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December 13, 2000

Complications

Question from Tampa, Florida, USA:

I am 20 years old and have had diabetes for two years. I have been on an up and down rollercoaster with controlling it and then not controlling it. I went on a kayaking trip and because of the position of my legs my left foot went asleep. I didn't think anything of it, but the next day my big toe on my left foot was still numb. I am very concerned, but my next doctor appointment isn't for six months, and my doctor is really hard to get an appointment with. Is this something that will go away if I make sure (from now on) my blood sugar is in good control or is this a permanent problem caused by not having good control? Should contact a physician about it immediately? Keep in mind that lately, I have not been doing very well with diabetes control. My blood sugar has been pretty high.

Answer:

Numbness of the hands and feet is typically seen with the most common form of diabetic neuropathy. The exact reason the nerves are involved is still not clear but, there seems to be an inability of the nerves to repair themselves and produce energy to function normally. Neuropathy is more common in patients with high sugars and with a long duration of diabetes. Previous clinical trials have shown that good blood sugar control can prevent the onset or slow the progression of this complication. There are no other preventive therapies for neuropathy. Sometimes, people with diabetes can have other reasons for numbness. These other reasons may include compression of nerves, such as with carpal tunnel syndrome.However, you need to work with your physician on this because the best way to diagnose it is with a clinical exam. Sometimes EMG with nerve conduction studies are performed. I am not sure why your big toe is numb, but I do know that your blood sugars sound awfully high a lot of the time.

JTL

[Editor’s comment: I am surprised to learn that your next appointment with your doctor is in six months. People with diabetes, especially when they are not in good control, should be seen at least every three months.

SS]