The Relationship Between Prediabetes and Peripheral Neuropathy-A Systematic Review and Meta-Analysis

The present systematic review and meta-analysis study aimed to investigate the putative relationship between pre-diabetes and neuropathy.

Original studies that assessed the association of pre-diabetes patients with neuropathy disorders in humans without setting and country were selected. The methodological quality of the included articles was evaluated using NHLBI quality assessment tools for observational studies. The meta-analysis was conducted using the relevant effect sizes to compare outcomes and the random-effects restricted model. An I² value > 50% and a p < 0.05 indicated substantial heterogeneity. Galbraith plot is demonstrated for heterogeneity. Egger's and Begg's test was used to evaluate publication bias. A non-parametric trim-and-fill analysis of publication bias was used to assess the number of missing studies.

According to the standardized mean difference (SMD) of included articles, there was a statistically significant association between pre-diabetes and the occurrence of peripheral neuropathy in the increasing neuropathy assessment metrics (e.g., Impaired unilateral vibration perception, Neuropathic pain, Sensory nerve dysfunction) 0.23[0.14; 0.33] and in decreasing neuropathy assessment metrics (e.g., corneal nerve fiber density, corneal nerve fiber length, warm threshold, cold threshold) -1.04[-1.05; -0.57].

Policymakers should give special attention to preventive strategies and effective lifestyle interventions for these patients to reduce the risk of neuropathy and its consequences.