DIABETIC NEUROPATHY

What Is Diabetic Neuropathy?

Diabetes sometimes results in the development of diabetic neuropathy, or diabetic nerve damage. High blood sugar levels have the ability to injure nerves throughout your body. In most cases, diabetic neuropathy affects the feet and legs.

Diabetic neuropathy symptoms range from discomfort and numbness in the legs and feet to issues with the digestive system, urinary tract, blood vessels, and heart. It largely depends on which nerves suffer damage. Some people only experience minor signs and symptoms. However, it also has the potential to present extremely unpleasant and debilitating symptoms for other people.

Diabetic neuropathy is a severe diabetic consequence that affects up to 50% of those who have the disease. However, continuous blood sugar management and a healthy lifestyle can usually prevent or reduce the progression of diabetic neuropathy. There are four primary forms of diabetic neuropathy, and you can have more than one type.

Peripheral Neuropathy

Distal symmetric peripheral neuropathy is another name for this kind of neuropathy. Diabetic neuropathy of this kind is the most prevalent. The feet and legs are the first to be affected, followed by the hands and arms. Peripheral neuropathy symptoms are frequently worse at night.

Autonomic Neuropathy

The autonomic nervous system regulates the stomach, heart, bladder, intestines, eyes, and sex organs. Diabetes has the potential to affect any of these areas’ nerves.

Proximal Neuropathy

Proximal neuropathy is a form of neuropathy that affects nerves in the thighs, hips, buttocks, and legs. It might also have an impact on the abdomen and chest. The symptoms generally appear on one side of the body, although they might extend to the other side.

Focal Neuropathy (Mononeuropathy)

The two types of mononeuropathy are cranial and peripheral. This refers to damage to a specific nerve in the body.

What Does Diabetic Neuropathy Feel Like?

There are a variety of symptoms, including modest early-onset signs that might be difficult to detect. Symptoms of diabetic neuropathy generally begin in the toes and progress to the head.

Numbness or tingling in the toes or fingers are the first symptoms you may notice. This feels similar to the sensation of “pins and needles” you feel when your foot falls asleep and it starts to awaken. Cramping in the feet, slow reflexes, and impaired balance or coordination are all possible side effects. Some people develop hypersensitivity, and even the tiniest touch can cause them great pain. Even bedsheets grazing your toes at night can cause significant pain.

A person may develop a hammertoe, which is one of the rare visible signs of diabetic peripheral neuropathy. This foot deformity causes the toes to curl inwards and develops as a result of an unconscious change in stride caused by pain or other symptoms. Symptoms become more apparent as the illness worsens, making treatment more difficult.

What Causes Diabetic Neuropathy?

There is no known explanation for each form of neuropathy. Uncontrolled elevated blood sugar, according to researchers, destroys nerves over time and interferes with their capacity to deliver impulses, resulting in diabetic neuropathy. The walls of the tiny blood vessels that carry oxygen and nutrients to the neurons are also weakened by high blood sugar.

Risk Factors of Diabetic Neuropathy

Neuropathy can affect anybody with diabetes. However, these risk factors increase your chances of developing nerve injury.

• Poor control of blood sugar levels: You’re in danger for every diabetic consequence, including nerve damage, if your blood sugar isn’t under control.
• History of diabetes: The longer you have diabetes, the more likely you are to develop diabetic neuropathy, especially if your blood sugar isn’t properly controlled.
• Kidney disease: The kidneys can be harmed by diabetes. Toxins are released into the bloodstream when the kidneys are damaged, which can cause nerve injury.
• Being overweight: A BMI of 25 or above increases your chances of developing diabetic neuropathy.
• Smoking: Smoking causes your arteries to shrink and stiffen, decreasing blood flow to your legs and feet. This makes wound healing more difficult and affects peripheral nerves.

What Are the Symptoms of Diabetic Neuropathy?

The symptoms you experience depend largely on what type of diabetic neuropathy you have. Below, we list the symptoms of diabetic neuropathy by type.

Peripheral Neuropathy

• Reduced ability to feel temperature changes or pain, and even numbness
• Burning or tingling sensations
• Cramps or sharp pains
• Heightened sensitivity to touch
• Extreme foot problems like bone or joint pain, infections, and ulcers

Autonomic Neuropathy

• Hypoglycemia unawareness
• Bowel or bladder issues
• Gastroparesis, or slow emptying of the stomach, which results in loss of appetite, nausea, and vomiting
• Changes in the way the eyes adjust from light to dark environments
• Lowered sexual responses

Proximal Neuropathy

• Sharp pain in the thighs, hips, or buttocks
• Weak or shrinking thigh muscles
• Trouble rising from a sitting position
• Acute stomach pain

Focal Neuropathy

• Double vision or trouble focusing the eyes
• Aching sensations behind one eye
• Bell’s palsy (paralysis on one side of the face)
• Tingling or numbness in the fingers or hand, but not in the pinky finger
• Weakness in the hands that results in dropping items

How to Diagnose Diabetic Neuropathy

A physical exam and a thorough assessment of your symptoms and medical history are typically enough for a clinician to diagnose diabetic neuropathy. Doctors examine the following while attempting a diagnosis.

