In the Dark About Diabetic Nerve Damage

Distal sensorimotor polyneuropathy in diabetes and prediabetes may go unnoticed

(RxWiki News) If a diabetes patient has nerve damage, treatment can keep the problem from getting worse. Unfortunately, some patients don't even know they have nerve damage.

A team of German researchers recently studied a group of patients with diabetes or prediabetes and distal sensorimotor polyneuropathy (DSPN) – a condition in which both nerves that provide feeling and those that control movement become damaged.

These researchers found that the vast majority of these patients were unaware they had DSPN.

Even the majority of diabetes patients who said a doctor examined their feet (one of the most common locations for diabetic nerve damage) did not know they had DSPN.

"Control your blood sugar to help prevent diabetic nerve damage."

This study was conducted by Brenda W.C. Bongaerts, PhD, of the Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf in Germany, and colleagues. 

These researchers set out to examine rates of unawareness of DSPN in patients with diabetes or prediabetes in a sample of older adults in Augsburg, Germany.

Prediabetes is a condition in which blood sugar levels are high, but not high enough to be considered diabetes.

With DSPN, patients can lose feeling in any part of the body. They can have trouble swallowing or difficulty using their arms, hands, legs or feet. DSPN can also lead to pain, burning or tingling in any part of the body.

For this study, Dr. Bongaerts and colleagues identified people with diabetes or prediabetes from a population of older adults aged 61 to 82 years. Diabetes or prediabetes was determined by glucose tolerance status – a measure of how quickly the body clears sugar from the blood.

The researchers then determined which patients had DSPN as defined by impaired foot-vibration perception (reduced ability to feel vibrations on the feet) and impaired foot-pressure sensation (reduced ability to feel pressure on the feet).

Patients with DSPN were considered unaware of their condition if they answered "no" to being asked, "Has a physician ever told you that you are suffering from nerve damage, neuropathy, polyneuropathy, or diabetic foot?"

Out of 1,100 people, 154 (14 percent) had DSPN. Of those with DSPN, 140 (about 91 percent) were unaware that they had the condition.

Participants with prediabetes had the highest rate of DSPN, at 23.9 percent. Of these patients, 10 out of 11 (91 percent) did not know they had DSPN.

At a rate of 22 percent, participants with diabetes had a similarly high rate of DPSN as those with prediabetes. A total of 30 out of 39 (77 percent) of these diabetes patients were unaware of having DSPN.

Of the participants with diabetes who reported having had their feet examined by a doctor, 18 of 25 (72 percent) were unaware of having DSPN.

In conclusion, the study authors wrote, "Our findings showed a high prevalence of unawareness of having clinical DSPN among the prediabetic and diabetic groups and an insufficient frequency of professional foot examinations, suggesting inadequate attention to diabetic prevention practice."

In other words, this study showed that many patients with diabetes or prediabetes did not know they had this serious disorder and that there may be a need to increase foot exams for this population.

This study was published in the May issue of Diabetes Care.

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Review Date: 
May 21, 2013