The tingling, burning, itching, and numbness of diabetic neuropathy are well known to all too many diabetics. But did you know that the condition can be triggered not just by high blood sugars but also by too much salt?

After five to ten years of poorly controlled diabetes, many diabetics experience a form of nerve damage known as diabetic neuropathy. This condition manifests itself in an astonishing number of ways. There can be the well-known

* Numbness or insensitivity to pain or temperature
* Tingling, burning, or prickling
* Sensitivity to touch, even light touch and
* Sharp pains and cramps

of peripheral neuropathy. But there can also be the

* Bloating, alternating constipation and diarrhea (diarrhea is worse at night), nausea and vomiting, loss of appetite
* Copious sweating while eating
* Dizziness when moving from seated to standing position
* Overheating and
* Problems with bladder control

of autonomic neuropathy. And there can even be the

* Aching behind an eye
* Chest or abdominal pain sometimes mistaken for angina, heart attack, or appendicitis
* Double vision
* Inability to focus the eye
* Pain in the chest, stomach, or flank
* Pain in the front of a thigh
* Severe pain in the lower back or pelvis and
* Problems with hearing

of focal neuropathy, all caused or aggravated by prolonged, uncontrolled, high blood sugars in diabetes.

All of these wide-ranging varieties of nerve damage in diabetes stem from a combination of high blood sugars, deficiencies in antioxidants, high triglycerides and cholesterol, and too much salt. Uncontrolled blood sugars cause an accumulation of hydroxyl radicals, peroxinitries, and superoxides, all of which soak up antioxidants needed to protect nerves. If there are enough antioxidants in circulation, however, the free radicals don't do damage.

When there is a shortfall in available antioxidants, free radicals attack the structure of a nerve, causing it to be riddled with holes, known as vacuoles. When enough vacuoles accumulate, the nerve simply dies.

Treating this panoply of nerve problems is accomplished, as you might imagine, with antioxidants. The best-studied antioxidant for this purpose is alpha-lipoic acid. Relatively high doses of alpha-lipoic acid, 600 to 1800 milligrams a day (the absolute maximum you should take), often restore sensation and then relieve burning over a period of 3 to 4 weeks.

You do have to continue to take the alpha-lipoic acid to get its benefits, and you should take a formula that combines alpha-lipoic acid with the B-vitamin biotin, which alpha-lipoic acid depletes. Or, even better, keep your blood sugars under control. Just a few weeks of keeping blood sugars under 100 mg/dl (5.5 mM) all the time, not just after meals, begins to reverse diabetic neuropathy in noticeable ways.

There are several other ways to treat this condition:

* Acupuncture relieves pain, but it won't work if you are on certain antidepressants. That's because the mechanisms through which acupuncture relieves pain depends on an adequate amount of serotonin at the nerves. If you are still building up serotonin levels, the acupuncture will not work.
* Transcutaneous electrical nerve stimulation (TENS) can relieve pain caused by neuropathy in the hands and feet. Just don't start with the setting too high.
* And if dizziness is a problem, try elastic stockings. Keeping circulation going to the brain prevents vertigo.



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