If you have diabetes, you know it well: Too much sugar isn’t good for you. People whose blood sugar is too high or difficult to control are more susceptible to cardiovascular disease, kidney damage, eye problems and other complications, including nerve damage (diabetic neuropathy).
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“High blood sugar is toxic to your nerves,” says pain management specialist Robert Bolash, MD. “When a nerve is damaged, you may feel tingling, pins and needles, burning or sharp, stabbing pain.”
Diabetic neuropathy typically starts in your toes, feet or ankles and creeps up your body as the condition worsens, he says. However, nerve damage also can affect your hands and wrists as well as your heart, digestive system, sex organs and more.
How to avoid diabetic neuropathy
Up to 70 percent of people with diabetes have some kind of nerve damage, reports the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).
“Anyone with diabetes can get nerve damage at any time,” says Dr. Bolash. “There is an association with very high levels of blood sugar and the development of diabetic neuropathy, but the two do not always go hand in hand.”
Unfortunately, even patients with very mild cases of diabetes may be affected with severe cases of nerve pain, he says. According to the NIDDK, the highest rates of nerve damage are among people who have had diabetes 25 years or longer.
To avoid diabetic neuropathy, Dr. Bolash advises: Control your blood sugar — and keep it as close to nondiabetic levels as possible.
Bad news, good news
The bad news about diabetic neuropathy is that it’s tough to reverse. It also can cause serious problems, especially in your feet.
If you don’t feel blisters, sores or other foot injuries and don’t promptly care for them, you can develop raging, difficult-to-treat infections that, in severe cases, may require amputation.
The good news is that while you can’t always cure diabetic nerve damage, you often can relieve its symptoms.
“We work with endocrinology specialists to help patients control blood sugar levels. That’s critical to helping prevent or delay additional nerve damage,” says Dr. Bolash. “Then, to manage any discomfort, we explore a range of treatments.”
Medication, nerve stimulation offer relief
Oral medications, including prescription antidepressants and anticonvulsants, can reduce the sensation of pain. (Over-the-counter ibuprofen is usually not effective for nerve pain.) Topical medications can target pain located in a small area.
For more severe pain, advanced treatments such as nerve stimulation can make a big difference and improve function. This treatment can be applied to the skin or placed along the spinal cord to change unpleasant nerve pain into something more tolerable.
“Stimulation doesn’t fix the damage from diabetes,” says Dr. Bolash. “It tricks the brain’s ability to sense pain.”
If you have diabetes, discuss any nerve pain with your primary care physician and be sure to be screened for diabetic complications.
Physicians can diagnose neuropathy before the patient feels it, and early intervention can make a substantial difference. The sooner nerve damage is detected, the easier it can be treated.