Neuropathy is the damage or dysfunction of one or more nerves and is usually marked by burning pain, numbness, tingling or muscle weakness. These nerves play a crucial role in sensation, touch, movement, and other functions.
People with diabetes are at risk of nerve damage, and this can cause serious problems in various parts of the body including your feet, organs and muscles. Of all the available treatments, stable glucose control is probably the most important for slowing the progression of neuropathy.
Continue the read to find out more about diabetes-related neuropathy and whether the condition can be reversed.
Diabetic neuropathy is nerve damage that is caused by diabetes. According to scientists, high blood sugar levels, and high levels of fats in the blood from diabetes can damage your nerves.
The risk of developing neuropathy increases the longer you have diabetes, and this can be within the first ten years after diagnosis. About half of all people with diabetes will experience neuropathy at some point in their lives.
The symptoms of diabetic neuropathy depend on the type of neuropathy and on which and how many nerves are affected. People with the condition could have one or a combination of the types of diabetic neuropathy.
Below are some common types:
Usually affects the nerves leading to your extremities – feet, and legs, and sometimes affects the hands and arms. This type of neuropathy is very common, and it generally starts in the feet, usually both feet at once.
Signs and symptoms of peripheral neuropathy are often worse at night, and may include:
- Tingling (feelings of “pins and needles” in your feet) or burning feeling
- Sharp pain or cramps (stabbing or shooting pains in your feet)
- · Increased sensitivity to touch (for example, light-weight objects such as bedsheets may hurt the feet at the slightest touch
- Increased sensitivity to cold or heat
- Numbness or reduced ability to feel pain or feelings of heat or cold in your feet or arms
- Muscle weakness in the feet and legs
- Serious foot problems, such as ulcers, infections, and bone and joint damage that heal slowly
Damage to the nerves that control your organs is known as autonomic neuropathy. This may lead to problems with your heart, digestive system, genitals, sweat glands, and eyes. Some of the problems encountered are:
- Erectile dysfunction in men, problems with orgasm or vaginal dryness in women
- Bladder control problems such as urine retention or incontinence
- Gastroparesis – when the digestive tract cannot move food efficiently, resulting in diarrhea, constipation, bloating, nausea, and vomiting.
- People with autonomic neuropathy can become unaware of hypoglycemic symptoms
- The difficulty for the eyes adjusting in dark or bright places
- Problems with sweating – intolerance to heat, not being to sweat properly, or sweating associated with meals (gustatory)
- Irregular heart rate, lightheadedness, or feeling dizzy after standing
- The precise cause of autonomic neuropathy is unknown.
This can also be called diabetic amyotrophy and causes weakness in the muscles of the shoulders, hips, thighs, and buttocks. This is a rare and disabling type of nerve damage typically affecting the elderly with diabetes.
The damage typically affects one side of the body, and the symptoms improve gradually with time or treatment. Symptoms include:
- Muscle weakness in your legs makes it difficult to be on your feet without help
- Sudden and sometimes severe pain in affected areas
Damage to a single nerve, such as in your hand or leg, is known as mononeuropathy. All the types of diabetic neuropathy above are examples of polyneuropathy, and unlike these types, focal neuropathy comes on suddenly and usually affects the head, torso, or legs.
Entrapment syndromes are the most common types of focal neuropathy, and carpal tunnel syndrome is an example. Symptoms of mononeuropathy include:
- Inability to focus the eyes
- Double vision
- Aches behind an eye
- Pain in the thighs
- Difficulty with hearing
- Facial paralysis on one side (Bell’s Palsy)
- Pain in the lower back, chest, stomach, flank, or pelvis
Diabetes can cause irreversible nerve damage because the body cannot repair damaged nerve tissues. However, scientists are researching various treatment options for diabetic neuropathy.
Although there is no way to reverse the effects of neuropathy, you can take steps to slow the progression of the condition. These include:
- · reducing blood sugar
- · managing nerve pain
- · routine inspection of your feet inspecting to ensure they are not injured, unwounded, or infected.
It is crucial to control your blood sugar to help stop further nerve damage. You can achieve blood glucose control by using the following techniques:
- Eat foods rich in healthy fats, such as those found in nuts and olive oil, and choose lean proteins like chicken and turkey.
- Thirty minutes of exercise, at least five times per week, including weight training and cardio exercise in your program.
- Regularly consume veggies and plant proteins like tofu and beans.
- Avoid sodas, sweetened beverages including coffee and tea, fruit juices, processed snacks, candy bars, and other items high in excess sugar.
