Diabetes comes with a host of complications but one of the most common ones is diabetic neuropathy or nerve damage caused by diabetes. In fact, it actually accounts for hospitalisation more frequently than other complications of diabetes.

Nerve pain and damage

It is a group of symptoms that patients with diabetes may develop when the peripheral nerves are injured. It can present as numbness, tingling and pain that gradually develop over the years.

The pain can be described as sharp or burning, although in extreme cases, it can feel like someone is cutting through one’s flesh with a knife.

“It usually happens after a certain duration of diabetes and on the background of poorly controlled diabetes and sometimes also high blood pressure and cholesterol. All the nerve damages fall back to small nerve damages because the nerves are actually supplied by small vessels,” said Dr Zanariah Hussein, consultant endocrinologist.

Certain nerves control pain sensation especially at the extremities, so the first symptoms of pain are usually at these areas, especially the toes, heels and feet. It can also present in the fingers, face and neck.

How does diabetes cause nerve damage?

Let’s take a step back (no pun intended) to learn how diabetes can cause damage to the nerves. The long-term high glucose load weakens the walls of the vessels while high blood pressure can cause blood clots or even burst weak vessels. When coupled with high lipid or cholesterol, the vessels become narrowed, so the blood flow becomes further compromised.

When the vessels are damaged, it also causes damages to the nerves because their supply of oxygen and nutrients is affected. When the nerves are damaged, besides feeling pain, diabetics may also have a reduced ability to feel pain. Loss of sensation can cause injuries to these areas to go unnoticed, further complicating them, as diabetics also find it harder to heal from wounds due to their poorer blood circulation.

Treatment and management

Besides tighter glucose control, treatment involves pain management through a range of medications from topical agents and antiepileptic drugs to opioids. Physical therapy may also be prescribed to alleviate symptoms.

However, as the saying goes, prevention is better than cure.

“These complications are all related to poor diabetes control. If we diagnose diabetes earlier, get it under control, in fact, we can prevent most of these complications,” said Dr Zanariah.

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