Diabetic Neuropathy

A quick run-down on Diabetes.

Diabetes is a metabolic disease that causes high blood sugar levels in our bodies. The common symptoms of Diabetes are

• Increased hunger levels
• Frequent urination
• Blurry eyesight
• Wounds that do not heal

However, only a proper medical test would reveal if a person has Diabetes.

Overview

Diabetic Neuropathy is nerve damage caused by Diabetes. If you have high blood glucose levels, it will affect your nerves.

Diabetic Neuropathy is mainly caused when you don’t keep your blood sugar level in check. It mostly affects your nerve in the legs and feet; in rare cases, it might affect your arms and may be painful.

Diabetic Neuropathy can be less painful if treated early and also if your blood glucose level is under control. Early symptoms can be treated with a few medications.

What is Diabetic Neuropathy?

Diabetic Neuropathy is a particular type of nerve damage that occurs in a person’s nervous system if they have Diabetes.

High levels of glucose content in our blood can damage the nerves in the body.

This particular type of nerve damage most often damages nerves present in the legs and feet.

This condition mostly affects the legs and feet, where for some affected people, the symptoms are mild; others are severe and at times even fatal.

Diabetes can harm the entire nervous system. This damage is painful.

Even though it can occur to a person in several ways, the most common way it occurs can be associated with high levels of blood sugar for a long period.

What are the types of Diabetes-related Neuropathy?

Diabetes-related Neuropathy is characterised by four types. They are

1. Peripheral Neuropathy
2. Autonomic Neuropathy
3. Proximal Neuropathy
4. Focal Neuropathy

Peripheral Neuropathy

Peripheral Neuropathy usually affects the feet and the legs. Only in certain rare cases it would affect the other parts of the body like the arms, back and core region.

Other than Diabetes, Peripheral Neuropathy can be caused by traumatic injuries and metabolic-related issues.

Symptoms of Peripheral Neuropathy include;

• Tingling feeling
• Permanent or partial numbness
• Burning sensation
• Pain in the infected region.

The symptoms at an early stage get better if the blood sugar level is kept under check. If the symptoms get severe, a medical professional would recommend a few medications.

Autonomic Neuropathy

Autonomic Neuropathy affects a person’s digestive system. The most affected part of the body is the stomach. If a person is infected with Autonomic Neuropathy, they will experience a few symptoms like

• Slight or excessive bloating
• Irregular bowel movements and diarrhoea
• Few heat burns
• Frequent nausea and vomiting
• Urinary tract infection
• Abnormal sweating
• Sexual difficulties

When the nerves that control involuntary body functions are damaged, Autonomic Neuropathy occurs. The nerve damage interferes with the passing of signals between the brain and other organs.

Other than Diabetes, infections may also be one of the causes of Autonomic Neuropathy.

Proximal Neuropathy

If infected by Proximal Neuropathy, a person may experience pain in their hips or thighs. The pain which is caused can be on only one side or both sides. Most commonly, the pain is on a single side.

People with this affliction need proper medical assistance and physical therapy to overcome their weakness and pain.

Proximal Neuropathy affects people of older age and is common in both women and men. Type 2 Diabetes is the major cause of Proximal Neuropathy.

Symptoms of Proximal Neuropathy include loss of reflex, weight loss, muscle wasting, difficulty in standing and sitting and severe pain in the hip and thigh region.

Focal Neuropathy

The focal Neuropathy would affect a person suddenly. It would affect specific nerves in the body. The most affected parts are the nerves in the torso, legs and hands.

Focal Neuropathy can be characterised based on the following symptoms;

• Vision doubling
• Mild or moderate eye pain
• One-sided paralysis
• Pain in the midsection of the body
• Ulnar entrapment
• Peroneal entrapment
• Carpel tunnel syndrome

Carpal tunnel syndrome is a common entrapment that occurs in people with type 2 Diabetes. Still, only less than 12 percent of people are affected by this type of Neuropathy

Causes of Diabetic Neuropathy

The primary cause of Diabetic Neuropathy is high glucose levels and untreated for a long time.

A study conducted in 2013 revealed that there is some correlation between wound healing and blood glucose level.

When people suffering from Diabetes Mellitus underwent surgery, if their Diabetes was in a controlled state, the wound healing occurred at the normal rate and was satisfactory.

Wound healing and blood glucose levels are interrelated. High-glucose level impairs the white blood cell function, which suppresses your immune system.

Uncontrolled Diabetes leads to serious health issues such as Neuropathy and also slows down the healing process.

Diabetes constricts the blood vessels and causes poor circulation of blood throughout the body. This causes difficulty in the distribution of nutrients throughout the body, which results in slow healing of the wound does not heal at all.

The other causes of Diabetic Neuropathy include physical injuries, high cholesterol levels and mechanical injuries such as carpal tunnel syndrome.

