Physical activity, glycemic control and peripheral neuropathy

This study evaluated the association between physical activity, glycemic control and peripheral neuropathy among diabetic patients.

Peripheral neuropathy (nerve damage often resulting in pain and/or loss of sensation) is a common complication among diabetic patients. Peripheral neuropathy not only impairs activities of daily living, but also makes patients more susceptible to infections in the affected limb, which may result in permanent disability. Physical activity is known to improve blood flow and help regulate both glucose levels and the immune response. This study assessed physical activity and glycemic control to determine their effect on the risk of developing diabetic neuropathy.

339 diabetic patients taking part in a National Health and Nutrition Examination Survey were included in this analysis. When addressing physical activity and glycemic control separately, physical activity was not found to be associated with the risk of developing peripheral neuropathy. Proper HbA1c levels (a measurement of average blood glucose levels over the past 3 months) were found to be associated with a 45% reduced risk of developing peripheral neuropathy, but this association was not found to be significant on statistical analysis.

However, among diabetics with normal HgbA1c levels and engaging in moderate-to-vigorous physical activity, the risk of developing peripheral neuropathy was reduced substantially more than what would be expected based on the individual effects of physical activity and glycemic control alone. Among diabetics with normal HgbA1c levels and engaging in moderate-to-vigorous physical activity, the risk of developing peripheral neuropathy was reduced by 76% compared to inactive diabetics not properly controlling blood glucose levels.

This study concluded that although physical activity was not directly associated with diabetic neuropathy, the findings suggest that proper physical activity coupled with good glycemic control is associated with significant reductions in the risk of developing diabetic neuropathy.

Future longitudinal studies with long follow-up periods are required to evaluate to what extent physical activity and improved glycemic control can help prevent diabetic end-organ damage, particularly diabetic neuropathy.

Consult with your physician regarding the optimal lifestyle and physical activity to prevent diabetic end-organ damage.