A study of people with type 2 diabetes shows that having an A1C greater than 7% for at least three years increases the risk of diabetes-related neuropathy. Neuropathy Treatment near Pike Creek DE can help manage this type of nerve damage that can occur with diabetes. The level of sugar in the blood, also called glucose, is raised because of diabetes. Over time, high blood sugar levels can damage nerves throughout the body.
Diabetic neuropathy most often damages nerves in the legs and feet. Peripheral neuropathy is one of the leading causes of disability worldwide. Diabetes is the most common cause of neuropathy, accounting for 50% of cases. More than half of people with diabetes develop neuropathy, and diabetic peripheral neuropathy (DPN) is a major cause of decreased quality of life due to pain, loss of sensation, unsteadiness in gait, fall-related injuries, and foot ulceration and amputation. Most patients with non-diabetic neuropathy have cryptogenic sensory peripheral neuropathy (CSPN).
There is an increasing amount of literature relating prediabetes, obesity and metabolic syndrome to the risk of suffering from both NPD and CSPN. This association may be particularly strong in patients with type 2 diabetes. There are no effective medical treatments for CSPN or DPN, and aggressive glycemic control is an effective approach to reducing the risk of neuropathy only in type 1 diabetes. Several studies suggest that lifestyle-based treatments that integrate dietary counseling with exercise could be a promising therapeutic approach for early DPN in type 2 diabetes and CSPN associated with prediabetes, obesity and metabolic syndrome.
About 30 percent of patients with frank diabetes for more than a decade have some form of neuropathy. It usually occurs as numbness, itching, or tingling in the legs, but it can also be pain. It can even present as digestive problems, such as difficulty digesting food or diarrhea due to problems with the nerves in the intestines. Most diabetic neuropathies are caused by peripheral artery disease, in which small blood vessels are blocked or partially obstructed and cannot carry oxygenated blood to areas of the body.
These areas have pain or other difficulties due to lack of oxygen. The specific mechanism of diabetic neuropathy is complex, but it includes a lack of oxygen and blood flow to the nerves, as well as oxidative stress. The American Diabetes Association recommends that people with diabetes get an A1C test at least twice a year. However, there are some cases of diabetic neuropathy that are due to a very rapid drop in HbA1c levels (i.e., long-term glycemic variability, or HbA1c variability), may be a better predictor of some macrovascular and microvascular diabetic complications than average HbA1c levels, although its relationship with the development of DPN has not yet been established.
The average HbA1c levels that discriminated between patients with and without DPN records were 6.5% (unadjusted) and 7.1% (adjusted). If you and your healthcare team want to lower your HbA1c levels, be sure to discuss safe and durable strategies to achieve this objective. The optimal cutoff levels of HbA1c as indices for preventing DPN were 6.54% and 6.55%, respectively, with the former having a sensitivity and specificity of 73.8% and 43.3%, and the latter with a sensitivity and specificity of 73.4% and 43.6%, respectively. This sample size was obtained by extracting the maximum data from the database used according to pre-specified criteria and methods, such as the availability of long-term HbA1c data and the comparison with the baseline variables.
Keeping your A1C level at 7% or lower will control your blood glucose level and increase your chances of avoiding neuropathy. The average HbA1c levels over the 3-year observation period were 7.2 ± 1.0% in the DPN group and 6.9 ± 1.1% in the control group; 48.0% and 62.5% of patients they had an average HbA1c level of. AUC area under the curve, coefficient of variation CV, diabetic peripheral neuropathy with DPN, dipeptidyl peptidase-4 DPP-4, glucagon-like peptide-1 GLP-1, hemoglobin A1c HbA1c, high-density lipoprotein HDL, low-density lipoprotein LDL, standard deviation SD, sodium-glucose cotransporter 2 SGLT2, type 2 diabetes mellitus. The index date was defined as the date of the first diabetic peripheral neuropathy (DPN) diagnosis record for the DPN group and the date of the last hemoglobin A1c (HbA1c) record for the control group.
The operating characteristic curve of the hemoglobin A1c receptor averages as an indicator of diabetic peripheral neuropathy. The model included the average HbA1c level (continuous value) selected from several HbA1c parameters, in addition to all the baseline variables, except for the coincidence factors (age, sex and duration since the first record of type 2 diabetes mellitus), the DPN test and body mass index.
