If you are a Type-1 diabetic, then your pancreas fails to produce insulin, which is an essential molecule that allows the cell membranes to allow entry and metabolize glucose (aka sugar) molecules. If you are a Type-2 diabetic, then your pancreas produces insufficient insulin to efficiently metabolize the quantity of glucose you consume. Supplemental insulin and other types of treatment may be necessary under those circumstances. 

The excess glucose remains inside your bloodstream, where it can damage and destroy nerve cells over time. We call this neuropathy. It can also inhibit skin cells from healing, which can cause non-healing wounds (aka ulcers). This is why surgeons recommend getting your diabetes under control before proceeding with surgical intervention to treat an unrelated medical condition.

How this disorder can affect your abilities to complete basic work activities can be profoundly disabling. Neuropathic pain, numbness, and tingling in the feet may prevent someone from standing and walking for a full working day. Neuropathic issues with the hands may cause someone to be unable to operate a computer, telephone, and other essential technology in today’s digital economy. Many of our clients have been terminated or quit due to the overwhelming complications from diabetic neuropathy.

Based on representing thousands of clients with this condition, a strong case typically charts the following course:

  1. Referral: Establish care with an Endocrinologist. Your primary care physician can refer you to one. 
  2. Compliance: Take your medications every day. Find a system to make this work for you. (If the SSA sees any signs of non-compliance in your medical records, then they will severely discount the severity of this condition.)
  3. Monitoring: 
    1. Check your blood sugars at least twice daily.
    2. Has your A1c been measured? Try measuring it 2-3 times every year.
  4. Compliance: Achieve dietary compliance and report it to your doctor.
    1. Cut these out (1) soda pop, (2) candy, (3) alcohols, (4) carbohydrates, and (5) anything else recommended by your doctor.
    2. Replace them with (A) water/juice, (B) fresh fruits and vegetables, and (C) anything else recommended by your doctor.
  5. Routine Treatment: Get diabetic foot examinations. If neuropathy affects your hands, then have the same doctor test those too.

written by: Jacob Hugentobler, Hearing Attorney

Image Credit (Hand): Peripheral Neuropathy, Complete Spine & Pain Care, available at https://www.completepaincare.com/patient-education/conditions-treated/peripheral-neuropathy/

Image Credit (Feet): Avery Hunt, New Capsaicin Patch Helps to Reduce Diabetic Peripheral Neuropathy of the Feet, Practical Pain Management (08/13/2020), available at https://www.practicalpainmanagement.com/resources/news-and-research/new-capsaicin-patch-helps-reduce-diabetic-peripheral-neuropathy-feet