Hey, today I wanted to talk about Diabetic Neuropathy. How does too much sugar cause nerve damage? What is the best way to stop further nerve damage, and how can we improve nerve damage instead of just blocking nerve pain?
Excess glucose in the body triggers several harmful processes that contribute to nerve damage.
One key pathway involves the conversion of glucose into sorbitol and then fructose. This process increases osmotic stress within nerve cells and reduces ATP production, which is essential for cellular energy. As a result, nerve function declines and neuropathy develops.
Another pathway involves the formation of Advanced Glycation End-products (AGEs). These compounds increase the production of reactive oxygen species, which leads to oxidative stress. This oxidative damage directly injures nerve tissues.
Additionally, high glucose levels promote inflammation and further oxidative stress. This combination reduces ATP production even more, worsening nerve damage over time.
Nerve health also depends on the integrity of the myelin sheath, which acts as a protective covering around nerves. In healthy conditions, this sheath allows proper signal transmission. However, when damaged, nerve communication becomes disrupted, leading to symptoms like numbness, tingling, and burning sensations.
Excess sugar can also damage small blood vessels. This reduces blood flow to nerves, limiting oxygen and nutrient supply. Over time, this contributes to further degeneration of the myelin sheath and overall nerve function.
Medications such as Gabapentin and Lyrica are commonly prescribed for neuropathy.
These drugs primarily work by reducing pain signal transmission to the brain. They may block sensory nerve signals or inhibit certain pathways involved in pain perception.
While this can provide relief from symptoms, it is important to understand that these medications do not repair nerve damage. Instead, they prevent the brain from receiving pain signals.
Pain itself is a warning sign that something is wrong with the nerves. When this signal is blocked, the underlying nerve damage may still be present and continue to progress without being addressed.
One method used to assess nerve damage is the vibratory sensation test.
This test uses a 128 Hz tuning fork placed on areas such as the toes, ankles, and legs. A healthy individual should be able to feel the vibration clearly.
If the vibration is not felt, it may indicate reduced nerve function and a higher risk of neuropathy.
Another commonly used test is the monofilament test.
This involves applying light pressure to multiple points on the foot using a specialized filament. Patients should be able to feel each point.
If certain areas cannot be felt, it suggests loss of protective sensation, which is a key sign of neuropathy.
So basically, I’ll explain a little more about the laser treatment. So there are a couple of articles I wanted to share with you. This is a very nice article, let’s talk about laser treatment on nerve repairs.
So basically, as you can see this article is from 2022 and I highlighted where you can see laser therapy increases ATP synthesis as I explained earlier, too much glucose leads to reduced ATP synthesis, whereas with laser therapy we want to increase ATP synthesis and reduce oxidative stress and that will produce a significant amount of structural and cellular changes for the nerve. Basically, one way to improve nerve damage.
This is another nice article Enhancement of Nerve Regeneration by Therapeutic Laser published in 2010. So basically, this is the link at the bottom which you can copy and paste in the the link so you can read more about it.
It’s basically talk about that the laser actually shows that it can actually heal the nerve. This is the references and I hope this helped you to understand a little bit more about neuropathy and how neuropathy can be stopped. And what can we do to improve the nerve damage?
About the Author
Dr. Davinder Bhela, DPM
July 12, 2025
