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). Advertising Policy Cleveland Clinic is a non-profit academic medical center. Advertising … Read More
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 Robert Bolash, MD, a specialist in Cleveland Clinic’s Department of Pain Management. “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.
“Anyone with diabetes can get nerve damage at any time,” says Dr. Bolash. “It’s most common in people whose blood sugar is poorly controlled and those who have had diabetes a long time.” According to the NIDDK, the highest rates of neuropathy are among people who have had diabetes 25 years or longer.
To avoid getting diabetic neuropathy, control your blood sugar, keeping it as close to nondiabetic levels as possible, advises Dr. Bolash.
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 neuropathy, you often can relieve its symptoms.
“We work with endocrinology specialists to help patients control blood glucose 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.”
Oral medications, including prescription antidepressants and anticonvulsants, which 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.
Nerve stimulation is an advanced treatment that can help in cases of more severe pain. The 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.”
All patients with diabetes should discuss neuropathy with their primary care physician and 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.