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Hyperglycemia does it by increasing the rate of transformation of NAD to NADH. Hypoxia makes it difficult for cells to turn NADH back to NAD. In both conditions the increased NADH is recycled back to NAD by processes that produce free radicals, chemically reactive compounds that can damage tissue. Williamson and his coauthors propose that long-term use of these processes causes the damage seen in diabetes.
However, I suspect there is some other reason. When diabetes affects the nerves, it usually takes many years of high blood sugars to cause symptoms. And the most common type of nerve damage from diabetes is peripheral neuropathy. This is pain, tingling or numbness that first occurs in the feet.owever, I suspect there is some other reason. When diabetes affects the nerves, it usually takes many years of high blood sugars to cause symptoms. And the most common type of nerve damage from diabetes is peripheral neuropathy. This is pain, tingling or numbness that first occurs in the feet.