SCRIPT NUMBER 80
DIABETIC NERVE DAMAGE
(TWO SPEAKERS)
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
SPEAKER 1:
High concentrations of sugar in your blood can cause
damage to the nerves of your body. If the cause of the high sugar levels this
diabetes, the nerve damage is called diabetic neuropathy, and it is a common
and serious complication of that disease.
SPEAKER 2:
We 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.
SPEAKER 1:
What nerves do high blood sugar levels damage, and what
are the symptoms?
SPEAKER 2:
High 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
occurred.
Symptoms, when they develop, include a feeling of tingling, burning, or prickling
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 even 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.
SPEAKER 1:
What do symptoms mean?
SPEAKER 2:
Symptoms don’t necessarily mean that permanent nerve
damage has occurred, but they should warn you of your need medical attention,
because early treatment offers the best chance of relieving your symptoms, and
of 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.
SPEAKER 1:
How does high blood sugar cause nerve damage?
SPEAKER 2:
The mechanism 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. High blood sugar levels damage the walls of
the small blood vessels that supply oxygen and nutrients to the nerves.
SPEAKER 1:
If I’m diabetic, what are my risk factors for developing nerve
damage?
SPEAKER 2:
Poor control of blood sugar levels is by far the greatest risk
factor. Keeping your sugar 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. Alcohol acts directly as a poison to
nerves. Additionally, people who drink heavily frequently don’t eat the vitamins
and nutrients their nerves need to stay healthy.
SPEAKER 1:
If I’m careful, can I cure my nerve damage?
SPEAKER 2:
Diabetic nerve damage has no known cure. Treatments
focus on controlling the diabetes to slow progression of nerve damage, on
relieving the symptoms, and on managing the complications to restore function.
SSPEAKER 1:
How can a diabetic control their blood sugar levels?
SPEAKER 2:
It’s 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.
SPEAKER 1:
Tell me about other effective diabetes treatments.
SPEAKER 2:
A diabetic should keep their blood pressure under control.
Your blood pressure should be less than 130/80 millimeters of mercury. You may
require blood pressure medicine to get you to a healthy range.
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. So, if
you are a diabetic who smokes, stop.
PEAKER 1:
All of these treatments take a mental toll, don’t they?
SPEAKER 2:
All of these 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. 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.
SPEAKER 1:
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.