Smoking and alcohol also cause nerve damage. Vitamin B12 deficiency can also lead to Diabetic Neuropathy.

Metformin, a common diabetic tablet, lowers the vitamin level in the blood.

Symptoms of Diabetic Neuropathy

Numbness or reduced ability to feel pain or temperature changes

Numbness or reduced ability to feel pain or temperature change is one of the prominent symptoms when you have Diabetic Neuropathy.

When your blood glucose level is in control, there will be no damage to your nerves.

The numbness and touch sensitivity mainly occur in your legs and arms. Chronically effectively, blood glucose level causes numbness and touch sensitivity.

Tingling or burning sensation

Tingling or burning sensations in your hands and feet may be the symptoms of nerve damage due to high glucose levels in your blood.

Diabetic Neuropathy damages the nerve that sends a signal to your hands and feet. Another prominent symptom is burning or sharp pain in your toes and fingers.

At the start, they will be mild and then lead to unbearable pain. Even walking can cause sharp pain and may be painful in some cases. Slowly, the pain develops and spreads throughout your hands and legs.

Some people may experience severe pain; even soft touches can be painful. Studies show that up to fifty percent of diabetic people experience nerve pain.

Diabetic Neuropathy can affect your life and may lead to loss of sleep and depression.

Sharp pains or cramps

People with uncontrolled Diabetes face many complications, and one such is Diabetic Neuropathy.

Diabetic Neuropathy leads to damage to your nerves and causes pain in your movement. Your lifestyle will be affected, and you cannot lead a happy life.

Sharp pain and cramps are one such symptom of Diabetic Neuropathy. Hyperglycaemia is one of the main causes of such symptoms. If left untreated, there might be serious complications like leg amputations.

Along with sharp pain and cramps, you might also experience numbness, pain and burning sensation. Diabetic Neuropathy alleviates your pain and affects your quality of life.

Increased sensitivity to touch

Chronic high-level glucose leads to severe symptoms, and one such is the increased sensitivity to touch. This can be very painful to an extent where even a light touch can be painful. For example, when a piece of cloth comes in contact and it might weigh too heavy.

Studies show that 60-70 percent of people develop Peripheral Neuropathy if they have uncontrolled chronic Diabetes. There are cases that do not suffer pain still, there is no sure evidence of such.

These symptoms are the result of damage to the nerves that carry messages from your brain to other parts such as your hands and legs.

These symptoms are very painful and lead to major consequences. In the worst case, they can cause death.

A small wound may not heal easily due to very poor blood flow, and risks are very dangerous such as ulcers which eventually lead to amputation of the affected part.

These symptoms may not be very prominent at the early stages and take years to develop into a noticeable pain. By then, it will be very late, and the consequences may be unbearable or untreatable.

It is always advised to keep your blood glucose level in check. Diabetes is one of the ninth leading causes of death.

People with uncontrolled chronic Diabetes also experience kidney failure, heart attacks, lower limb amputation and also blindness.

Serious foot problems, such as ulcers, infections and bone and joint pain

People with Diabetes experience foot-related problems such as infection, pain and ulcers. Diabetic Neuropathy affects the toes and balls of your feet, which makes movement difficult.

Foot ulcers are more common in people with Diabetes. Foot ulcers don’t show any obvious symptoms.

The first symptom will be the formation of black tissue. There would be some foul smell from your feet, swelling and irritation. Sometimes irritation may be accompanied by redness.

Hyperglycaemia leads to nerve damage. Another significant damage caused by Hyperglycaemia is it slows down the healing process and increases your pain.

The last stage of chronic high blood glucose level is nerve damage. This can be painful and leads to loss of your feet if left untreated.

Always consult your doctor about your health condition, and if you have any unusual symptoms, seek medical help without any delay.

Risk Factors of Diabetic Neuropathy

Chronic high blood sugar level causes nerve damage. Over the years, scientists concluded that high blood glucose level interferes with body functions, and there is some malfunction. Still, scientists are not sure of the causes.

Some of the risk factors are discussed below.

Poor blood sugar control

People still enjoy life with Diabetes, but they have controlled blood glucose levels. Diabetes increases your risk of other diseases by an extra one percent.

The uncontrolled blood sugar level is when your glucose level is above 180/dl consistently.

Uncontrolled blood glucose not only affects your nerves but also causes many health-related problems like kidney failure and heart diseases too.

Diabetes history

People with long-term Diabetes get affected by Neuropathy, and it is one of the common complications.

Research has revealed that over 50% of people get affected by Neuropathy. The history of Neuropathy also plays a major role.

The longer you have Diabetes higher is the risk of Neuropathy, especially when you have an uncontrolled high blood glucose level. If you have a controlled blood sugar level, there is no risk or less risk is involved.

