Peripheral neuropathy is a feeling of numbness, pain, and weakness in the peripheral nerves of the hands and feet. It can result from infections, traumatic injuries, genetics, and exposure to neurotoxins, but the most common cause is diabetes. For individuals with diabetes, one of the most important things they can do to prevent diabetic neuropathy is to have their A1c levels checked and take measures to control their glucose levels.
What is A1c?
Many people interchange the terms blood glucose and blood sugar. To make matters more confusing, the criteria for making a diagnosis of diabetes has changed over the years. This is a result of more sophisticated tests being developed due to new research into diabetes and its complications.
In 1997, the criteria for the diagnosis of diabetes was lowered from 120 mg/dl to 110 mg/dl. This was further refined in 2002 to incorporate a normal fasting blood glucose of greater than 100 mg/dl. Now, a fasting blood sugar between 100 and 125 mg/dl is prediabetes. People in this range are more likely to develop full-blown diabetes and its potential side effects, such as peripheral neuropathy.
Fasting blood glucose levels used to be the standard definitive test for the diagnosis of diabetes. However, a new standard test, measuring hemoglobin A1c, gives an estimate of blood sugar levels over the previous three months. The advantage of A1c is that it gives a history of blood sugar levels over time and demonstrates long-term trends, rather than a single reading, which could be anomalous. Fasting glucose can be compared to a snapshot that can give a different picture depending on when it is taken. People with an A1c of 5.7 to 6.4 percent are considered prediabetic and those with an A1c of over 6.5 percent are considered diabetic.
Diabetes and Neuropathy
According to some estimates, nearly 30 percent of all patients with diabetes who have had uncontrolled A1c levels for at least a decade have neuropathy. The first signs of neuropathy are typically numbness, itching, or tingling in the feet, ankles, or legs. However, it can also appear as pain in the beginning too.
Diabetic neuropathy can also cause digestive trouble, such as diarrhea and other problems. This is caused when the nerves in the bowels become damaged. The physiological cause of diabetic neuropathy is peripheral artery disease. This is where the small blood vessels become constricted by plaque and oxygen fails to reach certain parts of the body. The pain and sensations are caused by a lack of oxygen, which stimulates the nerve.
Signs of Something More Serious
The effects of uncontrolled A1c levels include a series of complications. Peripheral neuropathy is only the beginning of these complications and it is a sign that more serious things that could develop if medication and diet fail to control A1c levels. Unless glucose levels are controlled, the damage will continue to spread and can eventually lead to heart attack, peripheral vascular disease, heart attack, retinopathy, and kidney disease.
Is a common misconception that A1c levels must be drastically out of control for these types of damage to occur, for these complications have occurred in people who have prediabetes. Those who have hypertension are especially prone to developing diabetic complications, even if their blood sugar levels are only slightly out of range. Add elevated triglycerides and LDL levels to the mix and the chances for developing serious complications increase even more.
Preventing Diabetic Neuropathy
The best strategy is to prevent the damage from occurring in the first place. This can be done by working closely with a licensed medical professional to control A1c levels in a long-term plan. Eventually, nearly 60 to 70 percent of all diabetics will suffer some type of nerve damage, according to the National Institute of Diabetes and Digestive and Kidney Disease.
The good news is that working carefully with a physician and adhering to a specialized diet and medication regime, as well as getting enough exercise, can help prevent not only diabetic neuropathy, but other, more serious, complications as well. Medications won’t work alone. Diabetics who take medication and do not control their diet or exercise can still experience progressive nerve damage.
Keeping A1c levels under control is the safest bet to prevent diabetic neuropathy and other complications from occurring. Continuing to ignore the importance of controlling A1c levels means that there is a more-than-likely chance of experiencing the pain and discomfort of not only diabetic neuropathy, but more serious conditions. Controlling A1c levels will help diabetics live a happier, healthier, and potentially longer life. This means more time to do the things that they enjoy and build memories with those they love.
