Diabetes is a scary thing. It is almost literally a curse many people bear, and sometimes, has consequences more serious than even diabetics themselves ever come to terms with.
I recall a friend of mine – a teacher – who used to complain to me on a regular basis about her health. She used to whine about headaches while teaching, nausea, fatigue… and we usually listened (as best as we could anyway, as some of the stories tended to be re-runs). We were never really surprised with her stories, given the stressful nature of her job, and the fact she made no secret the fact she had type-II diabetes.
One day however, she started complaining about pain on top of her foot. Of course we listened, and of course she was met with our usual responses and advice. “Maybe you’re working too hard?” I asked her. And we shrugged it off.
She started to complain more and more about the pain though. I started to worry for her, as it had been two weeks since she first told us about it, and she claimed it seemed to have spread to both feet. She tried to act calm, and laughed off my advice to see a doctor. The last straw came a few hours later; she started to complain about pain in her lower abdomen, right where the liver should be.
I set an appointment with a doctor to have her checked up. When he finally did so, we found out her diabetes had damaged her peripheral nervous system.
Peripheral neuropathy is a condition where the peripheral nervous system – the system of nerves that sends signals from the brain and spinal cord to the target organs and back – has its function impeded for any number of reasons. It is the most commonly caused by diabetes, and is also the most common cause of death among diabetics. Diabetes is thought to lead to this condition when capillaries that supply nerves or innervated tissue are damaged by the high concentrations of sugar in the blood. This damage can happen anywhere in the body, and because of that, it can affect any number of systems and organs. Without proper treatment, peripheral neuropathy could escalate to cause more pain, or even dulling of sensor motor function.
The doctor prescribed duloxetine. The drug, though meant to treat severe anxiety or depression, was meant to dull the pain of peripheral neuropathy by inhibiting reuptake of the neurotransmitters called serotonin and norepinephrine. He also put her on a short physical therapy program and warned her to be stricter with regards to her glucose control; advice she took happily.
The treatment worked; while the doctor told us that the only true way of dealing with diabetic peripheral neuropathy is to observe and control glucose levels, the physical therapy and medication worked wonders to reduce the liver pain and foot pain my friend was going through. As it turns out, the body is able to reverse the damage dealt to the nervous system; but only if the onset of neuropathy is recent. Had we waited even a few days longer, the damage could have been permanent.