November is Diabetes Awareness month, and in that spirit, I wanted to discuss some of the reasons why diabetics face the challenges that they do. The three subjects that diabetics commonly wrestle with are neuropathy, immunopathy, and vasculopathy. All three are tied to the excess blood sugar present in a diabetic patient.
Neuropathy is a term meaning malfunctioning nerves. As mentioned before, a diabetic patients blood sugar is not as tightly controlled as a non-diabetic. Often the excess sugar will begin to deposit in places it is not normally found, like a nerve. Sugar is osmotically active, meaning that sugar will attract water to it. When sugar draws excess water to a nerve, the nerve begins to swell and be compressed against surrounding tissue. This can cause numbness, or a low aching pain, especially in the legs and feet. When nerves stop functioning, a person loses the ability to sense pain. This lack of sensation may be so blatant that a diabetic could step on a nail and not feel a thing.
Immunopathy is a term meaning a malfunctioning immune system. White blood cells are the cells that protect the body from bacteria and other infections. They help the heal cuts and scrapes we get normally. But just like before, high blood sugar causes white blood cells to malfunction. Instead of wounds healing fast and clean, non-healing ulcers can form. These ulcers can act as entry points for bacteria into the body.
Vasculopathy is a term meaning malfunctioning arteries and veins. It has been shown that diabetic arteries tend to harden and become narrowed very fast. So in addition to not feeling pain when an injury happens and white blood cells not healing the injury, diabetics have decreased blood flow to the legs and feet, thus decreasing the chance of healing an injury.
If not cared for quickly, a non-healing wound on the legs or feet may set the stage for amputation. It is imperative for diabetic patients to routinely see a podiatrist. Their feet will thank them.