WRIC Richmond News and Weather - Diabetic neuropathy: how diabetes affects your nerves

Checking your blood sugar. Taking your insulin. Going to the doctor. Managing diabetes is hard work. But if you don't control your diabetes well, sometimes it literally can get on your nerves in the form of diabetic neuropathy.

Chronic high blood sugar levels can lead to nerve damage. About half of people with diabetes have diabetic neuropathy - nerve damage caused by diabetes.

Nerve basics

Nerves run throughout your body. They:

• Send messages to your brain, including such things as temperature, pain and touch
• Tell your muscles when to move
• Control many systems in your body, such as the digestive system

Diabetes and your nerves

Over time, chronic high blood sugar levels harm the nerves throughout the body. The nerves in the arms, legs and vital organs can all become damaged.

When nerves get damaged, they don't work well. Like faulty wiring, nerves start to fail, fire randomly and "short out." They can become unable to carry signals back to the brain. Nerve damage can also be felt as tingling and shooting pain. Damage to other nerves can cause problems with digestion, urination and heart rhythm.

Symptoms

Some people with nerve damage have no symptoms at all. Others have symptoms that start gradually and get worse over time. While some people have sudden and severe signs of nerve damage. Common symptoms include:

• Pins and needles sensation.
• Burning, stabbing or throbbing pain.
• Numbness.
• Loss of feeling in the hands and feet. This can lead to serious problems, such as infection and amputation. For example, you may walk around with a cut or injury and not even notice. A small scrape on your foot can lead to a foot ulcer (open sore). If an ulcer gets infected and is not treated, it may lead to loss of your foot or leg.

Treatment

The goals of treatment are to stop nerve damage from getting worse, and to minimize pain. The first step is to get your blood sugar levels under good control by following the diabetes care program that your doctor prescribed.

There are medicines available to help you control the pain. Talk to your doctor first before taking any new medication:

• NSAIDs (nonsteroidal anti-inflammatory drugs) may help with pain and inflammation, but can lead to stomach ulcers and kidney problems.
• Certain types of antidepressants including duloxetine (Cymbalta) and anticonvulsants such as pregabalin (Lyrica) are approved to treat the pain of diabetic neuropathy.
• Topical creams, such as capsaicin cream, that are applied to the skin may help relieve pain.

Non-medication pain relief therapies might include acupuncture, biofeedback or physical therapy. Ask your doctor if these are options for you.

How to reduce your risk

Nerve damage from diabetes can often be prevented. Here's how:

• Keep your blood sugar levels in check. Lowering A1C to goal has been shown to help prevent nerve damage in type 1 and type 2 diabetes.
• Follow your diabetes care plan as prescribed by your doctor. This will help keep your blood sugar under control.
• Exercise. Being active may help keep nerves healthy. Always talk to your doctor first before you start any exercise program.
• Care for your feet. Check your feet each day, and wear shoes that fit well. Have a comprehensive foot exam by your doctor at least once a year.
• Don't smoke. If you do, quit. Smoking raises your risks for foot problems and amputation.
• Call your doctor if you have any symptoms of nerve damage.

Some risk factors for nerve damage are beyond your control, though:

• Age. Your risk of getting nerve damage rises as you age.
• How long you've had diabetes. The longer you have diabetes, the more your chances of having nerve problems. You are most likely to have nerve damage if you've had diabetes for 25 years or longer.
• Family history of nerve damage. Problems with nerve damage can be hereditary.