EDP column by Dr Ketan Dhatariya

“I have had diabetes for 12 years and my feet tingle at night. Why is this?”

It sounds as though you may have the beginnings of diabetes related nerve disease. Diabetes is due to having too much glucose (sugar) in the blood. If your blood sugar levels have been high for a long time then you are more likely to get the problems associated with poorly controlled diabetes. These can include eye disease and kidney disease, as well as the nerve disease.  To prevent yourself from getting these problems it is important that if you are diagnosed with diabetes to get it under control as quickly as possible and keep it under control for as long as possible.

Lots of very large medical studies have shown that good diabetes control is the key to preventing the complications of diabetes. However, equally important is keeping your blood pressure under control. Because, over time, both diabetes and blood pressure get worse, it is important to get yourself regularly reviewed at your doctors – the nurse may be able to do the tests required – to check your blood pressure and also look at your feet every year. If your blood pressure is too high, or if you have symptoms of nerve damage then you may need to see your doctor to put you on medications to help. Or, if you are already on some medication, then to increase it if necessary.

There are lots of medications that are available to help diabetes related nerve damage. It is always best to try the simple things first, such as paracetamol which many people find very helpful. After that there are a number of medications that work by helping to ‘deaden’ the damaged nerves. Many of these drugs are used as antidepressants or to help control seizures for those with epilepsy. In those conditions there may be problems where the nerves send signals to the brain in an uncoordinated manner giving the symptoms. The drugs help to calm the nerves down. By using these drugs does not mean to say that you have depression or epilepsy, but that the drugs are helpful in this situation. Often the dose may need to be increased or, if they do not work or if you get side effects, they may have to be changed to another drug. It is often a matter of trial and error.

As always, it is best to discuss new symptoms with your pharmacist or your GP who will be able to help you more.

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