic implications. 

While there is not much knowledge about prediabetes in the general population, experts agree on the urgent need to increase awareness and pay more attention to PN caused by prediabetes, particularly because it may be reversed when recognised early. A recent review article published by international experts highlights the increased risk of PN in people with prediabetes. Due to high heterogeneity of clinical studies, the documented prevalence of PN in prediabetes varies widely from 2 per cent to 77 per cent, but the association is obvious. Experts state that PN in prediabetes urgently needs to be given more attention by implementing detection and prevention strategies.

As a partner to International Diabetes Federation (IDF), P&G Health is committed to continued efforts to raise awareness on diabetes and its associated complications including Peripheral Neuropathy and Nerve Damage. This year on occasion of World Diabetes Day 2023, P&G Health is set to unveil a new, innovative campaign, ‘Know The Signs’, which aims to increase awareness about PN amongst key stakeholders, including healthcare professionals and medical organisations, influencers, partners, consumers, as well as patients. 

Management of PN in diabetes and prediabetes

There’s plenty one can do to help prevent peripheral neuropathy or stop it getting worse such as making healthy lifestyle choices. A healthy balanced diet including plenty of fruits, vegetables, whole grain foods, antioxidants, and low-fat protein is good for your nerves. Exercising for 30 to 60 minutes 3 or more times a week (with your doctor’s approval) is another way of boosting your overall health and wellbeing, as well as your nerve health. It’s also important to avoid risk factors like repetitive movements, cramped or confined positions, handling toxic substances, smoking or heavy drinking.

Increasing community awareness on the importance of nerve health and potential risk factors including the unknown such as prediabetes is another way to improve patient care. Early diagnosis is a very effective way to enable better treatment outcomes, better quality of life, and damaged nerves can be regenerated if nerve care damage has not progressed too far.

Treating doctors may also advise taking neurotrophic B vitamins that are effectively proven in combination with other therapies or lifestyle changes to support your nerve health. Treatment of PN should happen based on the condition of the individual patient. A physician can assess the cause, the symptoms and the overall status and prescribe the most suitable treatment.

If a person is worried about nerve health or feels some symptoms that might be due to nerve damage, he/she should consult a physician. It is important for patients to communicate openly with their healthcare team and follow their recommendations for treatment. 

Dr Inna Eiberger, Director and Global Head (Nerve Care) Medical & Technical Affairs, P&G Health