Diabetes is one of the most prevalent diseases among Australian seniors.
The latest ABS reports show that one in six people over 65 are affected (this rate has doubled in the past two decades) and that diabetes accounts for more than 10% of all hospitalisations in patients over 55. It is the seventh leading cause of death in Australia and is a major cause of pain, disability and blindness.
Much is reported about the symptoms and statistics of diabetes, yet its neurological toll on sufferers is still widely unrecognised. Diabetes results in a dramatically increased risk of stroke and other cardiovascular diseases, which can cause a ‘domino effect’ on the body’s central (the brain and spine), and peripheral (limbs and extremities) nervous systems.
What is Diabetes?
Diabetes causes elevated blood sugar levels, which often leads to elevated cholesterol levels. This can then lead to cardiovascular disease and obstructive sleep apnoea, which is common in diabetes. This both impedes the capacity to exercise and sleep well, which further increases the risk of the aforementioned conditions. All of this impairs both nervous systems and may ultimately contribute to dementia, specifically ‘vascular cognitive impairment’.
Peripheral Nerve Damage
Peripheral nerve damage is a major, and yet often underestimated, complication of diabetes. Such damage may cause:
- Pins and needles,
- ‘Burning’ pain in the feet,
- and Poor balance due to accelerated ageing of the body’s longest nerves.
Sufferers can experience troublesome foot pain (which often makes barefoot walking extremely painful), and burning pain (which can turn night-time attempts to sleep into misery). Diabetics often also experience leg-muscle pain with exercise, called ‘claudication’, preventing activities such as golf, tennis, and bowls. This inability to exercise then exacerbates the other complications of diabetes, in a vicious cycle.
The Good News
The good news is that early diagnosis, medical interventions, and lifestyle changes – especially weight-loss and exercise – can greatly relieve the symptoms of diabetes holistically, which, in turn, makes ‘sticking to’ such lifestyle changes easier; thus, improving long-term outcomes for diabetics overall.
Proper testing is imperative – not simply initial testing from a GP or Endocrinologist to establish the primary diagnosis; but regular nerve testing from an experienced Neurologist/Neurophysiologist to pinpoint any related damage and monitor the progress of any deterioration to the nerves, which can cause major complications over time if not adequately addressed.
Nerve testing also helps to exclude co-existing disorders, such as carpal tunnel syndrome and ulnar neuropathy at the elbow, which are more common in diabetics, or other disorders altogether such as renal failure, vitamin B12 deficiency, and axonal peripheral mononeuropathies. Co-existing neuropathies may appear at a superficial glance to be independent from the diabetes and even detract from or mask an accurate diagnosis if not assessed appropriately.
Courtesy of Professor John Corbett, MB, BS (HONS), FRCP (UK), FRACP, MA (Oxford), D. Phil (Oxford), MACLM, Professor of Medicine (Griffith)