The feeling of being on "pins and needles" is wonderful-if it describes how children feel when looking forward to a birthday party or adults when anticipating a special vacation. But where diabetes patients are concerned, those words often are used to describe a painful chronic condition, called diabetic peripheral neuropathy, that results from damage to nerves (typically in the hands, arms, feet and legs) caused by elevated blood sugar. Affecting about 60% of people with type 1 and type 2 diabetes, neuropathy is the leading cause of diabetes-related hospital admissions and amputations, and it is not curable-so finding any information about how to prevent it or slow its progression is valuable.

Now a study from the University of Michigan has uncovered a crucial clue that helps identify patients most at risk for neuropathy progression. Researchers analyzed data from 427 people with diabetes and early-stage neuropathy using advanced technology to measure the amount of damage to patients' peripheral nerves at the beginning of the study and again one year later. The surprising finding was that those whose neuropathy got worse over the year were the same ones who also had elevated levels of triglycerides, a type of fat in the blood. In fact, having elevated triglycerides was a more accurate predictor of neuropathy progression than other factors such as blood sugar or high levels of cholesterol.

What does this mean for your health?

According to study coauthor Kelli A. Sullivan, PhD, assistant research professor in neurology at University of Michigan Medical School, people with type 2 diabetes frequently have elevated triglycerides primarily because they are so often overweight, which is known to be associated with high triglycerides. The study's findings could be a crucial indicator to doctors that they should monitor triglyceride levels in overweight or obese diabetic patients as closely as they do blood sugar.

Fortunately, there are ways to bring elevated triglyceride levels down into a normal range. Lifestyle habits have a strong impact on normalizing triglycerides-this includes shedding excess pounds and having a healthy diet that limits fats and sugars... not smoking... and moderate alcohol consumption, especially red wine. Exercise is a must, says Dr. Sullivan, as demonstrated in a 2006 Italian study that showed regular long-term aerobic exercise improved neuropathy in early stages. And since having more muscle mass benefits nerve tissue as well, strength training is helpful too.

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