Leprosy and Diabetes: Common Questions Answered - Hansens Disease

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Several questions?


Recently, in history class, I heard the teacher mention that An Lushan had rotten hands and feet in his later years, his nose decayed, and he lost his eyesight.
The teacher suggested that An Lushan's issues might have been caused by diabetes, so I would like to consult a physician regarding several questions:
1.
Can leprosy lead to blindness?
2.
If I come into contact with a leprosy patient, is there a risk of bacterial infection and developing the disease?
3.
Why was there once a high incidence of leprosy in Taiwan that caused panic, but now there are very few new infections reported?
4.
I have heard that diabetes can lead to foot ulcers; can it also cause hand ulcers?
5.
Can diabetes cause the nose to decay?
These questions may seem strange.
I apologize for asking about diabetes in a leprosy clinic; I hope the physician can forgive me.

Haoqi, 20~29 year old female. Ask Date: 2002/12/25

Dr. Xie Nanguang reply Hansens Disease


1.
Leprosy can lead to blindness in both eyes.

2.
This may be due to insufficient awareness campaigns; on one hand, there may be fewer new cases leading to a lack of attention; on the other hand, as it is an infectious disease, efforts to prevent public panic may have resulted in limited outreach, contributing to the lack of awareness.

3.
For issues related to diabetes, please consult a specialist in diabetes.

4.
The slight delay in response is due to my search for relevant information, as there is very little documentation regarding Mr.
An Lushan's medical condition at that time, making it difficult to distinguish between leprosy and diabetes; however, based on the most primitive methods of diagnosing diabetes today, the presence of a large number of ants around the urine could indicate diabetes, which Mr.
An Lushan may have experienced, leading the teacher to conclude that An Lushan had diabetes.

Reply Date: 2002/12/25

More Info


Leprosy, also known as Hansen's disease, is a chronic infectious disease caused by the bacterium Mycobacterium leprae. It primarily affects the skin, peripheral nerves, mucosal surfaces, and eyes. Diabetes, on the other hand, is a metabolic disorder characterized by high blood sugar levels over a prolonged period. Both conditions can lead to significant health complications, but they are distinct in their causes and effects. Let's address your questions one by one.

1. Can leprosy cause blindness?
Yes, leprosy can lead to blindness, primarily due to damage to the nerves that control the eyes and eyelids. The disease can cause a loss of sensation in the cornea, leading to injuries that can go unnoticed. Additionally, the inability to blink properly can result in exposure keratitis, which can further damage the eye and potentially lead to blindness if not treated.

2. Can I get leprosy from contact with a leprosy patient?
Leprosy is not highly contagious. It is believed to spread through prolonged close contact with an infected person, particularly through respiratory droplets. However, the majority of people have a natural immunity to the bacteria, and only a small percentage of those who come into contact with the bacterium will develop the disease. Therefore, casual contact is unlikely to result in infection.

3. Why has leprosy become less common in Taiwan?
The decline in leprosy cases in Taiwan and many other parts of the world can be attributed to effective public health measures, including early diagnosis, treatment with multidrug therapy (MDT), and increased awareness. The stigma associated with leprosy has also decreased, leading to better access to healthcare for affected individuals. As a result, new cases have significantly declined.

4. Does diabetes cause foot ulcers and can it affect the hands?
Diabetes can lead to foot ulcers due to neuropathy (nerve damage) and poor circulation. When blood sugar levels are poorly controlled, it can damage nerves, leading to a loss of sensation in the feet. This can result in unnoticed injuries that can become infected and lead to ulcers. While foot ulcers are more common, diabetes can also affect the hands. Diabetic neuropathy can lead to similar issues in the hands, including loss of sensation and increased risk of injuries.

5. Can diabetes cause nasal tissue damage?
Chronic high blood sugar levels can lead to various complications, including skin infections and poor wound healing. While it is less common for diabetes to directly cause nasal tissue damage, individuals with diabetes are at a higher risk for infections, including those that can affect the nasal passages. Additionally, conditions like diabetic rhinitis can lead to nasal symptoms, but significant tissue loss is more typically associated with infections or other underlying conditions.

In summary, while leprosy and diabetes can both lead to serious health issues, they do so through different mechanisms. Leprosy can cause blindness and skin lesions, while diabetes can lead to neuropathy, poor wound healing, and increased susceptibility to infections. If you have concerns about either condition, it is essential to consult a healthcare professional for appropriate evaluation and management.

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