Does enhanced glucose control prevent the development of clinical neuropathy in patients with type 1 and type 2 diabetes mellitus?
Enhanced glucose control prevents clinical neuropathy in type 1 diabetes but increases the risk of severe hypoglycemia, requiring careful risk/benefit evaluation.
According to high-quality evidence, enhanced glucose control significantly prevents the development of clinical neuropathy and reduces nerve conduction and vibration threshold abnormalities in type 1 diabetes mellitus. In type 2 diabetes mellitus, enhanced glucose control reduces the incidence of clinical neuropathy, although this was not formally statistically significant (P = 0.06). However, enhanced glucose control does significantly reduce nerve conduction and vibration threshold abnormalities. Importantly, enhanced glucose control significantly increases the risk of severe hypoglycemic episodes, which needs to be taken into account when evaluating its risk/benefit ratio.
Callaghan et al. (Fri,) studied this question.