Diabetes can hurt, but it doesn’’t have to!

You might be thinking – what the heck is she talking about? My diabetes does not hurt.  Well for some individuals that is true, while for others, the pain caused by diabetes-related nerve damage can sometimes seem unbearable.

Exactly what am I talking about?  It is estimated that 60-90% of all people living with diabetes will develop some type of nerve damage in their diabetes journey.  For some individuals, the nerve damage might affect their heart or their stomach, perhaps even the hand and wrist with Carpal Tunnel Syndrome (when the nerves in your wrist are compressed and your hands go numb or become painful) or Trigger Fingers (when you finger gets “stuck” and can’t open properly).  Unfortunately for most, the nerve disease is primarily in the feet and lower legs, and that is where the pain of diabetes can really be felt.

Diabetic neuropathy is the damage to the nerves throughout the body.  It is caused by too much glucose in the nerve itself.  The nerves tend to become thickened and are compressed into a small space so they become irritated.  Most individuals with diabetic peripheral neuropathy (meaning nerve disease in the periphery or limbs) report the feeling of tingling or the foot “falling asleep”.  Eventually this gets worse and they might call it hot poker pain. It tends to be worse at night so that even the weight of the bed sheets is bothersome.  With time, the nerve disease can also affect the circulation and the bone structure of the foot.  This can lead to the devastating complication of foot ulcers. 

For individuals with diabetes, it is imperative to have a full foot exam once a year.  You need to check your feet every single day for any signs of inflammation or infection.  You should perform good foot care, and never cut your toenails if you can’t see them or reach them.  Seek professional help to keep your feet healthy.  Many communities have foot care nurses to help you understand how to take care of your feet and also to help with nail cutting and callous removal.  Do not perform bathroom surgery!

But, what about the pain?  For many people this is unbearable and unfortunately the medications we use to treat the pain of nerve disease may not provide great relief.  Often painkillers are required as well.  Things you can do?  If you smoke – QUIT.  Limit the amount of alcohol you drink, as this tends to increase neuropathy symptoms, and prevent further complications by taking good care of your feet.

Most recently, a new form of treatment for the pain of diabetic nerve disease has been approved by Health Canada.  FREMS is a series of electronic impulses that appears to help with painful neuropathy by improving blood flow and oxygen to the affected area.  Often the medications prescribed to improve the symptoms may not be effective or have side effects that are not tolerated.  FREMS offers an alternative treatment with minimum risk and some good results in small studies.

So does diabetes hurt?  Sometimes it does.  The best way to prevent diabetic nerve disease is to take really good care of your diabetes.  Remember working hard at diabetes now will have a long-term effect on all complications and may help prevent your diabetes from hurting you!