Diabetes can damage the nerves that carry signals throughout the body. This nerve damage is known as diabetic neuropathy.
When you have diabetes, you are more likely to have high levels of glucose and triglycerides in your bloodstream. Given enough time, these will damage the nerves that send pain signals to your brain and also the small blood vessels that supply nutrients to the nerves…causing neuropathy.
Obviously, the best way to prevent or delay the onset of diabetic neuropathy is to control blood glucose and blood pressure.
Four main types of diabetic neuropathy
Nerve damage caused by diabetes can manifest itself in various parts and functions of your body. Symptoms vary depending on the type of diabetic neuropathy you have.
There are four main types…
autonomic neuropathy It is a group of symptoms that occur when there is damage to the nerves that control daily bodily functions, such as blood pressure, heart rate, sweating, digestion and emptying of the bowels and bladder, and digestion. It causes a major disruption in the functioning of your body.
mononeuropathy gold focal neuropathy is damage to a specific nerve in the face, torso (half of the body), or leg. It is more common in older adults. Mononeuropathy often strikes suddenly and can cause severe pain. However, it usually does not result in any long-term problems.
proximal neuropathy It is a rare and disabling type of nerve damage in the hip, buttocks, or thighs. This nerve damage usually affects one side of your body, making movement difficult, but it rarely spreads to the other side.
diabetic peripheral neuropathy (DPN) is the most common type of diabetic neuropathy and is the main subject of this essay.
DPN is damage to the nerves that allow you to feel pain, heat, and cold. It usually affects the feet and legs first, followed by the hands and arms.
Your symptoms can often be worse at night. These may include one or more of the following:
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numbness or reduced ability to feel pain or temperature changes
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tingling or burning sensation, a bit like “pins and needles”
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“electrical” jolts that go through your feet at random intervals (which may cause your feet or legs to jerk)
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sharp pains or cramps
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increased sensitivity to touch (even the weight of a sheet can be painful)
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muscular weakness
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loss of reflexes, especially in the ankle
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loss of balance and coordination
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serious foot problems, such as ulcers, infections, and bone and joint pain
If you experience any of these symptoms and the clinic you attend for your diabetes has not yet checked you for diabetic peripheral neuropathy, you should insist on getting tested as soon as possible.
However, you may not have symptoms even though your nerves are damaged.
How common is diabetic neuropathy?
About half of the people in North America and Europe who have diabetes also have some form of nerve damage. In fact, 2 out of 10 people already have diabetic peripheral neuropathy when they are first diagnosed with diabetes.
A person who has prediabetes, is obese, or has metabolic syndrome (three out of four high blood glucose, high blood pressure, high cholesterol, and belly fat) has a much higher chance of getting DNP than a healthy person.
So if you’re diabetic, it’s very important to have your DPN checked regularly by your doctor…when you’re diagnosed with diabetes and every year thereafter.
What are the controls for diabetic peripheral neuropathy?
Your doctor will perform a series of checks to see if you have DPN.
He or she will first visually check your feet and legs, looking for cuts, sores, and circulation problems. You can then watch him walk by to check his balance.
After that, he’ll probably want to know how sensitive you are to changes in temperature…usually just by asking.
He or she will also want to know how sensitive you are to light touches. The doctor may hang a thin piece of string or thread over your foot while you look away, occasionally touching the string to your foot to see if you notice. In another test, you can use a tuning fork on your toes and feet to see how sensitive you are to vibrations.
Your doctor will also do some blood and urine tests. These help him or her keep track of their blood glucose and triglyceride levels.
These lab tests can also help rule out other causes of neuropathy, such as thyroid problems, kidney disease, low vitamin B12 levels, infections, cancer, HIV, and alcohol abuse… neuropathies arising from such causes may need a different treatment.
The consequences of diabetic peripheral neuropathy
Some of the symptoms of PND can be very painful, making walking and even sleeping comfortably at night very difficult.
Also, DPN makes it more likely that you could get a serious infection in one of your feet. This is because the reduced ability to feel pain associated with this type of neuropathy means you may not notice minor cuts, blisters, or other injuries to your feet because you can’t feel them.
Because diabetes reduces the efficiency of your immune system, minor cuts may take longer to heal… these wounds can become serious before you find them. In fact, they could become seriously infected, which means that if you don’t get proper care in a timely manner, you could lose a toe or foot to amputation.
soccer puddle…is another threat that arises from DPN. Severe neuropathy can weaken the bones of the foot. As a result, the bones can crack or break.
Because your feet lack feeling, you could continue to walk on your broken foot, deforming it…the arch, for example, could collapse and bulge.
If caught early and after a rest period, a trained doctor can treat Charcot foot with special shoes and orthotics. Serious cases, however, would require surgery.
How to take care of your feet
Nothing can be done to reverse the damage caused to your feet by diabetic peripheral neuropathy.
However, there are several things that can be done to relieve pain and prevent DPN from getting worse.
Analgesics…over-the-counter medications aren’t very good at treating peripheral neuropathy pain. Products you put on your skin to numb it, such as lidocaine, can help mask the pain. Medications used to treat depression (eg, citalopram) and seizures (eg, gabapentin) may reduce pain.
Personally, this writer has found Neurostil (gabapentin) very helpful in relieving pain in the soles of the feet due to DPN.
Plus, physical therapy in the form of special exercises designed to restore your sense of balance and the sensations in your feet can keep you moving (and improve your mood at the same time). Just google “exercises for peripheral neuropathy in the feet” for lots of suggestions.
taking care of your feet…because your feet are numb, you may not notice minor injuries that can turn into major problems. So you should check your feet thoroughly every day… for sores, cuts or burns… not forgetting to check between your toes. You can use a mirror to see the bottom of your soles. If you discover any problem that does not go away in a day or two, you should see your doctor.
Keep your feet clean. You should wash them every night in lukewarm water, testing the water to make sure it’s not too hot before you set foot. Be sure to dry them well afterwards.
When lying down, raise your feet (for example, on pillows) to maintain circulation. Wiggling your toes will also help keep your feet healthy.
appropriate footwear… spend on good, comfortable shoes that breathe and have plenty of room for your toes. The width should be suitable for your feet. Make sure the seller takes the trouble to measure your feet correctly. The best ones are various types of shoes, especially those with gel or air cushions on the soles. Consider the use of inserts or buy special shoes for diabetics.
Show your shoes to your doctor when you go for a checkup and ask for his opinion.