Neuropathy from Diabetes

Finally some good news about the two-faced Judas

Wil DuboisBy

It's the ultimate betrayal. The diabetes equivalent of Judas. Of Benedict Arnold. Of Quisling, Philby, or Ames. Your own body turns on you. But it is, at its most basic, nothing more than a short circuit.

I'm talking about the high blood sugar complication called neuropathy. Neuro from the Greek neuron, or nerve, and pathy from the Greek pathos—disease. A disease of the nerves. But people who suffer from it generally have a simpler, shorter name for the condition. They just call it "hell."

Neuropathy from diabetes is a double-edged sword. Janus. The two-faced god of ancient Rome. It has an evil ying-yang dual nature: the short-circuiting electrical impulses of the scrambled neurons create phantom pain; while at the same time erasing all trace of "protective sensation," the biological head's up that you have a rock in your shoe or just stepped on a nail.

An elderly patient of mine summed it up for me this way: "It's not fair. I can't feel what's really there, but I can feel things that aren't." He is plagued day and night, night and day, by a sensation he tells me is like being stung by hundreds of fire ants—yet he can't even feel the carpet beneath his feet. I recently read in a medical text the rather dry statement that, "Neuropathy severely decreases the patient's quality of life." Ya think?

But for reasons that continue to astound me, neuropathic hell seems to be the complication we least like to talk about. That's odd, as it's by far the most common. The spotlight seems to always to go to blindness and kidney failure; but some degree of neuropathy is present in at least 70% of us who have diabetes. It's more a witch's familiar than a complication.

I could spend all day depressing you with statistics about neuropathy, such as slow healing, stubborn ulcers, 82,000 amputations each year, and 41,000 deaths. And that would be just scratching the surface. Neuropathy is often presented as a one-way ride from which there's no return. It's used as the big, bad, ugly baseball bat in a game of medical carrot and stick. We're told to keep our blood sugar in control to avoid joining the legion of the damned. Good old-fashioned medical tactics to scare us bad diabetics straight. We're buried in facts, figures, and statistics about how bad things will be for us if we fail.

Um…. Wait a minute... (You can't see it, but I'm raising my hand to speak. Now I'm frantically waving it over my head.)

So neuropathy from diabetes affects 70% of us, right? And recent statistics show that only 40% of us are meeting our diabetes treatment targets, right? So that means you're telling us that 60% of us are destined to fail, as it were? And that's our plan?

The conversation is so dark and one-sided, I worry that people will metaphorically crawl under a rock and wait to die. Abandon all hope all ye who enter here.

On an internet video conference the other day, my good friend, diabetes advocate and blogger George "Ninjabetic" Simmons, started talking about his personal experiences with the complication. It got me thinking about how we teach people about diabetes. How we "motivate" them.

Hell, I didn't even know George suffered from neuropathy. And he suffers greatly—but his pain is nothing more than a mild tingle. His real suffering comes from the fear of slow healing, stubborn ulcers, and only 1 amputation, and 1 death.

George also told me he was excited to attend a neuropathy session at a recent TCOYD seminar. He was even more excited when the speaker indicated that maybe neuropathy wasn't a one-way street after all. But then the speaker broke out the stereotypes, and the fear mongering, and started showing pictures of slow healing, stubborn ulcers, 82,000 amputations each year, and 41,000 deaths. George bolted for the door. Right behind him, I suspect, are the other 15-and-a-half-million not-in-control persons with diabetes in our country.

So George, I hope all the slow healing, stubborn ulcers, 82,000 amputations, and death talk so far didn't scare you off, and that you are still reading. Because I have some neuropathy news, and the news ain't all bad. In fact, I promise, for the rest of this piece all the news will be good.

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Last Modified Date: January 27, 2014

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by Brenda Bell
Many people say that depression is a side effect or complication of diabetes. Without discounting the association of the psychological condition with the physical one, I'm not convinced that our high and/or unstable glucose levels are directly responsible for that change in our mental state. My belief is that the unrelenting need for self-care, for following the sort of care schedules that can drive licensed, professional caregivers crazy, is what overwhelms us...
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