Lifestyle diseases like diabetes and
hypertension have become endemic in our modern urban societies and health care
systems across the world struggle to cope with the burden of such diseases.
Complications and fatalities that result from these diseases often claim some
of the most productive members of our society and this has a huge cost socially
We are often warned about the high risk of
diabetes if suffering from hypertension and likewise of the high risk of
hypertension to those suffering from diabetes. Several studies suggest that the
rate of incidence of diabetes in hypertensive patients is three times higher as
compared to other patients and the same holds true if the conditions of hypertension and
Neuropathy in Diabetes
Despite the obvious link between the two
conditions we still lack a clear understanding of their role in the development
of neuropathy, which is a condition of nerve damage. Peripheral neuropathy is
one of the most persistent chronic complications of diabetes and it can have a
profound effect on the quality of life. Over the decades, researchers and
medical professionals alike have noted a distinct relationship between the
presence of hypertension and heart disease, a relationship that could also have
some bearing on the development of neuropathy. Researchers have been studying
the connection and relationship between these conditions and the progression of
treatment is simply aimed at management of the condition,
as there is no cure for neuropathy. Symptoms of neuropathy in the feet and
other forms of diabetic nerve pain can therefore only be controlled through the
management of blood sugar levels, diet, exercise and blood pressure regulation.
This makes it all the more important for us to understand the prevalence and
progression of peripheral neuropathy in hypertensive and diabetic patients.
Sural nerve damage is a subtype of peripheral neuropathy. A study was recently
conducted to this end using a morphological and morphometric study of the sural
Why is this Important to Diabetes?
sural nerve is regarded as a nerve that is purely sensory, which is why sural
nerve damage explains most of the neuropathy symptoms in diabetes. Sural
neuropathy, which is the condition of sural nerve damage, results in abnormal
tingling and sensations of pain in the skin around the foot and ankle. This is
one of the most common symptoms in diabetics and is known as diabetic foot
Findings of the Study
found that diabetes has a profound effect on the sural nerve myelinated fibers.
Myelin is an outer layer or sheath that covers most of the nerves. This heath
covers the axon of the neuron and it is essential for the proper transmission
and reception of impulses. If there is any damage to myelin or myelinated fiber
or if there is a reduction in myelin it affects nerve functioning. As the study
indicates, myelin fiber size is significantly reduced in diabetes.
the other hand, small fiber neuropathy was found to be associated with hypertension
along with a marked reduction in the number of Schwann cells. In the context of
neuropathy this is important, as the Schwann cells are responsible for the
creation and production of myelin. A reduced density of Schwann cells, as
observed in the study, therefore affects myelin formation and consequently
functioning of the nerves. Because of the relationship between diabetes and
hypertension there was an increase in the average size of myelinated fibers.
makes it clear that hypertension contributes to the development of neuropathy
and can in fact be one of the biggest risk factors for diabetic neuropathy. The
combined action of both diseases, with the two neuropathies causes complex
alterations in myelin structure with both large and small fibers neuropathy.
When diabetic neuropathy is already present it was also observed that
hypertension could then cause an exacerbation of the alterations in myelin
What are the Implications?
Diabetic neuropathy may not
be curable, but with timely intervention and management of your condition, the
progression or even the onset of diabetic neuropathy may be prevented and
delayed. Make sure that your blood sugar levels are always kept under control
with regular monitoring and timely medication. Keeping blood sugar levels
consistently within the normal range is the key to preventing neuropathy and
. In addition, dietary and lifestyle modifications are
also essential, not just to control diabetes but also to prevent the
development of hypertension. Likewise, patients suffering from hypertension
should monitor blood sugar levels as well and take steps to prevent the onset
of diabetes. As illustrated by the study, the coexistence of hypertension and
diabetes is a lot more worrying than either conditions in isolation and sadly
having one condition predisposes you to the other.