• The strength and tone of your muscles
• Reflexes of the tendons
• Level of sensitivity to vibration and touch

How to Test for Diabetic Neuropathy

In addition to the physical exam, your doctor may perform or prescribe certain tests to aid in the diagnosis of diabetic neuropathy, such as the ones listed below.

• Filament test: To evaluate your sensitivity to touch, your doctor will brush a delicate nylon fiber (monofilament) across regions of your skin.
• Sensory testing: This noninvasive test determines how your nerves react to vibration and temperature changes.
• Nerve conduction testing: This test determines how rapidly your arms and legs’ nerves conduct electrical impulses. It’s frequently used to determine whether or not someone has carpal tunnel syndrome.
• Muscle response testing: This test, known as electromyography, is frequently used in conjunction with nerve conduction investigations. It monitors the electrical discharges that your muscles create.
• Autonomic testing: Special tests may be performed to see how your blood pressure varies in different postures and whether or not you sweat regularly.

How to Treat Diabetic Neuropathy

The goal of diabetic neuropathy treatment is not to cure it, as the condition has no cure. However, treatment for diabetic neuropathy has certain goals aimed at improving a patient’s quality of life.

• Slowing the progression of the disease
• Relieving and managing pain
• Managing complications and restoring function

Slowing Progression

The key to avoiding or postponing nerve damage is to keep your blood sugar within your goal range on a regular basis. Some of your current symptoms may be alleviated by proper blood sugar management. Based on criteria like your age, the length of time you’ve had diabetes, and your general health, your doctor will determine the optimal target range for you.

Keeping your blood pressure under control, keeping a healthy weight, and enjoying regular physical activity are all key strategies to help reduce or prevent neuropathy from worsening.

Relieving and Managing Pain

There are a variety of prescription medicines available to treat diabetes-related nerve pain, but not all of them work for everyone. Talk to your doctor about the advantages and possible side effects of any drug you’re considering to see what could work best for you. Certain treatments include the following types of medicine.

• Anti-seizure medication: Some medicines that are used to treat seizures can also be used to alleviate nerve pain. Pregabalin is the drug of choice, according to the American Diabetes Association. Another possibility is gabapentin. Drowsiness, dizziness, and edema are all possible side effects.
• Antidepressants: Even if you aren’t depressed, certain antidepressants can help with nerve pain. Mild to severe nerve pain may benefit from tricyclic antidepressants. Amitriptyline, desipramine, and imipramine are examples of this family of drugs. Dry mouth and sleepiness are two common side effects that can be uncomfortable. 

An antidepressant and an anti-seizure medication may be used together in some cases. These medicines can also be used with pain relievers such as acetaminophen or ibuprofen over-the-counter medications, or a lidocaine skin patch (a numbing substance).

Managing Complications and Restoring Function

You may need the support of different experts to handle issues, such as a urologist (a doctor who treats urinary system problems) and a cardiologist (a doctor who treats heart problems), who can help prevent or cure difficulties.

How to Prevent Diabetic Neuropathy

Certain lifestyle changes or home remedies can help reduce your risk of diabetic neuropathy.

• Control your blood pressure. You’re at a much higher risk of problems if you have high blood pressure and diabetes. Maintain your blood pressure in the range recommended by your doctor, and have it tested at every office visit.
• Choose your foods carefully. Consume a well-balanced diet that contains a range of nutritious foods, including fruits, vegetables, and whole grains. To help you reach or maintain a healthy weight, keep portion sizes small.
• Stay active on a daily basis. Exercise increases blood flow, lowers blood sugar, and keeps your heart healthy. For most individuals with diabetes, the American Diabetes Association advises 150 minutes of moderate-intensity exercise each week. It’s also a good idea to get a couple brief bursts of movement every 30 minutes by taking a break from sitting. Speak with your doctor to determine the right exercise regimen for you.
• Stop smoking. Tobacco use, in any form, increases your chances of developing impaired circulation in your feet. If you smoke cigarettes, speak with your doctor about quitting.

Call the Pain Relief Center Today

If you suffer from, or fear you suffer from diabetic neuropathy, The Pain Relief Center is here to help. We understand what you’re going through, and we understand that you’re desperate for a solution. When your health, quality of life, and mobility are all at stake, don’t settle for less. Call The Pain Relief Center in Plano at 214-709-1904 to schedule an appointment with a board-certified pain management physician at The Neuropathy Institute.