Preventing And Treating Diabetic Neuropathy
Whether youre trying to prevent diabetic neuropathy, or trying to stop it getting worse, the most important thing to do is to control your blood sugar levels. That means:
- sorting out any medical problems
- following the right diet for you
- exercising regularly
- taking or using any medication prescribed
- avoiding things that can cause problems, such as smoking and excessive drinking
If you have diabetic neuropathy, discuss with your doctor or diabetes nurse how to protect your skin and deal with pain. The usual pain relief, such as paracetamol and ibuprofen, might not work with the pain of diabetic neuropathy. If so, talk to your doctor about other forms of pain relief.
You can also visit a podiatrist . They will give you advice on the best shoes and socks to help your feet.
What Are The Types Of Diabetic Neuropathy
Diabetic neuropathy can damage different nerves throughout your body. Types of diabetic neuropathy include:
- Autonomic neuropathy: Damage to nerves that control your organs.
- Mononeuropathy: Damage to a single nerve, such as in your hand or leg.
- Peripheral neuropathy: Most commonly affects your feet and legs and sometimes affects the hands.
- Proximal neuropathy: Leads to weakness in hips, thighs, buttocks and shoulders.
Understanding Diabetic Peripheral Neuropathy
High blood glucose levels over an extended period of time can damage the nerves that go to the arms, hands, legs, and feetthese are known as the peripheral nerves.
This damage prevents important nutrients from reaching these areas, as a result the nerves can no longer function properly or disappear.
Diabetic peripheral neuropathy increases the risk for foot ulcers and amputation. People with diabetes that have nerve damage in their feet and toes often don’t notice minor cuts, sores, or blisters in these areas.
If left untreated, these small wounds can easily become infected, lead to gangrene, and may eventually require amputation of the affected area.
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One Of The Key Type 2 Diabetes Symptoms: Leg Pain
In 30 seconds
Whats one of the major type 2 diabetes symptoms? Leg pain. It is the result of nerve damage or diabetic neuropathy thats a consequence of high blood sugar levels.
The glucose in your blood is normally regulated by the hormone, insulin. However, some, usually older, people develop whats known as insulin resistance. This is when the insulin that your body produces does not work as it should. Its known as type 2 diabetes and the result is high blood sugar, which can be quite serious.
Leg pain or tingling or numbness in your limbs is not the only symptom. Unintended weight loss, a need to urinate more frequently, and increased hunger and thirst are all common symptoms, too. If youre experiencing any of these, you must talk to a healthcare professional.
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Type 2 diabetes would seem benign were it not for the threat of rising blood sugar levels – the main sugar found in blood. It is an important source of energy and provides nutrients to the body but having too much of it can inflict damage on the vessels that supply blood to vital organs, thereby increasing the risk of heart disease and stroke. Constant cold feet could be a sign your blood sugar levels are too high.
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When Diabetes Leads To Nerve Damage
Nerve damage caused by uncontrolled blood sugar is a serious complication of diabetes. Find out how to protect yourself.
Tingling, numbness, pain in the arms, legs, hands, or feet these are all common signs of diabetic neuropathy, or nerve damage. Up to 70 percent of people with diabetes will develop some type of neuropathy, making it one of the most common side effects of this disease.
Diabetes: Understanding Neuropathy
Although tingling, numbness, or pain in the extremities are common signs of neuropathy, others may experience no symptoms at all. Nerve damage can also occur in internal organs, such as the heart or digestive tract. Diabetes-related neuropathy can affect muscle strength, sensation in various parts of the body, and even sexual function.
People who develop diabetic neuropathy are typically those who have trouble controlling their blood glucose levels, blood pressure, cholesterol, and body weight. Although researchers haven’t quite figured out exactly why this happens, they know that neuropathy can occur due to:
- Alcohol use and smoking
- Injuries such as carpal tunnel syndrome
- Nerves that become inflamed related to autoimmune conditions
- Neurovascular issues that damage the blood vessels responsible for bringing nutrients and oxygen to your nerves
Your risk also increases the older you get and the longer you have diabetes, with the highest rates of neuropathy occuring in people who have had diabetes for at least 25 years.
Diabetes: Where Neuropathy May Strike
Treat The Symptoms Of Nerve Damage
Peripheral nerves carry information to and from the brain. They also carry signals to and from the spinal cord to the rest of the body. Peripheral n…
- Pain in your feet, legs, or arms
- Nausea, vomiting, or other digestion problems
- Bladder problems
- Erection problems or vaginal dryness
If you’re prescribed medicines for symptoms of nerve damage, be aware of the following:
- The medicines are often less effective if your blood sugar is usually high.
- After you start the drug, tell your provider if the nerve pain doesn’t improve.
When you have nerve damage in your feet, the feeling in your feet can be reduced. You can even have no feeling at all. As a result, your feet may not heal well if they are injured. Caring for your feet can prevent minor problems from becoming so serious that you end up in the hospital.
