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Sugar Havoc On Limbs

Nerve damage due to diabetes can ultimately lead to ulceration and amputation of the toes, feet and lower limbs.

In 1985, 30 million people worldwide were thought to have diabetes. A little over a decade later, the estimate rose to over 150 million.

Today, according to IDF figures, it exceeds 250 million. Unless action is taken to implement effective prevention and control programmes, the total number of diabetics will reach a staggering 380 million by 2025.

According to the 2011 National Health and Morbidity Survey (NHMS) conducted by the Health Ministry, one in five Malaysians are diabetic, which means diabetes afflicts up to a staggering 22% of the country’s population.

Diabetes 101

Diabetes is a chronic disease that arises when the pancreas does not produce enough insulin, or when the body cannot effectively use the insulin it produces. Insulin is a hormone that enables cells to take in glucose from the blood and use it for energy.

Failure of insulin production, insulin action, or both, leads to raised glucose levels in the blood (hyperglycaemia). This is associated with long-term damage to the body and failure of various organs and tissues.

Diabetes is a chronic, life-long condition that requires careful monitoring and control. Without proper management, it can lead to very high blood sugar levels. Complications include cardiovascular disease, kidney disease, eye disease and nerve disease, which can ultimately lead to ulceration and amputation of the toes, feet and lower limbs.

Remember: Do not ignore the signs of nerve damage!

Diabetic neuropathy

Peripheral nerves are responsible for the sensations you feel, such as touch, pain and temperature. There are literally millions of these nerve endings in your fingers, hands, toes and feet, and they keep you out of danger and away from the things that are hot, cold, sharp, etc.

In peripheral neuropathy, you may have loss of feeling, tingling, numbness or burning sensations in your feet and hands. Nerve damage starts even before a person is diagnosed with diabetes. Even somebody with pre-diabetes may have neuropathy.

Although tingling, numbness, or burning sensations in the extremities are common signs of neuropathy, others may experience no symptoms at all. Nerve damage can also occur in internal organs, such as the heart or digestive tract. People who develop diabetic neuropathy are typically those who have trouble controlling their blood glucose levels, blood pressure, cholesterol, and body weight.

How can you tell if you have nerve damage? Doctors diagnose nerve damage on the basis of symptoms and a physical examination. During the assessment, your doctor may check blood pressure, heart rate, muscle strength, reflexes, and sensitivity to position changes, vibration, temperature or light touch.

Scary amputation statistics

Up to 70% of diabetics have nerve damage, which can lead to foot or leg amputations due to reduced blood flow and sensation to the feet. Experts recommend that people with diabetes have a comprehensive foot exam each year to check for peripheral neuropathy. People diagnosed with peripheral neuropathy need more frequent foot exams.

Diabetes is one of the leading causes of lower limb amputation throughout the world – up to 50% of all amputations! In fact, the risk of a leg amputation is 27.7 times greater for a person with diabetes.

Bringing blood sugar levels to within normal range is the first step to prevent further nerve damage. Regular blood sugar monitoring, meal planning, physical activity, oral medication or insulin will help control blood glucose levels.

It may take some time, but generally, the symptoms will improve when there is good glucose control. Good blood sugar control can also help prevent or delay the onset of further problems.

Besides regular foot examinations, scientists have discovered that damaged nerves can be regenerated with a specific nutrient known as mecobalamin.

Mecobalamin is the active form of vitamin B12, which helps promote healthy nerves and protects against the degeneration process of the nervous system.