Diabetes and obesity are growing worldwide pandemics. Neuropathy is a debilitating complication of that is characterized with damage to nerves in the limbs, possibly leading to amputation. Obesity and unbalanced levels of fat in the blood are also both known to be neuropathy risk factors; however, the exact profile of fats in the blood that is associated with neuropathy in type 2 diabetes is not well understood.
As a result of her work at the NeuroNetwork for Emerging Therapies, Dr. Feldman believes that understanding fat profiles early in type 2 diabetes may identify individuals who are at risk for developing neuropathy, giving doctors a head start in helping these patients.
"I am very excited about our new findings. Measuring lipids today in a patient with diabetes can inform us of their risk of developing neuropathy ten years from now," explained Dr. Feldman. "This discovery allows us to prescribe lipid-lowering therapies, which include diet, exercise, and medications, that target the specific lipids most predictive of neuropathy. This is the first step towards truly personalized medicine for our patients with diabetes."
In this study, published in the Annals of Clinical & Translational Neurology, Dr. Feldman and her team examined fat profiles that were derived 10 years prior to a diagnosis of type 2 diabetes neuropathy in a cohort of the Gila River Indian Community. What they found was that significantly decreased medium-chain acylcarnitines (which help transport fats to the mitochondria for energy) and increased total free fatty acids (that is, fatty acids released from body fat) were associated with the incidence of peripheral neuropathy many years later.
Participants with neuropathy also were found to have decreased phosphatidylcholines, an important component of membranes, and increased lysophosphatidylcholines, a fat biomolecule, in their blood profile 10 years prior. These, also, could turn out to be early markers for neuropathy.