Aggressive Sugar Control May Hinder Diabetic Neuropathy
Diabetes has numerous documented medical problems associated with it. One of the more serious issues is diabetic neuropathy. A new study shows that both the development and effects of neuropathy can be delayed by very carefully limiting the blood glucose levels of those with diabetes, a process known as aggressive sugar control. There are significant risks associated with this process, though, particularly for those with Type 2, or non-insulin-dependent, diabetes. Diabetic neuropathy involves any damage or deterioration to the nervous system due to diabetes. This is a rather common problem, especially for those who have suffered from diabetes for a long period.
A study published in the Cochrane Database of Systematic Reviews suggests that as many as 10 percent of those diagnosed with diabetes exhibit some form of neuropathy at the time of diagnosis. This increases to as much as 50 percent after having the disease for 10 years. The study indicates that aggressive sugar control can affect that rate of development. Aggressive sugar control involves constantly keeping the patient’s blood glucose levels below 120 mg/dl. However, this must be done very carefully, as extremely low blood glucose levels, hypoglycemia, is a serious medical condition that can even result in death.
Patients who were subjected to aggressive sugar control showed a statistically significant decrease in risk for developing neuropathy, the risk dropping by as much as 2 percent per year. This result, though, only applies to those with Type 1, or insulin-dependent diabetes. For those with Type 2 diabetes, the decrease was only measure to be approximately 0.58 percent, which the researchers declared to not be high enough to be statistically significant. For patients with Type 1 diabetes, it may seem like that somewhat decreased risk immediately justifies aggressive sugar control. However, the test subjects also displayed a drastic increase in risk for hypoglycemia, reaching as high as three times the normal risk level. This increased risk was similar for both types of diabetes. As a result, the researchers could not provide suggested action for Type 2 diabetes victims, as the benefits did not necessarily outweigh costs. For those with Type 1 diabetes, the researchers believe that the aggressive sugar control was worth the risk of hypoglycemia, based solely on their statistical analysis. The researchers gathered their results from several trials, each involving more than 1,200 test subjects. After a year, each subject was tested, having their limbs and body manipulated to determine the rate of deterioration of their nervous systems. Researchers monitored how the patients responded to various forms of stimulation, including basic movement, pressure, and vibration. Although the increased risk for hypoglycemia is a serious issue, the researchers are adamant that aggressive sugar control can provide significant benefits. The also state that this method of treatment is the only documented treatment currently proven to work. Other researchers in the field may attempt to discover a method similar to aggressive sugar control that does not result in such a dramatic increase in risk for hypoglycemia in the future.