Diabetic neuropathy requires careful monitoring and lifestyle changes.

Jan Roger Johannesen

Q. What is diabetic neuropathy?

A. Burning, stabbing sensations in the hands and feet are painfully familiar to some people with diabetes who have a condition called neuropathy. According to the American Diabetes Associ­ation (ADA), diabetic neuropathy is one of the most common complications of diabetes.

However, severe, disabling forms are relatively rare, and many times -- with proper diet and treatment -- symptoms of neuropathy can lessen and even disappear.

Diabetic neuropathy dam­ages nerves that run through­out the body. These nerves connect the spinal cord to muscles, skin, blood vessels, and other organs.

Neuropathy symptoms occur when nerve fibers are damaged, lost, or healing. Symptoms can include prickling, tingling, burning, aching, or sharp jabs of needle-like pain. Sometimes diabetic neuropa­thy pain can interfere with sleep or daily activities.

Researchers do not yet know what causes diabetic neuropa­thy. Glucose control seems to play an important part, accord­ing to the ADA. The condition is more likely to occur in people who have had diabetes for a long time or who have poor glucose control.

In some cases, neuropathy can be prevented. In the Diabetes Control and Complications Trial study, people on tight glucose control developed diabetic neuropathy one-third less than people in the standard-treatment group.

Most doctors agree that people with diabetic neuro­pathy should reach an ideal weight, follow a regular exer­cise program, and manage blood glucose levels. In addition, avoiding alcohol and cigarettes will probably help protect nerves from damage.

Once diabetic neuropathy has started, it's important to avoid injuries and further complica­tions. For example, if you lose feeling in your feet and toes, you could injure your foot without even feeling it. Loss of feeling is why people with diabetes should not use electric blankets and heating pads without talking to their doctor first.

Diet is another way to help protect against diabetic neuropathy, according to researchers at the Mayo Clinic of Rochester, Minnesota. Alpha-lipoic acid (ALA), an antioxidant found in many vegetables, fruits, and vitamin supplements, shows promise in treating some neuropathy symptoms associated with diabetes.

When patients are given ALA, researchers have found a fourfold improvement in reducing pain. Better still, ALA produces no unfavorable side effects. Other drugs often prescribed for managing the symptoms of neuropathy typically have more side effects.

The principal dietary sources of alpha-lipoic acid are spinach, broccoli, tomatoes, peas, brussels sprouts, and liver. Alpha-lipoic acid is approved in Germany in the treatment of diabetic neuropathy, but in the U.S., the supplement is still being evaluated by the Food and Drug Administration.

Before taking alpha-lipoic acid in supplement form, be sure to talk to your doctor or diabetes educator about safety issues, dosages, and possible inter­actions with other drugs. Several multi-vitamin formulas marketed to people with diabetes include anywhere from 50 to 100 mg of ALA.

Adding ALA to your diet may help in pain management and improve nerve health and decrease episodes of diabetic neuropathy.

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