Monday, August 22, 2011

Sometimes Pain is Good

By now I’m sure we are all familiar with Type 2 Diabetes Mellitus (DM). It is a disease that touches almost everyone’s life. Let’s quickly review what DM is. After eating a meal containing carbohydrates, the body breaks down the food and absorbs the available nutrients, which in turn increases the amount of sugar in the blood. In order to use that sugar, the body secretes insulin to move the sugar out of the blood and into our cells. In DM, our cells become insensitive to insulin, so that even if insulin is present, the sugar stays in the blood.

So your blood sugar is higher. So what? It doesn’t cause any pain, so why worry about it? Therein lies the problem! We need pain… Let me explain.

The problems with high blood sugar are numerous, and I hope to eventually address all aspects of this condition in future blog posts. But for now, we will focus the discussion around the notion of losing protective pain sensation. We have millions of nerve endings in our skin and bone that signal pain. With prolonged periods of high blood sugar, those nerves begin to swell and lose their capacity to function properly. As a result, we lose the ability to sense pain in our extremities, especially in the foot and ankle.

Sounds like a nice side effect right? Wouldn’t life be great if all the foot aches and pains we experience suddenly disappeared? You might be tempted to agree, but in truth, pain serves a very important purpose. Pain keeps us from engaging in activities that have potential to injure vital structures in the body. It alerts our brain to immediate needs that need to be addressed. Without it, you are at risk of injuring yourself without even knowing it. Instead of feeling the pain of a minor cut on a toe and applying a band aid, you don’t feel anything and walk around with an open cut ripe for infection. Losing pain sensation is known as Peripheral Neuropathy, and it commonly accompanies DM. Peripheral Neuropathy is often the root cause of many problems faced by diabetics.

Hopefully, it is clear why pain so is important to being healthy and why blood sugar needs to be tightly controlled. But if I haven’t scared you yet, stay tuned for next week’s blog. We’ll discuss a devastating complication of peripheral neuropathy that severely handicaps the foot’s function. And the worst part about it is that you won’t even feel it!