Sweet Relief: Understanding the Connection Between Diabetes and Chronic Pain

What is Diabetes?

Approximately 30 million Americans live with diabetes, a chronic condition affecting how the body processes food into glucose—a vital energy source for cells. When glucose builds up excessively in the bloodstream, the pancreas typically responds by releasing insulin, a hormone essential for transferring glucose into cells. However, individuals with diabetes either do not produce enough insulin or cannot utilize insulin effectively, leading to elevated blood sugar levels.

Diabetes comes in two primary forms:

Type I Diabetes: An autoimmune condition where the pancreas stops producing insulin due to immune system attacks on insulin-producing cells. Type I diabetes often develops during childhood or adolescence, requiring lifelong insulin therapy.
Type II Diabetes: The most common type, occurring when the body develops resistance to insulin or when the pancreas doesn't produce enough insulin to maintain normal blood sugar levels. This type typically develops later in life, commonly associated with obesity, sedentary lifestyles, and genetic factors.

How Diabetes Affects the Body

Prolonged high blood sugar levels from diabetes can significantly impact various bodily systems, especially nerves and blood vessels, resulting in diabetic neuropathy—a type of nerve damage. This damage can interfere with normal nerve signaling and blood circulation, affecting multiple organs and tissues throughout the body.

Diabetic neuropathy can lead to severe complications, including:

Peripheral Neuropathy: Affects the feet and legs, causing increased risk for ulcers, infections, and joint damage. Symptoms include burning sensations, numbness, and loss of coordination, making daily activities challenging and potentially dangerous due to reduced sensation.
Autonomic Neuropathy: Disrupts the autonomic nervous system, affecting heart rate, blood pressure, digestion, bladder control, and sweating. Patients may experience dizziness upon standing, digestive issues such as bloating or constipation, and difficulty regulating body temperature.
Proximal Neuropathy: Weakens muscles in the hips, thighs, and legs, often resulting in difficulty walking or moving. This type typically causes sudden, severe pain and can significantly limit physical activity.
Mononeuropathy: Targets a single nerve, leading to sharp, localized pain typically felt in the thigh, shin, or foot. Symptoms tend to be sudden and severe but often resolve spontaneously over time.

Additionally, diabetes-related nerve damage elevates risks for heart disease and kidney dysfunction due to impaired blood vessels. High blood sugar can cause vascular damage, reducing blood flow to vital organs and increasing the risk of strokes, heart attacks, and kidney failure.

Chronic Pain Associated with Diabetes

Chronic pain from diabetic neuropathy varies widely but frequently includes:

Numbness and Tingling: Commonly felt in feet, legs, hands, and upper body due to nerve damage. Persistent numbness can lead to unnoticed injuries, resulting in infections and complications.
Foot Damage: Can progress to joint and bone deterioration, significantly impacting mobility and potentially leading to severe complications, including ulcers and amputations if left unmanaged.
Shoulder Pain (Frozen Shoulder): Diabetes can cause joint stiffness and muscle impairment in the shoulder, resulting in limited mobility and chronic discomfort. This condition may severely impact daily activities like dressing or lifting objects.
Back Pain: Individuals with diabetes are 35% more likely to develop persistent back pain due to nerve inflammation and damage. This can significantly reduce mobility and overall quality of life.
Skin and Oral Health Issues: Increased susceptibility to bacterial and fungal infections on the skin and mouth, including conditions like oral thrush and slow-healing wounds.

Managing and Relieving Chronic Pain from Diabetes

While diabetic neuropathy currently has no definitive cure, several approaches can help manage symptoms and slow disease progression:

Medication Management: Following a proper medication regimen as prescribed by your healthcare provider is crucial for managing diabetes and related neuropathic pain. This includes regularly taking medications aimed at controlling blood sugar levels, such as insulin, metformin, sulfonylureas, or SGLT2 inhibitors, to help prevent or slow nerve damage. Additionally, specific medications may be prescribed to address diabetic neuropathy symptoms, including anticonvulsants (e.g., gabapentin), antidepressants (e.g., duloxetine), or topical creams formulated for nerve pain relief. Regular communication with your healthcare provider about your symptoms and medication effectiveness is essential to safely adjust dosages and optimize your overall diabetes and pain management
Regular Exercise: Physical activity can lower blood sugar levels, enhance circulation, and improve nerve function. Activities like walking, swimming, or cycling can significantly benefit individuals with diabetes.
Proper Footwear: Diabetic shoes can reduce foot pressure points, decreasing the risk of painful ulcers and infections. Regular foot checks and careful foot hygiene are crucial preventive measures.
Healthy Diet: Consuming a balanced diet high in fiber (such as whole grains, vegetables, and fruits) can help regulate blood sugar levels, thereby managing pain symptoms effectively. A diet low in refined sugars and processed foods is particularly beneficial.
Pain Management Techniques: Interventional pain management strategies, guided by specialists like Dr. Matthew Kohler of Ospina Medical, can significantly reduce pain and improve quality of life. Treatments may include nerve blocks, spinal cord stimulation, and medication management tailored specifically for diabetic neuropathy.

Seeking Specialized Care

Living with diabetes-related chronic pain requires careful management and tailored treatment strategies. For personalized guidance, book your initial consultation today with Dr. Matthew Kohler at Ospina Medical. Dr. Kohler specializes in interventional pain management, offering comprehensive care plans that may significantly improve pain management and overall quality of life.

Written By: Kaitlyn Tsai

Edited By: Camden Rowe

Medically Reviewed By: Matthew Kohler, MD