SCRIPT NUMBER 80
DIABETIC NERVE DAMAGE
(ONE SPEAKER)
PROGRAM NAME: HEALTH NUGGETS
PROGRAM TITLE: DIABETIC NERVE DAMAGE
PROGRAM NUMBER: 80
SUBJECT: SYMPTOMS, MECHANISM, COMPLICATIONS, RISK FACTORS,
TREATMENTS OF DIABETIC NERVE DAMAGE
KEY WORDS: DIABETIC NEUROPATHY, A1C, DIABETIC SUPPORT
GROUPS
DATE OF SCRIPT: OCTOBER 5, 2012
AUTHOR: RICHARD YUKL, MD, FACS
High concentrations of sugar in your blood can cause damage to the nerves of
your body. If the cause of these high sugar levels this diabetes, the nerve
damage is called diabetic neuropathy, and it is a common and serious
complication of that disease. I want to talk with you today about diabetic
neuropathy because it is possible to prevent or slow the progression of this
condition by living a healthy lifestyle, and by controlling your blood sugar levels.
High blood sugar levels can damage any nerve, but they most often damage the
nerves in your feet and legs. The damage develops slowly, being most
commonly found in people who have had diabetes for at least 25 years. A
diabetic may not even notice problems until considerable damage has already
been done.
Symptoms, when they occur, include a feeling of tingling, burning, or a prickling
sensation starting in your toes or the balls of the feet and spreading upward.
There may also be numbness that prevents you from feeling cold, heat, or pain if
you step on a foreign body such as a splinter. You may develop sharp, jabbing
pains that worsen at night, muscle weakness and pain when walking, and serious
foot problems such as infections and ulcers.
Symptoms do not necessarily mean that permanent nerve damage has occurred,
but they should warn you of your need of medical attention, because early
treatment offers the best chance of relieving your symptoms and preventing
complications. As an example, if you are a diabetic, a minor sore on your foot
that doesn't heal can progress into an ulcer without treatment, and untreated foot
ulcers may eventually require surgery or even the amputation of your foot.
As another example, diabetic damage to the nerves that control your urinary
bladder can prevent it from emptying completely, allowing bacteria to multiply
and a urinary tract infection to develop.
The mechanism by which high blood sugar levels damage nerves isn't
completely understood, but it probably involves a combination of factors. We
know that there is a complex interaction between blood vessels and nerves, and
that high blood sugar levels damage the walls of the small blood vessels that
supply oxygen and nutrients to your nerves. Sugar also interferes with the ability
of your nerves to send electrical signals in the way they were created to function.
Poor control of blood sugar levels is by far the greatest risk factor for developing
diabetic nerve damage. Keeping the levels within a safe target range is the best
way to protect the health of both your blood vessels and your nerves.
Smoking is another risk factor. Tobacco contains nicotine, which narrows and
hardens your arteries, reducing blood flow to your legs and feet, and to the
nerves that control them.
Drinking alcohol is yet another risk factor for diabetic nerve damage. Alcohol acts
directly as a poison to nerves. Additionally, people who drink heavily frequently
suffer poor nutrition. They don’t eat the vitamins and nutrients their nerves need
to stay healthy.
Diabetic nerve damage has no known cure. Treatments focus on controlling the
diabetes to slow progression of nerve damage, relieving the symptoms, and on
managing the complications to restore function.
Let us look at how you, as a diabetic, can control your level of blood sugar. It is a
big commitment. Constant monitoring and frequent insulin injections or by mouth
medications are required to keep your blood sugar at a safe level of 70 to 130
mg/deciliter before meals. Your doctor will instruct you on both the proper diet to
follow and the exact amount of insulin you require to stay in this safe range.
Modern labs have recently developed a test called an A1C. It helps in monitoring
the success of your diabetic management by measuring your average blood
sugar level over a period of 2-3 months. Your diabetes is controlled if your level
is less than 7 percent.
Blood pressure control is another effective diabetes treatment. A diabetic should
keep their blood pressure less than 130/80 millimeters of mercury. You may
require blood pressure medicines to achieve optimal blood pressure control.
Next, eating a balanced diet that includes a variety of healthy fruits, vegetables
and whole grains, and one that limits your portion size is an effective diabetes
treatment. It helps you achieve and maintain a healthy weight.
Being active every day will help you to effectively manage your diabetes by
helping you to maintain a healthy weight, and to keep your blood sugar and blood
pressure under control. You should aim for about 30 minutes of moderate
exercise at least five times a week.
Finally, the use of tobacco in any form by a diabetic increases their risk of dying
from a heart attack or a stroke as compared with a non-smoking diabetic. It also
makes you more likely to develop circulation problems in your feet. So, if you are
a diabetic who smokes, stop.
All of these diabetes treatments - keeping your blood sugar and blood pressure
under control, following a healthy diet and getting physical exercise, avoiding
alcohol and smoking - may seem bothersome, but they do help slow diabetic
nerve damage, and failure to follow such precautions can be damaging to your
health or even your life.
Living with diabetic nerve damage can be stressful and frustrating because there
are often no outward signs, making it difficult for others to understand your
condition. Some people find that diabetes support groups are helpful because
there you can talk to others who truly understand what you're going through.
Members of support groups can offer you encouragement as well as advice
about living with diabetic nerve damage. Ask your doctor for information about
support groups in your area.
Health Nuggets is written by Dr. Richard Yukl, a medical doctor working in the
United States. The medical views expressed in this program are his and may
differ for your particular health needs. If you need medical advice, please consult
a medical professional in your area.