Dec 19

Diabetic Neuropathy

DiabetesBariatric surgeons see a good many patients who are obese and also suffer from obesity-related conditions like heart disease or diabetes. In turn, these patients often develop problems related to those conditions. For diabetics, one of the most common results is “diabetic neuropathy” or “diabetic peripheral neuropathy.”

Because diabetes damages the tiny blood vessels that carry oxygen to nerves, those vital tissues are damaged. Over time, the nerve tissues will lose the ability to function properly. They will “misfire,” sending messages too slowly, at the wrong time or not at all. The symptoms of diabetic neuropathy often develop gradually, and patients may not notice anything until a lot of damage has occurred. For some patients, the symptoms are mild, but for others, this neuropathy can be very painful, even disabling. You may have seen prime-time advertisements for Lyrica or Cymbalta, drugs used to treat these symptoms.

The fact that these ads are seen in expensive, prime-time slots should tell you how common this condition is. A few weeks ago, we commented on this in our article, “Diabetes is Prime Time.” It is a “growth market” for pharmaceutical companies and they will pay big money to get their products known to the public. Unfortunately, these drugs may be effective for relieving pain, but they will not cure the condition. There is no cure for diabetic peripheral neuropathy. We do not know how to repair the damage done to nerve tissue. Naturally, the best solution is to prevent the problem if at all possible.

Proper foot care is extremely important to diabetic patients. Feet are the most peripheral part of a person’s circulatory system (the most distant from the heart) and they have the greatest potential for nerve damage, infection, ulcers, sores, and problems with circulation. If these problems are not treated quickly, they will develop into serious conditions, even resulting in amputation of the foot in the most severe cases.

About one half of diabetes patients will develop neuropathy, most often in the feet, but also in the arms and legs. This can cause numbness, pain, tingling, or burning sensations. Peripheral neuropathy is the most common complication of diabetes. For diabetic patients, control of blood sugar is the most important factor in preventing diabetic neuropathy.

The first line for this control is the patient themselves and good care from primary care doctors and specialists. When these measures are not effective, bariatric surgery is the most effective treatment for type-2 diabetes in individuals who are affected by obesity. Weight loss surgery may result in remission or improvement in nearly all such type-2 diabetes cases. Bariatric surgery procedures (gastric sleeve or gastric bypass surgery) improves type-2 diabetes in nearly 90% of patients by reducing or eliminating medications, reducing blood sugar levels to normal levels and improving diabetes-related problems like neuropathy.

Last week we commented on the growing body of evidence that supports these facts. (see “Evidence Supporting Weight Loss Surgery Mounts”). After several decades of observation, medical science has come to the conclusion that for some individuals, bariatric surgery is the best option for treating type-2 diabetes. If you have any question about, bariatric surgery or any other area included in general surgery, please contact our office. You may use Contact Dr Birkedal or phone us at (386) 210-9794. Our offices, located in Daytona, New Smyrna and Palm coast are all part of the Florida Hospital Network.

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