Q. How does diabetes affect the nerves?
A. One of the major potential health consequences of diabetes is nerve damage, or neuropathy, which results from chronically high blood sugar levels over time. The most common form is peripheral neuropathy, which affects the nerves responsible for sensation in the arms, legs, feet, and hands. Neuropathies can also occur in the hips, thighs, or buttocks, on in nerves controlling digestion and other internal bodily functions.
Aaron Cypess, an endocrinologist at Joslin Diabetes Center and Beth Israel Deaconess Medical Center, says that diabetics who develop peripheral neuropathy usually feel numbness in the affected area, followed by tingling or “pins and needles,” and later pain. People with advanced symptoms may also have muscle weakness, difficulty walking and balancing, and a greater susceptibility to injury and infection. Other neuropathies can cause problems with digestion, urination, sexual response, vision, blood pressure, and heart rate.
Nerve damage is a big concern for diabetics, he says, because “there isn’t really anything that can reverse it.” Treatments are available to help manage some symptoms and alleviate pain, but it isn’t possible to undo damage to the nerves. “One wants to keep the blood sugar in a certain range so the likelihood of developing [neuropathy] is low, and likelihood of progression is low,” he says.
Neuropathies can arise from a host of other causes, including alcoholism, vitamin deficiency, injuries, or infections. For that reason, Cypess says, even people who have diabetes should have the condition evaluated thoroughly to understand why it’s happening.
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