Peripheral polyneuropathy in prediabetes and metabolic syndrome (review and clinical case)

The increasing prevalence of prediabetes and metabolic syndrome poses a major public health challenge at both regional and global levels. Diabetic neuropathies are the most common complications of diabetes, contributing to high morbidity, increased mortality, reduced quality of life, and increased healthcare costs. Prediabetes is characterized by glucose levels in the intermediate range – above normoglycemia but below the diagnostic threshold for diabetes. Adults worldwide may have impaired glucose tolerance and impaired fasting glucose, yet most are unaware of prediabetes. Over the past decades, there has been considerable debate about whether prediabetes and metabolic syndrome are associated with peripheral polyneuropathy. This review and the accompanying case report examine current data confirming the increased risk of distal polyneuropathy in individuals with prediabetes and metabolic syndrome. Diagnosis and assessment of the severity of peripheral polyneuropathy in individuals with prediabetes and metabolic syndrome are primarily based on clinical assessments of neuropathy and electrophysiological studies. The data presented should help raise awareness and translate current knowledge about peripheral neuropathies in people with prediabetes and metabolic syndrome into clinical practice. The current recommendation that over-weight or obese adults be screened for prediabetes and metabolic syndrome and offered or referred preventive interventions should ultimately lead to the prevention of peripheral neuropathy. Treatment includes lifestyle modification, pharmacotherapy aimed at pathogenesis, symptomatic treatment of neuropathic pain and prevention of complications.

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