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What Problems Does Diabetic Neuropathy Cause
Peripheral neuropathy can lead to foot complications, such as sores, ulcers, and infections, because nerve damage can make you lose feeling in your feet. As a result, you may not notice that your shoes are causing a sore or that you have injured your feet. Nerve damage can also cause problems with balance and coordination, leading to falls and fractures.
These problems may make it difficult for you to get around easily, causing you to lose some of your independence. In some people with diabetes, nerve damage causes chronic pain, which can lead to anxiety and depression.
Autonomic neuropathy can cause problems with how your organs work, including problems with your heart rate and blood pressure, digestion, urination, and ability to sense when you have low blood glucose.
How Can I Take Care Of Myself
Diabetes patients can take the following self-care measures:
Work with primary care physicians and endocrinologists to control glucose levels
Examine the skin of feet and lower legs regularly to look for injuries
See a healthcare provider promptly for calluses, sores on the skin, or other potential problems so they can be treated properly.
Wear good-fitting, comfortable shoes that protect the feet
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How Is Neuropathy Diagnosed
Diagnosis will occur on the basis of your individual symptoms and a physical exam. The doctor may test your blood pressure, heart rate, strength, reflexes and sensitivity. Foot examinations are recommended for all diabetics.
Other tests may be applied, such as:
- Nerve conduction studies
Doctors should screen for neuropathy amongst diabetic patients at least once per annum.
At an annual check the test for neuropathy will involve the doctor stimulating the foot with a small plastic implement or tuning fork to see if you correctly detect the sensation. Tests to confirm or monitor existing neuropathy may include ultrasound, nerve studies and biopsies, or referral to a specialist neuropathy consultant who may conduct further tests.
Diabetic neuropathy is the result of damage to the nerves. Nerves help us to feel sensations and also play an important part in the function of our organs.
Diabetic neuropathy is a long term complication of diabetes and tends to develop over a period of years or decades. With good blood glucose control neuropathy can be significantly delayed or avoided.
The first instances of nerve damage are likely to be noticed as reduced feeling in the bodys extremities, such as the hands and feet.
Later symptoms may include numbness, tingling, pain or a burning feeling in the feet or hands. If nerve damage affects the organs, symptoms could include:
- Delayed stomach emptying and digestion problems
- Faintness or dizziness
- Sexual difficulties
How Long Will The Problem Last
Once a person has neuropathy, the symptoms will persist indefinitely, but most people with diabetic neuropathy are able to lead active, fulfilling lives. Keeping blood sugar under good control may stop neuropathy from worsening.
For excellent patient education resources, visit eMedicineHealth’s Diabetes Center and Men’s Health Center. Also, see eMedicineHealth’s patient education articles, Diabetes Mellitus and Diabetic Foot Care.
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Bodman MA, Varacallo M. Peripheral Diabetic Neuropathy. StatPearls. 2021 Jan. . .
Carmichael J, Fadavi H, Ishibashi F, Shore AC, Tavakoli M. Advances in Screening, Early Diagnosis and Accurate Staging of Diabetic Neuropathy. Front Endocrinol . 2021. 12:671257. . .
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Bromberg MB. Peripheral neurotoxic disorders. Neurol Clin. 2000 Aug. 18:681-94. .
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Diabetes And Nerve Pain Reasons
The reasons behind diabetes leading to nerve damage are not precisely known. It is understood that uncontrolled blood sugar levels damage nerves and affect the ability to send and receive signals. High blood sugar also damages the capillaries or the small blood vessels that take nutrients and oxygen to the nerves. In some people, low Vitamin B12 levels may also cause nerve damage. The online neurologistmay prescribe blood tests to check for vitamin deficiency. Some other factors that cause diabetic neuropathy are:
- · Damaged blood vessels due to high cholesterol
- · Lifestyle factors like alcohol abuse or smoking
- · Mechanical injuries like those caused by carpal tunnel syndrome.
How Is Diabetic Neuropathy Treated
Theres no cure for diabetic neuropathy, but you can slow its progression. Keeping your blood sugar levels within a healthy range is the best way to decrease the likelihood of developing diabetic neuropathy or slow its progression. It can also relieve some symptoms.
Quitting smoking and exercising regularly are also parts of a comprehensive treatment plan. Always talk to your doctor or healthcare team before beginning a new fitness routine. You may also ask your doctor about complementary treatments or supplements for neuropathy.
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Physiotherapy Management And Exercise
Research has shown that strength training can moderately improve muscle function in people with peripheral neuropathy . Regular exercise can also help reduce neuropathic pain and help control blood sugar levels. Diabetic clients must tightly monitor their blood sugar levels during exercise to prevent major fluctuations. This may involve educating clients and monitoring blood sugars, ideally through a multi-disciplined approach in rehabilitation.
