Shocking Truth About Diabetic Neuropathy

August 12, 2024
Restore Podiatry Staff

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?

How Sugar Affect Nerve Damage

So, first, we’re going to find out how sugar affects nerve damage. Take a look at the diagram:

Too much sugar (glucose) leads to increased sorbitol, which then leads to an increase in fructose. Overall, this whole process increases osmotic stress and decreases ATP activity, ultimately leading to neuropathy and nerve damage.

There’s another pathway for nerve damage, as shown in this diagram.

Here, you can see that too much sugar leads to the formation of AGEs (Advanced Glycation End-products), which then cause an increase in radical oxygen species. These radical oxygen species lead to oxidative stress and injury to the nerves.

This is another helpful diagram.

That explains in detail how too much glucose leads to an increase in AGEs, oxidative stress, inflammatory stress, and superoxide production, along with the accumulation of ROS (Reactive Oxygen Species). Unfortunately, this reduces ATP production, leading to further nerve damage.

On the right, you can see a picture of the blue covering sheath, which is called Myelin.

This is what healthy Myelin looks like. However, the one labeled in red shows a damaged Myelin sheath, which affects nerve signal transfer, disrupting communication from your nerves all the way back to your brain.

This is another diagram.

You can see that too much sugar can also lead to excessive oxidative stress, which causes damage to the circulatory system. You could develop microvascular damage, which reduces the blood flow and supply to the nerve itself. This leads to less oxygen and fewer nutrients being delivered to the nerve, resulting in damage to the Myelin sheath covering.

Effects Of Gabapentin And Lyrica On Nerves

This is a nice table from different articles showing the effects of Gabapentin and Lyrica on nerves.

As you can see under the column “Effect on Pain,” this article mentions a reduction in pain signal transmission. Another one mentions blocking sensory nerve pain transmission and inhibition of NMDA. So, basically, all of these indicate that the purpose of these medications is to reduce pain transmission to your brain.

Let me show you this nice visual cartoon diagram.

In the black circle, that is your skin inside your feet. Whatever you’re experiencing—burning, tingling, numbness, or any abnormal feeling—that is the pain message your brain is receiving to warn you that there is something wrong with the nerve and that you need to fix that nerve damage.

However, by taking Gabapentin, Lyrica, or whatever medication you’re using, will block the pain signal to your brain, so your brain will not receive any message. I put a red X mark here to show that any pain sensation you have will not be communicated to your brain.

Unfortunately, this will not fix the nerve damage you have back in the skin, in the black circle. I hope this helps you understand why diabetic neuropathy is still present despite taking those medications.

Vibratory Sensation Test

So this is one of the tests that I use on patients to find out how much of the nerve damage is present. This is called the Vibratory Sensation test. We use this instrument called a 128 Hz Tuning Fork. You should be able to feel the vibration on your toes, as well as your ankles and legs. If you don’t feel the vibration, this indicates that you are at risk of developing neuropathy.

Monofilament Test

This is another diagram. Another test is called the Monofilament test. We use this test, and we put it on each location—the three blue locations, the three red locations, the two green locations, and the orange one. We put this test on all of these spots, and you should be able to feel all of them. If you don’t feel any of them, this is another indicator that you’re at risk of developing neuropathy.

had a patient who, just a couple of months ago, was not able to feel the vibratory sensation as well as the monofilament test, and then I did the treatment on her, which is basically a combination of the laser treatment along with the other treatment. And six months later she was able to get her vibratory sensation feeling back as well as the whole 10 spots feeling back.

Neuropathy Laser Therapy

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.

Conclusion

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?

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