Diabetic neuropathy is a potentially painful disease that affects many patients. The good news is that it can be managed or even prevented

Each year there are about 86,000 diabetes-related amputations in the U.S. That’s a frightening statistic, but according to the National Institute of Diabetes and Digestive and Kidney Diseases, doctors estimate that nearly half of the amputations caused by two leading and associated factors — diabetic neuropathy and poor blood circulation — could have been prevented.

Diabetic neuropathy is a term for a group of diseases brought about by diabetes that can lead to nerve damage throughout the body. Primarily it affects the extremities, and most often the feet. The precise cause of diabetic neuropathy is unknown, but researchers have found that high blood glucose levels (determined through diabetes testing) and poor blood circulation contribute to damage of the nerves and blood vessels.

For some, no symptoms

Some people with diabetic neuropathy experience no symptoms. They’re the lucky ones. “The most prevalent symptom is where the feet feel numb or tingly, like pins and needles when your foot is falling asleep,” says Dr. Silvio Inzucchio, an attending physician at Yale–New Haven Hospital and director of the Yale Diabetes Center in Connecticut. In about a third of cases, Inzucchio adds, “patients develop either very sharp pains or a constant burning discomfort.” The worst-case scenario is irreparable nerve damage and complete loss of sensation, which can lead to injuries, infection, skin ulcers and, ultimately, amputation.

“The most prevalent symptom is where the feet feel numb or tingly, like pins and needles when your foot is falling asleep,”

While not everyone with diabetes will develop neuropathy, almost half of the people who have had diabetes for more than 25 years do — and 50 percent of those patients have pain as a symptom. The pain, sometimes chronic and debilitating, cannot be completely relieved, but it can be managed with a variety of over-the-counter or prescription medications.

More generally, the disease can be managed — or even prevented when diabetes is first diagnosed — by asking diabetes questions, regular glucose testing with blood glucose monitors and changing some of the bad lifestyle habits that are the main culprits behind type 2 diabetes.

“People with diabetes need to develop healthy habits,” says Mary L. Gardner, RN, CDE, the diabetes program manager for XLHealth, a Baltimore-based company that manages Medicare patients with diabetes and other conditions. “They need to control their blood glucose, control their blood pressure, eat a well-balanced diet, exercise regularly, not smoke, limit their alcohol intake and see their doctor regularly.”

Self-care is key

“If you take better care of yourself,” says Gardner, “you have a very good opportunity to delay or prevent the complications of diabetes, including neuropathy.”

Exercise — a combination of cardiovascular and strength-training routines — is near the top of every list of treatments for diabetes. The physical benefits are far-reaching and undeniable: blood glucose control, weight maintenance, muscle toning, aerobic improvement, increased heart strength, improved blood circulation and better bone density.

“Not only does physical activity improve the elasticity of blood vessels,” Gardner says, “but it also makes the body more resilient and your mood and mental well-being better.” In fact, one of the treatments for diabetic neuropathy includes mood-enhancing drugs that are commonly used to treat depression, which often accompanies the disease.  These medications are used because they block pain pathways.

Alas, there is no cure for diabetic neuropathy, so any type of treatment will only ease symptoms. The best bet is to get blood glucose under control (use a diabetes testing meter such as the ACCU Chek meter), as that may help prevent or delay the onset of further problems. As researchers learn more about the underlying causes of neuropathy, new treatments may become available to help slow, prevent or even reverse nerve damage.