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Triglycerides implicated in diabetes nerve loss

To stall progress of neuropathy, doctors should monitor levels of an easily measured blood fat as closely as they do blood sugar, study suggests

ANN ARBOR: A common blood test for triglycerides – a well-known cardiovascular disease risk factor – may also for the first time allow doctors to predict which patients with diabetes are more likely to develop the serious, common complication of neuropathy.
 

In a study now online in the journal Diabetes, University of Michigan and Wayne State University researchers analyzed data from 427 diabetes patients with neuropathy, a condition in which nerves are damaged or lost with resulting numbness, tingling and pain, often in the hands, arms, legs and feet.

The data revealed that if a patient had elevated triglycerides, he or she was significantly more likely to experience worsening neuropathy over a period of one year. Other factors, such as higher levels of other fats in the blood or of blood glucose, did not turn out to be significant. The study will appear in print in the journal’s July issue.

“In our study, elevated serum triglycerides were the most accurate at predicting nerve fiber loss, compared to all other measures,” says Kelli A. Sullivan, Ph.D., co-first author of the study and an assistant research professor in neurology at the U-M Medical School.

“These results set the stage for clinicians to be able to address lowering lipid counts with their diabetes patients with neuropathy as vigilantly as they pursue glucose control,” says Eva L. Feldman, M.D., Ph.D., senior author of the study and the Russell N. DeJong Professor of Neurology at the U-M Medical School.

With a readily available predictor for nerve damage – triglycerides are measured as part of routine blood testing – doctors and patients can take pro-active steps when interventions can do some good, says Feldman.

“Aggressive treatment can be very beneficial to patients in terms of their neuropathy,” says Feldman, who is also director of the A. Alfred Taubman Medical Research Institute and director of the Juvenile Diabetes Research Foundation Center at U-M for the study of complications in diabetes.

People can reduce blood triglyceride levels with the same measures that reduce cholesterol levels: by avoiding harmful fats in the diet and exercising regularly.

Context: Diabetic neuropathy affects around 60 percent of the 23 million people in the United States who have diabetes. It is a complication in both type 1 and type 2 diabetes.

Until now, doctors have lacked an effective way to predict which diabetes patients are at greatest risk of neuropathy. Most often, the condition becomes evident when irreversible nerve damage has already occurred. Neuropathy is the leading cause of diabetes-related hospital admissions and amputations that are not secondary to trauma.

Triglycerides are a type of lipid, or fat, that the body makes from calories it doesn’t need immediately. Triglycerides are stored in fat cells until they are needed to provide energy. When higher-than-normal amounts circulate in the blood, a person is at higher risk of cardiovascular disease.

 

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