Diabetes is a worldwide epidemic, with a growing prevalence rate in many developed nations. As it is affecting so many millions of people, you might be wondering, “can diabetes be cured?” The short answer is no, sort of, and it depends. If you’re confused, that’s ok, please read below as we get into more details about diabetes, it’s complications, and some strategies you can employ if you or a loved one has been diagnosed with this condition.
1. WHAT IS DIABETES?
Diabetes is a condition that affects blood glucose (sugar) levels; namely, it causes them to be too high for one of two primary reasons, which we will discuss below in more detail. Insulin is a hormone made from your pancreas that helps to transport glucose from our bloodstream into our cells, where it is utilised to produce energy. Diabetes is caused when your body doesn’t produce enough on it’s own or doesn’t utilise insulin well, leaving behind excess glucose in your blood. If left untreated or uncontrolled this excess blood sugar can lead to many serious health problems.
Diabetes type 1 is an autoimmune condition whereby it attacks the beta cells in your pancreas which produce insulin. This type of diabetes is usually diagnosed in children or young adults. With proper diagnosis and management, often these people can prevent most symptoms and severe complications from occurring.
Diabetes type 2 is the most prevalent form of diabetes, and occurs when your body does not produce enough insulin, or does not utilise it well. This can occur at any age, but is most often seen in middle-aged and older people. Risks of developing type 2 diabetes also continues to increase as you progress past middle-age. The most recent statistics available for diabetes in Singapore shows crude prevalence % to be roughly 20% of the population in 50-59 year olds, and nearly 30% in 60-69 year olds! This trend is expected to continue increasing as per year 2050 projection models. Clearly, we must start taking measures now to prevent this epidemic from getting worse as today’s youth and young adults mature over the years to come.
2. DIABETES SYMPTOMS AND RISK FACTORS
You may be at increased risk of developing diabetes if the following are true for you:
- Age 45 or older
- Family history of diabetes
- Overweight or obese
- High blood pressure
- Prediabetes or gestational diabetes when pregnant
- History of physical inactivity
Symptoms of diabetes can manifest in many ways, but some of the more common ones include:
- Frequent hunger, thirst and urination
- Unexplained weight loss
- Frequent or extreme fatigue
- Wounds that heal slowly or poorly
- Nerve damage (such as peripheral neuropathy and others)
- Foot problems
- Cardiovascular problems
3. MANAGEMENT, CAN IT BE CURED?
Getting back to our question at the beginning of the article, “Can diabetes be cured?” As you can see by now, it depends whether we are talking about type 1 or type 2 diabetes. There is no known cure for type 1; however, there are some management strategies which we will discuss shortly. For type 2 diabetes, technically there is no cure, but there are studies which show the disease can go into remission and be stabilised long-term. So technically you’re aren’t cured of the disease, but may be able to reach a point of not showing any signs or symptoms of diabetes, if you take the right steps.
Management for type 1 diabetes
Insulin injections are the most common and widely utilised treatment for type 1 diabetes. Injections are designed to replicate, as closely as possible, how your body would produce insulin every day in relation to your energy intake. The injections can be rapid, short, or long-acting and also work differently depending on the site of injection. If you are diagnosed with type 1 diabetes, speak with your doctor about setting the right protocols for your injection schedule.
There is also now a diabetes medication called Verapamil which has shown to help restore beta cell function in the Pancreas and has promise to help reduce insulin requirements. Some people are also now wearing implantable devices which can monitor their blood glucose in real time, linked to their smartphone app.
Management for type 2 diabetes
Luckily, the most common form of diabetes (type 2) is also the easier one to reverse with the right steps. It has been shown that diet and obesity both play a crucial role in the development of type 2 diabetes. Sometimes, these patients may be placed on medications by their doctor to help boost their body’s natural production of insulin, or their sensitivity to it.