- Eat fiber-rich meals to support stable blood sugar levels.
- As recommended by your doctor, check your blood sugar levels and keep records to help identify trends and fluctuations in your blood sugar.
- As directed by your endocrinologist or primary care physician, take antidiabetic medications such as insulin or metformin
It is necessary to take care of your feet and legs in addition to controlling your blood sugar levels because damage to the nerves in the feet and legs can result in a loss of feeling. You might not detect a cut or hurt of your foot or leg when there is nerve damage in your leg or foot.
For a healthy foot in people with diabetic neuropathy:
- Check your feet every day for cuts, open wounds, or any other changes to the skin or nails
- Wash your feet every day with soap and warm (not hot) water
- Never walk barefoot to avoid injury
- Wear shoes that fit well with clean, dry socks
- Regularly visit your foot doctor (podiatrist) for a check-up and trimming of your toenails if you cannot reach your feet
- keep your feet up when you are in a sitting position and wiggle your toes for a while many times in a day
- consult with your doctor in case you would want to keep fit for recommendations of feet-friendly activities.
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Anybody with diabetes can develop neuropathy. Although the exact causes of diabetic neuropathy are unknown, several factors contribute to the disorder and make nerve damage more likely. These factors include:
- Uncontrolled blood sugar leads to high levels in the blood. This can impair the nerves’ ability to transmit signals and damage blood vessels that supply the nerves with oxygen and nutrients
- Kidney disease results in the release of toxins that can lead to nerve damage
- Being overweight or obese
- High blood pressure
- Elevated triglyceride and cholesterol levels
- Smoking, narrows and stiffens the arteries, limiting blood flow to the legs and feet, thus making wound healing difficult and causing damage to the peripheral nerves
- Being older than 40 years
Early and accurate diagnosis of diabetic neuropathy gives patients the opportunity for effective treatment. Diagnosis is based on history, clinical examination, and appropriate laboratory tests. Your doctor may:
- Begin with a physical examination of the feet such as checking muscle strength and reflexes; ability to move affected areas in relation to touch, temperature, or vibration; color and condition of the skin, and look out for ulcers
- Undertake a comprehensive assessment – including blood pressure check, lipid profile, and blood glucose screening
- Requests additional tests when necessary, such as:
o Electromyography to assess how well the muscles are responding to electrical impulses from the nerves
o Nerve conduction studies to check the transmission of signals through a nerve
o Ultrasound to determine how parts of the urinary tract are functioning
o Skin biopsies to evaluate cutaneous nerve innervation
o Nerve and muscle biopsies
There are four major components of treatment for diabetic neuropathy:
Meticulous blood sugar control. The most crucial step in preventing further nerve damage is controlling diabetes.
People with Type 1 Diabetes should take more frequent insulin injections, while people with Type 2 diabetes may take additional oral medications or insulin injections.
- Lifestyle interventions such as eating a balanced diet and regular exercise to maintain normal body weight. A balanced diet should be a nutrient-dense diet low in saturated fats and high in whole grains, fruits, vegetables, and lean meat. Limit your daily alcohol consumption to no more than one to two drinks and avoid smoking
- Diabetic foot care to prevent complications
- Management of pain and complications with medications, relaxation training
Peripheral neuropathy may affect your balance. It may be difficult to walk or sit still comfortably if you have nerve discomfort. You might not notice a foot injury at once if you have nerve damage.
Diabetes patients must treat cuts on their feet and legs.
Diabetes can contribute to or worsen issues like peripheral artery disease (PAD), if left untreated, PAD might result in amputations.
Uncontrolled diabetes can result in hyperglycemia (high blood sugar). Elevated blood sugar levels over time can harm your nerves and blood vessels that supply your nerves with oxygen and nutrients.
Sources of information:
- Diabetes and Nerve Damage | CDC
- Diabetic neuropathy (nerve damage) | Diabetes UK
- Diabetic Neuropathy: Practice Essentials, Background, Anatomy (medscape.com)
- Diabetic Neuropathy | NIDDK (nih.gov)
- Patient education: Diabetic neuropathy (Beyond the Basics) – UpToDate
- Diabetic Neuropathy: Your Diagnosis (endocrineweb.com)
- Neuropathy | ADA (diabetes.org)
- Peripheral Diabetic Neuropathy – StatPearls – NCBI Bookshelf (nih.gov)
- Diabetic neuropathy – PMC (nih.gov)
- Diabetic Neuropathy | Johns Hopkins Medicine