By Leandrae T. Lapinig
What used to be a health problem of industrialized countries, diabetes – a metabolic disorder in which the body has high sugar levels for prolonged periods of time – is also now a common concern in the Philippines.
Recent reports estimated 4.3 million Filipinos were diagnosed with diabetes, while 2.8 million remained undiagnosed in 2021. Preliminary data between January and September 2023 showed 6.4% of deaths in the country were caused by diabetes.
According to health experts, among the common complications of diabetes are heart disease and stroke, kidney disease and failure, eye damage and blindness, digestion problems and erectile dysfunction, and those affecting oral health, hearing, and mental health.
Diabetes can also harm your nerves. That damage, called neuropathy, can cause numbness and pain. The US Centers for Disease Control and Prevention says nerve damage most often affects the feet and legs but can also affect your digestion, blood vessels, and heart.
“The number of people affected by diabetic neuropathy has more than tripled worldwide since 1990, reaching 206 million in 2021,” Dr. Liane Ong, lead research scientist at the University of Washington in Seattle and coauthor of the 2021 Global Burden of Disease, Injuries, and Risk Factors Study, was quoted as saying by Medscape Medical News.
In the Philippines, more than half of those who suffer from diabetic neuropathy, according to some studies. Around 80% of those with this kind of health issue go undiagnosed – hence the condition causing more complications.
Oftentimes, doctors talk about not just one but four types of diabetes-related neuropathy: peripheral, autonomic, proximal, and focal. The website, webmd.com, gives the following insights:
Peripheral neuropathy usually affects the feet and legs although in rare cases it may also affect the arms, abdomen, and back. Among the symptoms are tingling, numbness (which may become permanent), burning (especially in the evening), and pain.
Generally, autonomic neuropathy affects the digestive system, especially the stomach. It can also affect the blood vessels, urinary system, and sex organs. Symptoms include bloating, diarrhea, constipation, heartburn, nausea, vomiting, and feeling full after small meals.
Proximal neuropathy is a rare and disabling type of nerve damage in your hip, buttock, or thigh. It is more common in men and older people with type 2 diabetes. Symptoms include pain, weakness, loss of reflexes, and muscle wasting.
Focal neuropathy can appear suddenly and affect specific nerves, most often in the head, torso, or leg. It causes muscle weakness or pain. Symptoms include double vision, eye pain, paralysis on one side of the face, severe pain in a certain area, such as the lower back or leg(s), and chest or belly pain that is sometimes mistaken for another condition, such as heart attack or appendicitis.
Research suggests that up to one-half of people with diabetes have peripheral neuropathy, according to the US National Institute of Diabetes and Digestive and Kidney Diseases. More than 30% of people with diabetes have autonomic neuropathy.
Diabetic neuropathy has something to do with glucose. This type of sugar mainly comes from carbohydrates in the food and drinks you consume. “It’s your body’s main source of energy,” the Cleveland Clinic explains. “Your blood carries glucose to all of your body’s cells to use for energy.”
Several bodily processes help keep your blood glucose in a healthy range. Insulin, a hormone your pancreas makes, is the most significant contributor to maintaining healthy blood sugar.
“If you have elevated blood glucose levels (hyperglycemia), it usually indicates diabetes,” says the Cleveland Clinic. “Diabetes develops when your pancreas doesn’t make any insulin or enough insulin or your body isn’t responding to the effects of insulin properly.”
Now, going back to glucose. “Over time, high blood glucose levels can damage the small blood vessels that supply the nerves in your body,” the Diabetes Organization in the United Kingdom points out. “This stops essential nutrients reaching the nerves. As a result, the nerve fibers can become damaged, and they may disappear.”
The Mayo Clinic says anyone who has diabetes can develop neuropathy. But these risk factors make nerve damage more likely:
Poor blood sugar control. Uncontrolled blood sugar increases the risk of every diabetes complication, including nerve damage.
Diabetes history. The risk of diabetic neuropathy increases the longer a person has diabetes, especially if blood sugar isn’t well controlled.
Kidney disease. Diabetes can damage the kidneys. Kidney damage sends toxins into the blood, which can lead to nerve damage.
Being overweight. Having a body mass index of 25 or more may increase the risk of diabetic neuropathy.
Smoking. Smoking narrows and hardens the arteries, reducing blood flow to the legs and feet. This makes it more difficult for wounds to heal and damages the peripheral nerves.
A study published in 2013 found that 14% of patients with type 1 diabetes and 24% of patients with type 2 diabetes had diabetic neuropathy. About 70% had consulted a clinician for pain, but only 38% had received appropriate treatment.
Nathalie Raffier, author of the Medscape feature, said that 25%-30% of individuals with diabetic peripheral neuropathy have neuropathic pain. Not surprisingly, pain progresses with age.
Among those that can make the neuropathy worse is alcohol. Considered a toxin, it can damage nerve cells and worsen neuropathy symptoms. Experts advise those suffering from diabetic neuropathy to avoid alcohol at all costs.
Drinking coffee and other caffeine-containing drinks can also worsen symptoms. Caffeine has been found to irritate the nerves. As such, diabetics are advised to limit or avoid caffeine if they are experiencing nerve pain.
The best thing diabetics can do is to drink water and it has been found that water can reduce nerve pain. Experts say it’s critical to stay hydrated throughout the day to reduce inflammation and avoid triggering pain receptors. Eight 8-ounces of water each day is recommended. – ###