Specific exercise programs should include
- Muscle strengthening
- Aerobic activity
- Gait Evidence shows that resistant strengthening exercises lower blood glucose level
The youtube below shows some good exercises that a physiotherapist can employ to help manage the symptoms of diabetic neuropathy.
A 2014 review found that the biggest consequence of diabetic neuropathy was a increase in risk of falls. Therefore balance and falls prevention programs and or training, in the senior diabetic clientele in particular, by a physiotherapy is very beneficial.
Physiotherapy may also involve splinting for mononeuropathies eg. carpal tunnel or for muscle weakness eg Ankle foot orthoses.
As a consequence of diabetic neuropathy physiotherapist are involved in
Bladder And Sex Organs
Uncontrolled blood sugar forces your bladder to handle a lot of urine because your body retains more fluid. You may wake often at night to use the bathroom. The interrupted sleep can be one reason diabetes leaves you tired.
Or diabetes can damage your nerves so you wont feel that your bladder is full. You could leak pee. Weakened urinary muscles can make it harder for you to empty your bladder fully. Or you may pee too much.
Poor bladder control, plus high blood sugar and immune system problems, can lead to urinary tract infections .
When it comes to sex, men with diabetes are three times more likely to have trouble getting or keeping an erection . For women, their sex drive could drop, lubrication drops, and sex may hurt. Lowered blood flow or nerve problems could make it harder to have an orgasm.
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Who Is Most Likely To Get Diabetic Neuropathy
If you have diabetes, your chance of developing nerve damage caused by diabetes increases the older you get and the longer you have diabetes. Managing your diabetes is an important part of preventing health problems such as diabetic neuropathy.
You are also more likely to develop nerve damage if you have diabetes and
- are overweight
Research also suggests that certain genes may make people more likely to develop diabetic neuropathy.
What Causes Nerve Damage
It is not yet known exactly what causes the nerve damage that occurs in diabetes. However, neuropathy is more likely to affect people who have had diabetes for a long time or whose blood glucose levels have been high over a long period of time. But we don’t know how high glucose levels must be and for how long before nerve damage happens.
Neuropathy can be caused by a number of other things as well as diabetes:
- drinking too much alcohol over a long period of time
- a severe vitamin B deficiency or overdose
- an injury
- some medicines.
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Association Of Vascular Risk Factors With Dn
The risk factors for development of DSPN in 1172 patients with type I DM was studied over 7.3 years. Clinical evaluation, quantitative sensory testing, autonomic function tests, serum lipids and lipoprotein, glycosylated Hb, urinary albumin excretion rate, and serum creatinine were measured in 276 patients. In this study 23.5% developed neuropathy, which apart from the glycaemic control was related to potentially modifiable cardiovascular risk factors including raised serum triglyceride, body mass index, smoking, and hypertension. A stepwise progressive study of treatment of type II diabetic patients with hypotensive drugs, angiotensin converting enzyme inhibitors, calcium channel blockers, hypoglycaemic agents, aspirin, hypolipidaemic agents, and antioxidants. This study argues for the multifactorial nature of neuropathy and need for managing multiple metabolic abnormalities.
How Is Neuropathy Treated
The treatment for neuropathy varies based on the nerves affected. here are a number of medications doctors may prescribe for different types of neuropathy to help with pain and functional problems. Be sure to see your healthcare provider yearly with a list of any symptoms you are experiencing.
For example, people with gastroparesis may need specialized advice on how to change their eating to best cope and perhaps medication to help with digestion. Those with sexual dysfunction may benefit from specific treatments that address these issues.
When it comes to pain management due to neuropathy, pregabalin or duloxetine are usually the first lines of treatment for people with diabetes. Gabapentin can be used while taking into account cost and patients comorbidities and potential drug interactions. Tricyclic antidepressants may also be prescribed. Due to addiction risk and other factors, the use of opioids is not recommended as the first or second line of treatment.
Aso, for those who have nerve damage in the feet, regular foot exams become essential:
Remember, the most important thing is to optimally manage blood sugar levels. It is never too late to improve blood sugar control. Make sure to see a healthcare provider each year to talk about your symptoms. Earlier treatment usually leads to improved outcomes.
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Diabetes Nerve Damage Risk Factors
Diabetes can eventually lead to nerve damage. But any of the following factors are likely to increase your chances of developing diabetic neuropathy:
- · Uncontrolled levels of sugar in the blood heightens the risk of developing diabetic complications, including nerve damage.
- · The longer you have had diabetes, the higher the chances of damage to the nerves. The possibilities become higher if diabetes has been uncontrolled.
- · Being obese or having a Body Mass Index of more than 25 increases diabetes nerve damage risk.
- · Smoking hardens and narrows the arteries, thus reducing the blood supply to the feet and legs. It leads to nerve damage.
- · Diabetes affects the functioning of kidneys. Damaged kidneys are unable to process wastes efficiently and send toxins back into the blood causing nerve damage.