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According to the American Diabetes Association almost 26 million children and adults live with diabetes and 79 million are at risk of developing type 2, making diabetes an epidemic. Regardless of the type, this disease can lead to serious and even fatal complications.
One of those complications is diabetic neuropathy, a condition of nerve damage in the body due to high blood sugar levels. As explained by Virginia Valentine, clinical nurse specialist, “the nerve damage occurs slowly over time and it occurs as damage to the microcirculation that serves the nerves and so they end up with damaged nerves.”
“Think of them like electrical circuits and so you’re getting signals that are false like little jabs or itching or prickly tingling, eventually numbness when the nerves are totally damaged,” said Valentine. “It’s a serious complication that is very frustrating, very disabling.”
High blood glucose levels over time can lead to diabetic neuropathy. About 15 percent of people at the time that they are diagnosed with diabetes have some nerve damage. It’s quite subtle the way it develops, kind of slowly sneaking up on people. That’s why it’s very important that individuals living with diabetes recognize it early on and treat it.
There are very obvious symptoms that include prickly-tingly feeling in the feet. They can also feel itchy and/or feel in pain, especially at night. If a diabetic is unsure, they can check for decent feeling or have their doctor test for vibratory sensation.
In 1998 Deborah Grona was diagnosed with diabetes. By 2005 she was on insulin. Two years after that, she started noticing numbness at the very tips of her toes. It moved to the middle of her foot and then it went all the way up to her ankle. A burning and tingling sensation followed the numbness.
She started going to an endocrinologist who would test her feet every month. They noticed the neuropathy progressing. Grona described her experience as “tremendous pain, like you’re walking on hot coals.” When the ends of her toes were becoming numb that’s when the trouble began.
It limited her for four years, to the bathroom, the bedroom, her home office and back. She stopped participating in family activities and/or couldn’t do a lot of things she ordinarily did.
Diabetic neuropathy occurs in a higher percentage of people in the United States who are Hispanic, African American and Native American in the United States. These groups are more likely to have diabetes than the Anglo population.
“It’s a devastating complication,” said Valentine. “Sometimes people think, well how bad can this be, but the pain can very much limit your life and it’s progressive.”
The numbness makes the body unstable when standing or walking. It makes individuals clumsy, more likely to fall or get a sore on their feet. That person can also step on something and wouldn’t even feel it, ending up with a wound that can’t heal because the circulation is poor. That can lead to an amputation. Diabetes is the leading cause of non-traumatic amputation in the U.S.
“When you go to your doctor, always take off your shoes and socks because the physician is 7-8 times more likely to check your feet if you’re sitting there with bare feet than if you don’t,” said Valentine.
Keeping the blood sugar as close to normal as possible can help keep the neuropathy at bay. The American Diabetes Association recommends an A1C of 7%. Blood glucose control is really important as well as taking care of the feet, checking them daily, applying moisturizer and keeping them from getting calluses.
“It’s important to know that if you identify diabetes in the early pre-diabetes stage, many times it can be prevented and certainly delayed which is important,” said Valentine.