Poor Blood Sugar Control in Diabetic Teens May Lead to Nerve Damage Later in Life

Children who have poor glycemic control could face higher risks of developing neuropathy in adulthood, which is often caused by diabetes, according to research conducted by investigators from the University of Michigan. The study authors, who published their findings in Diabetes Research and Clinical Practice, noted that in their 30-year study, children diagnosed with type 1 diabetes (T1D) at a young age had more difficulty controlling their blood sugar levels as teens.^1,2

“This unique study emphasizes the importance of supporting teenagers with type 1 diabetes to manage their blood sugar well and ensure a smooth transition to adult care to prevent future complications,” Eva Feldman, MD, PhD, co-senior author, director of the ALS Center of Excellence at U-M Health, and James W. Albers Distinguished University Professor at U-M, said in a news release.²

What Is Neuropathy?

More than 20 million US adults experience neuropathy, which is nerve damage that causes pain, numbness, and tingling in the extremities. Symptoms often include muscle weakness, twitching, cramps, numbness, or lightheadedness. However, as the condition progresses, patients could experience imbalance, emotional distress, or trouble sleeping. Additionally, some patients could have a loss of sensation or motor control in their feet, while others suffer from neuropathic pain in their feet, legs, back, and hands, making basic activities difficult.^1,3

The condition is triggered by the failing of peripheral nerve cells that carry signals between the brain and other parts of the body. Diabetes is the most common cause of neuropathy, accounting for roughly 50% of the nearly 40 million US adults with diabetes.^1,3

“Neuropathy presents a spectrum of symptoms,” Daniel DiCapua, MD, Yale Medicine neurologist, said in a news release. “For some patients the symptoms are just an annoyance. But for others, the effects of neuropathy can be debilitating.”³

How Does Blood Control in Adolescence Impact Adult Years?

In the study, researchers followed participants for over 30 years to highlight how children diagnosed with T1D at a young age have trouble controlling their blood sugar as teens. Children diagnosed with T1D between 1990 and 1992 in Australia were enrolled in the 30-year Cognition and Longitudinal Assessment of Risk Factors study. Additionally, hemoglobin A1c (HbA1c) data were obtained from medical records, and microvascular complications were evaluated using self-reports, clinical screenings, retinal imaging, and urine albumin-creatinine tests.^1,2

Of the 43 eligible children from the original cohort, 30 were included as adults. After nearly 30 years of follow-up, the results demonstrated that 33% developed neuropathy and 63% developed diabetes-related eye disease. Average HbA1c levels were higher during adolescence than in childhood or adulthood. Greater deviation from mean childhood HbA1c was significantly associated with an increased risk of neuropathy, but not with retinopathy or nephropathy.^1,2

“Our findings suggest that difficulties maintaining blood sugar in adolescence may lead to greater difficulties in achieving future glycemic control,” Feldman said in the news release. “Although the mechanisms behind that association are unclear, hyperglycemia leads to impairments in cell metabolism, insulin signaling and glucose regulation, all of which could cause long-term challenges in optimal glycemic control.”²

The findings suggest that adolescent hyperglycemia increases the risk of developing neuropathy in adulthood, regardless of childhood glucose control. The study authors noted effective glycemic management during adolescence is crucial, and individuals with poor control may need additional support when transitioning to adult care.^1,2

“While clear links between glycemia and neuropathy have been found in type 1 diabetes, we know there are also vascular risk factors that play a key role in the development of neuropathy,” Kara Mizokami-Stout, MD, MSc, an assistant professor of metabolism, endocrinology and diabetes at U-M Medical School, said in the news release. “However, this study does underscore the need to maximize our support for younger individuals with diabetes."²

REFERENCES

1. Moran, Chris. Collyer T. Brown A. et al. Associations between HbA_1c and complications in children diagnosed with type 1 diabetes before age 6: A 30-year follow-up study. Diabetes Research and Clinical Practice, Volume 228, 112447

2. Diabetic teens with high blood sugar have higher neuropathy risk in adulthood. EurerkAlert! News release. October 9, 2025. https://www.eurekalert.org/news-releases/1101259

3. Yale Medicine. Neuropathy. News release. Accessed October 9, 2025. https://www.yalemedicine.org/conditions/neuropathy