We have another thread with a discussion on this paper.

It will take me some time to find it though. I'll look later today.

In essence one paper, in a medical subject is not a clincher.

There are so many other papers over the years on this subject that are the reverse of what this paper concludes, I tend to think
that more work needs to be done on the subject.

It is no accident that many people who visit this forum find
improved symptoms when they reduce sugar and starchy carbs in the diet. Insulin resistance and metabolic syndrome which is its other name, is a real problem, and it has real consequences in the body.

In fact even diabetic neuropathy has arguments as to what really causes it. Is it advance glyciation of DNA in cells? This is why A1C tests are given to measure how much sugar has damaged the red cells in the blood from spikes in blood sugar after eating. People with fairly normal or even low fasting sugars may show elevations in A1C.
Another theory is that sorbitol forms in the peripheral nerves cells from too much sugar in the blood, and damages nerves that way.

This is called the polyol pathway:
http://en.wikipedia.org/wiki/Polyol_pathway

So one paper while interesting is only one of many on this subject. I am not convinced yet that a workable answer is forthcoming on exactly why PN develops in some people with tendencies to diabetes. In fact diabetes is becoming an epidemic of sorts, and even now showing up alarmingly in Asia where it was less common.

I can understand how confusing this must be, when doctors and even Mayo latch onto a study, which really must be replicated elsewhere more than once to be acceptable. How studies are run and how the patients are selected, and how variables are managed determines much on how the study turns out.

I will say however, that my PN which started so long ago was hypothyroid in nature. Back then my fasting sugars were typically around 70. Now that I am prediabetic and watching everything I eat, my PN symptoms are a bit more common, but still not in any way disabling. I'll continue with the R-lipoic acid and Benfotiamine, etc along with my other supplements. They really have kept me in a pretty good place.

Here is a quote from the end of that article:
What does it really say? It says NOT TO TREAT medically, prediabetes.
This means, insulin injections, and oral drugs. What does treatment do in mild cases? It, according the ACCORD study, which ended its aggressive treatment arm for diabetics recently, means that treatment or aggressive blood sugar control resulted in DEATH. In fact that arm of the study, was prematurely ended because of unexpected rise in death rates from the aggressive attempts to keep A1C very low in those patients.

It is really important to realize that not all diabetics get diabetic PN, and not all diabetics get retinal and kidney damage! That's right,
the dreaded damage is thought to be more common and aggressive only in certain patients with certain genetic tendencies. Many diabetics do not develop the severe consequences at all. So therefore there is much leeway in how diabetic patients present, and live with their diabetes.

And yes, I agree, that doctors should not jump on ANY bandwagon when a patient comes in with PN symptoms.
It is just as likely that PN in a prediabetic, may be from the STATINS or antibiotics that doctor is giving that patient. Or the PN could be a vaccine injury from the increasing push to vaccinate everything!
Or it could be poisoning from heavy metals.

The assumptions doctors make, may close diagnostic doors on people, rather than opening doors and shining a light to find an answer. It is rather like alcoholic neuropathies that get labeled in people just because they drink. We've had people come here 10-20 yrs sober, and have been diagnosed with "alcohol induced neuropathies".... Which doesn't seem to make much sense to me!