Whether in combination with specific medications or not, we also know that personalised exercise routines and adherence to strict diets can also help reverse type 2 diabetes. Weight loss is often at the core of this strategy and studies have shown that losing even a modest amount of weight can reduce risk for type 2 diabetes by nearly 60%! Try to partake in a minimum of 150 minutes of exercise per week (30 minutes, 5 days a week). In your diet try to limit simple carbohydrates and sugar as much as possible, and increase your intake of high-protein and high-fibre foods instead. Foods high in polyunsaturated fats, such as fish, nuts, and vegetable oils, are also highly beneficial for keeping down blood sugar levels. Lastly, try to avoid alcohol as much as possible.
4. PERIPHERAL NEUROPATHY CAUSES AND TREATMENT
One of the most common problems we treat in our patients with diabetes is known as peripheral neuropathy, or sometimes also called diabetic neuropathy. The excess glucose in your blood can be toxic to nerve tissues, and over time may cause small diameter nerve fibres to die off. The most common location for this to occur is in the feet and lower legs, but can also happen in the hands or elsewhere.
Besides diabetes, other common causes of peripheral neuropathy include long-term medication use (especially cholesterol medications or those used to treat HIV/AIDS), chronic alcohol abuse, chemotherapy treatment, some autoimmune or hereditary disorders, toxic exposure, or vitamin/nutrition deficiencies, among others. Sometimes it may be difficult to pinpoint the cause(s) of your peripheral neuropathy, which is known as idiopathic neuropathy.
Different patients may experience a variety of symptoms with peripheral neuropathy. As mentioned, this will often start out in the feet and lower legs or in the hands and forearms. Some of the most common signs and symptoms may include:
- Numbness or reduced ability to feel pain or temperature changes
- Hypersensitivity to touch/pressure – even a bed sheet across the foot may become painful
- Tingling, burning, or freezing sensations
- Feeling of stepping on pins and needles
- Sharp shooting pains or cramps
- Worsening of the pain and symptoms at night
- Loss of balance and coordination
- Ulcers and infections of the feet which do not heal easily
Unfortunately, diabetic patients that go their doctors with these conditions are too often given few options to treat these secondary symptoms, and are often told to live with it as part of their condition. Thankfully, at Elite Spine Centres we have a range of therapeutic technologies and lifestyle coaching strategies in place to aid those suffering with peripheral neuropathy from diabetes and other causes. The treatment strategy will typically be multifaceted and include a combination of in-office therapy, home rehabilitation exercises, diet modifications and sometimes nutritional supplementation.
- Polychromatic Light Therapy (PLT) – Using a high density of medical grade LEDs at specific wavelengths, studies have shown an ability to stimulate the body’s natural repair mechanisms and also up-regulate Nitric Oxide (NO) production. Nitric Oxide helps to dilate small blood vessels and increases blood circulation to the extremities like the feet and toes.
- Whole Body Vibration (WBV) – High frequency vertical vibration platform is used which stimulates small fibre nerves, neo-vascularisation (blood vessel growth), and has shown ability to aid in lymphatic drainage which helps to clean the blood of toxins. This also helps with balance and coordination training, which are frequently impacted in patients with peripheral neuropathy.
- Low-level laser therapy (LLLT) – Studies have shown that specific frequencies of low-level laser light can stimulate cellular energy production and speed up wound healing, such as some patients with diabetic neuropathy might have as a complication.
- Manual manipulation and myofascial therapies – Very frequently we find patients with peripheral neuropathy symptoms to also have coexisting problems in their lower spine, hips, knees and feet. Poor posture, balance and movement problems may be to blame. Thus, a holistic approach of specific manual treatments and exercise is employed along with therapeutic technologies and lifestyle advice.
If you or a loved one suffers from diabetes or peripheral neuropathy symptoms which we described in this article, don’t hesitate to give us a call. We have helped many patients with these conditions to decrease their pain and symptoms with our customised treatment protocols, and given them back a quality of life which they thought they might not be able to achieve again. As diabetes and nerve conditions are often progressive, don’t wait until it’s too late. Take action today to start living your best life again!
Author: Dr. Michael Bryant