Kidney disease

Diabetes can increase the risk of kidney failure and damage.

Kidneys are responsible for filtering the toxins in your blood, and when there is damage in your kidney, toxin filtration will not be effective and will damage your nerves.

Being overweight

Being overweight always increases your risk of getting Diabetes. When you have uncontrolled Diabetes, it will damage your nerves which makes your movement painful.

Smoking

Smoking causes your arteries to narrow down. This will cause poor blood circulation and reduces the blood flow to your legs and feet.

Complications of Diabetic Neuropathy

Hypoglycaemia unawareness

When your blood glucose level falls below 70 mg/dL, the condition is diagnosed as Hypoglycaemia. Many people with low blood glucose levels don’t know that they have such a condition.

There will be no symptoms like Hyperglycaemia, and people think they are doing fine health-wise. This condition is called Hypoglycaemia unawareness.

People are unaware that they have such a condition until they go for a medical test. The reality is like Hyperglycaemia, Hypoglycaemia is also dangerous and needs to be treated.

Loss of a toe, foot or leg

Diabetic Neuropathy can cause nerve damage that makes you lose sensitivity. The blood flow will be restricted as a result of poor blood circulation.

When your feet lose sensitivity, you cannot experience any pain. When there is a foreign invasion, you will not feel anything, and it causes cuts.

The cuts may turn into an infection and damage your nerves. Such infection cannot be treated. If you need to stop the infection from spreading to other parts, doctors might recommend amputating your legs.

Urinary tract infections

High-blood glucose level leads to unwanted complication, and one such is a urinary tract infection.

Urinary tract infection is common in women with Diabetes. When you have high blood glucose levels, there is a chance of the development of microorganisms in your urinary tract.

The urinary tract nerve damage may cause complications like urine retention and reduced microorganism clearance. This results in an infection.

Research conducted revealed that 26-85 percent of women develop urinary tract infections, which might cause bladder dysfunction.

Sharp drops in blood pressure

Diabetic Neuropathy causes nerve damage that affects your blood circulation. It makes the body difficult to adjust to sudden changes in blood pressure.

At times there might be slow blood circulation and suddenly a sharp increase in the blood flow. This may cause sudden blacking out, dizziness and people may faint.

Digestive problems

Diabetic Neuropathy may affect the nerves in your digestive system. When there is damage to your digestive tract, you will have problems such as constipation or diarrhoea.

Diabetic Neuropathy may cause gastroparesis, a condition that causes improper stomach emptying, which leads to bloating and indigestion.

Sexual dysfunction

It is a common complication for men who have Diabetes. Men face erectile problems. They face these problems when Diabetes is not under control.

Women face lubrication problems. Autonomic Neuropathy causes sexual dysfunction.

Increased or decreased sweating

Sudomotor function controls the sweat glands in our body. Uncontrolled Diabetes can affect the nerve that controls sweat.

For some people, the nerve would always be active. So the body could not maintain a steady temperature, and there is a difference in temperature.

How can we treat Diabetic Neuropathy?

Diabetic Neuropathy has no proven cure. If a patient is undergoing treatment for this illness, it is mainly to:

• Slow down the development of the infection in the body
• Reduce or eradicate pain
• Manage the associated side effects or complications involved.

While treating this infection, it is important to keep the blood pressure within a specific range. This is done to prevent or delay nerve damage.

Having a stable blood sugar level may also help in managing the current symptoms. These blood sugar levels vary from person to person. Not all individuals need to maintain a particular blood glucose level.

Despite having a lot of medications for Diabetes-related nerve pain, it is not proven to be effective for everyone who takes them.

Professional medical advice is required. Only with proper medical assistance the patient would know the risks of taking medications.

To manage the side effects and the complications caused by the illness, it is necessary to have medical assistance from specialised doctors. For example, only a urologist should treat the urinary tract infections which are caused by the illness.

Pain management

Pain is inevitable. But how we handle it is important. There are many yoga and exercises to cope with Diabetes pain.

Diabetic Neuropathy pain can be reduced when you control your blood glucose level. The pain in your legs and hands can be reduced.

Not only exercise, start with your diet. Reduce the glucose content in your food and try to include proteins and other nutrients.

These habits not only help with your pain but also helps to improve your mood. You will feel healthy.

Managing complications

People affected with Diabetic Neuropathy should be educated on the disease properly. They should be aware of their health condition fully.

Some of the complications faced by patients are digestive problems, sexual dysfunction, drop in blood pressure, urinary tract infection, and in the worst case, they may lose their feet.

These complications can be avoided. If the complications are avoided, there might be a reduction in pain.

First, start with your blood glucose level. American Diabetes Association suggests people check their average blood glucose level for the past three months (A1C).

