Triglycerides and Diabetes updated PP

Triglycerides are also proposed to have an impact on the development of neuropathy. Triglycerides and obesity correlate with diabetic neuropathy independent of glucose control. Smith and Singleton found that obesity and triglycerides were related to small axon loss whereas hyperglycemia was related to large fiber loss indicating that hypertriglyceridemia and obesity have an independent effect on peripheral neuropathy (8). Wiggin et al analyzed samples from a double-blind placebo clinical trial with Acetyl-L-carnitine (ALC) at two doses.  Since the intervention had no effect, data from three arms (placebo, 1.5 and 3.0 gm doses) were combined.  The investigators found a correlation between elevated triglycerides and mixed small and large myelinated fiber density (MFD).   Further higher triglycerides were associated with those whose neuropathy progressed as evidenced by changes in MFD (9).