Nerve damage from diabetes is one of the complications of diabetes.
WORLD Diabetes Day (Nov 14) should be a constant reminder that this life-wrecking disease can destroy our lives as well as the lives of our loved ones. It is an irreversible disease, but with enough effort, we can delay or even halt the complications associated with the progression of the disease.
Control of blood glucose levels is paramount in order to minimise complications related to diabetes.
There are about 360 million people around the world who are living with diabetes.
According to the latest Malaysian National Health and Morbidity Survey (NHMS) in 2011, there was an alarming increase of diabetics in our population, from 14.9% in 2006 to 20.8% in 2011, which means about one in five adult Malaysians is a diabetic.
As mentioned above, diabetes is a chronic disease that is incurable, but it can be controlled. Poor blood sugar control over a prolonged period of time will lead to a number of complications, including heart disease, kidney disease, retinopathy (eye damage) and neuropathy (nerve damage).
Numbness, tingling, pain and/or a burning sensation on legs, toes, fingers, arms and hands are symptoms of nerve damage.
Did you know that 60-70% of diabetics have some form of nerve damage? If no immediate action is taken, it can lead to amputation – one of the most potentially serious complications of neuropathy.
Doctors estimate that almost 50% of all amputations are caused by neuropathy and circulatory problems that could have been prevented.
In Malaysia, a large number of diabetes patients are being admitted into orthopaedic wards in hospitals because of diabetic foot complications. The majority of them need long term hospitalisation. Some require repeated hospitalisations and surgery, while others require amputation around the foot or ankle, with some ending up with below knee or above knee amputation.
Amputations in general can be classed as major and minor. Major refers to the above or below the knee amputation whilst minor amputation refers to the removal or toes or feet.
Many of these hospital visits can be prevented through simple foot care routines. Thus all diabetics should have foot check-ups as a part of their regular care routine.
The risk of a leg amputation is 27.7 times greater for a person with diabetes.
Several key factors usually predispose to foot ulceration and ultimately amputation. These include:
- Peripheral neuropathy which reduces sensation – you may have a pebble in your shoe and can walk all day without realising it is there!
- Vascular disease which reduces blood flow to feet.
Together, these problems make it easy for one to get ulcers and blisters – leading to infections, which if left untreated, may lead to amputation.
Diabetics should have a basic awareness of the importance of foot care, and they must ensure that they go for regular foot examinations.
A basic foot care routine includes:
- Inspect your feet and toes daily and wash with mild soap. Strong soaps may damage the skin.
- Test water temperature with your fingers or elbows before immersing your feet because diabetics may not be able to feel if the water is too hot. Burns can easily occur this way.
- Gently dry your feet, paying particular attention to areas between the toes. Infection can develop in moist areas.
- If your foot is very dry, it may crack and possibly become infected. Soften dry skin with lotion, petroleum jelly, lanolin or oil.
- Report all sores, blisters, bruises, cuts, or other changes to your doctor immediately.
The risk for the development of ulceration can be assessed by a basic clinical examination of the foot.
Apart from practising good foot care and hygiene, diabetics should regularly be taking their blood sugar-lowering medications prescribed by their doctor.
A beneficial supplement for diabetics which was discovered by Japanese scientists is mecobalamin – an active form of vitamin B12 that helps regenerate damaged peripheral nerves.
Mecobalamin contains the neurologically active form of vitamin B12 vital to the central and peripheral nervous system that helps to protect against the degeneration as well as promote healthy nerves.
With mecobalamin, the liver does not need to convert the inactive form of B12, cyanocobalamin, to mecobalamin as it is already orally active.
Research has shown that this active form of vitamin B12 (mecobalamin) is more effective than the common vitamin B12 (cyanocobalamin) in regenerating damaged nerves in diabetics.
- Malaysian Diabetes Association
- National Health & Morbidity Survey 2006, MOH
- National Institute of Diabetes and Digestive and Kidney Disease (NIDDK) of the National Institute of Health, USA
- Diabetes UK
- American Diabetes Association (ADA)
- Yaqub BA, Saddiq A, Sulimani R. Effects of methylcobalamin on diabetic neuropathy. Clin Neurol Neurosurg. 1992;94(2):105-11