The medical test is personalised for every individual. It suggests that your average blood glucose level should be below 7.

If it is above the recommended range, it is important for you to consult your doctor and take precautions immediately.

Foot problems are very common for people who have Diabetes. Ulcers and infections are common in Diabetes. But they take a very long time to heal or never heal.

You can take some precautions before it can cause some major complications. Always check your feet for any cuts or infections. Clean your feet with mild soap and lukewarm water. Do not soak your feet in water for long.

Clean your toenails properly and also in between your toes. Dry it properly and apply some moisturiser.

Wear shoes that properly fit your legs. Make sure it is comfortable.

Home Remedies of Diabetic Neuropathy

Keep your blood pressure under control

Everything starts with you and your home. Always keep a check on your Diabetes level. When you have cravings for sugary food, try to choose an alternative option.

There are many sugar-free foods and chocolates available still, but they should be consumed in very low quantities. Consult your doctor before consuming any new foods.

There are many dark chocolates available; substitute them with traditional chocolate. Try to avoid caffeine.

Manage your stress levels and stick to your sleep cycle.

Make healthy food choices

Food cravings are common. But try to go for some healthy foods. Choose gluten-free foods that do not spike your blood glucose level.

Fruits have natural sugar called fructose. So choose the fruit which has very less sugar content and more nutrients.

Jamun fruit has proven effects in lowering your blood glucose level. Vitamin C also helps to reduce the blood glucose level. Amla is also good for Diabetes.

Be active every day

Food, along with physical activity, helps to control your blood glucose level. Exercise every day at least for half an hour. It need not be a high-intensity workout. Some basic workouts may work.

Physical activity always helps to control your blood glucose level. It also lowers the risk of cardiovascular diseases and other complications.

Start with small steps and be consistent in achieving your goals.

Stop smoking

Smoking habit is bad, and it may lead to Diabetes. When people with Diabetes smoke, it may lead to major consequences.

Nicotine interferes with the insulin function making the process tougher. Nicotine also increases the blood sugar level.

Quitting smoking helps your body to manage your blood glucose level efficiently.

When to see a doctor?

When you have Diabetes, especially chronic Hyperglycaemia, always notice the changes in your body. Even a small change can lead to significant effects.

If you feel unusual pain in your legs, numbness, weakness in your hands and feet, tingling and touch insensitivity. These are the early symptoms of Diabetic Neuropathy, and you should consult your doctor immediately.

If you have wounds or any kind of infection that did not heal or takes time to heal, immediately consult your doctor.

Can we reverse the effects of Diabetic Neuropathy?

The damage caused by the illness, especially the nerve damage, cannot be reversed. The side effects of the complications can be contained and managed. We can minimise the effects by

• Eliminating food that has a high sugar content
• Consuming food that has high fibre content.
• Having a balanced meal.
• Doing regular exercise.
• Following a proper medication plan.

Prevention of Diabetic Neuropathy 

Monitoring your blood glucose levels

Always have an eye on your glucose level. When you have chronic high blood glucose levels, it may lead to Diabetic Neuropathy.

At least once in six months, go for a medical check-up and keep your blood glucose level in control.

Taking medications as prescribed

Medications always help you to keep your blood glucose level under control. Never skip your meal and medication. Always have some food and take your medication.

Some people have the habit of compensating the medication for the days they skipped. Such habits may be harmful to health and of no use.

Never take medication of your own. Always consult your doctor before taking any tablets.

Managing your diet

It is difficult to control your food cravings. Try to manage your cravings and healthy foods. You need not always go for wheat foods can go for some interesting alternatives such as amaranth, millets, etc.

Try foods that are rich in Vitamin D and B12, like eggs, mushrooms and fatty fish. You can prefer more steamed foods than fried ones.

Being active

Always stay active. For every one hour of sitting, move around for ten minutes. Hydrate yourself well and eat healthy food.

Diabetes cannot be cured; still, you can lead a happy and healthy life if you have it in control.

What does Diabetic Neuropathy feel like?

Diabetic Neuropathy is chronic in nature. This means that it would last for a long time, mostly a lifetime from the time when a person is infected.

In case any person is affected by this illness, they need to pay attention to the level of glucose content in their blood.

Glucose management is an important method, a highly effective one, which is followed to reduce the negative effects of the illness.

 It is also important to pay close attention to the feet and legs. If ignored, little cuts and scratches may develop and cause bigger problems.

Therefore, it is important to remember that there is no permanent cure for Diabetic Neuropathy. Constant efforts need to be made to prevent the developing symptoms and manage them.

Having professional medical assistance is always recommended for better treatment. By doing so, the patient would lead a healthier lifestyle.

Conclusion

Diabetes is a disease that makes survival hard. Your daily routine can make a big difference, and you can lead a happy life.

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