Nerve damage or Neuropathy in Diabetes
Nerve damage from diabetes is called diabetic neuropathy. Some form of nerve damage is common in those suffering from type 1 or type 2 diabetes, especially if they’ve had the condition for some years and if ignored, this can lead to several complications.
Diabetic neuropathy is a loss of sensory function beginning distally in the lower extremities that is also characterized by pain and substantial morbidity. Over time, at least 50% of individuals with diabetes develop diabetic neuropathy. (Source)
By the time I was diagnosed with type 2 diabetes, my right leg, from the calf down already had some nerve damage. I wake up with numb hands. While medications can help, it takes a long time to see any results.
Nerve problems can strike at any time and the risk increases with age in long-term diabetics, as well as those with chronically high blood glucose or whose blood sugar, blood pressure and weight is not under control. Besides this, low insulin levels, inflammation in the nerves, injuries, genetics, and lifestyle factors such as smoking and alcohol use are also responsible.
Types of diabetic neuropathy
No organ or body part is spared when it comes to nerve damage. Diabetic neuropathy can be broadly of four types and each of these affects different parts of the body.
- Peripheral neuropathy is the most common and results in loss of feeling in the hands, feet, toes, legs, and arms.
- Autonomic neuropathy causes changes in digestion, bowel and bladder function, sweating, and sexual response. It can also affect the nerves of the heart, affecting blood pressure, the lungs, and the eyes. Another serious complication is when those with low blood sugar are unaware of the warning signs.
- Proximal neuropathy causes pain in the thighs, hips, and buttocks and this may make the legs feel weak.
- Focal neuropathy causes sudden weakness in a nerve or a group of nerves, resulting in muscle weakness and pain.
The symptoms of neuropathy depend on the type and the nerves involved.
Symptoms of neuropathy in diabetes
Over a period of time, nerve damage can spread through the body. While some people feel symptoms, others don’t.
Specific symptoms of nerve damage from diabetes to watch out for are:
• numbness, tingling, or pain in the toes, feet, legs, hands, arms, and fingers
• wasting of the muscles of the feet or hands
• indigestion, nausea, or vomiting
• diarrhea or constipation
• dizziness or faintness due to a drop in blood pressure after standing or sitting up
• problems with urination
• erectile dysfunction in men or vaginal dryness in women
• weakness
• problems with balance
These symptoms are often accompanied by weight loss and depression.
How diabetic neuropathy is diagnosed
Nerve damage from diabetes is usually diagnosed via a physical exam, symptoms and some tests. During the physical exam, the doctor checks blood pressure, heart rate, muscle strength, reflexes, and sensitivity to position changes, vibration, temperature, or light touch.
This is followed by a thorough foot exam. Other tests include a nerve conduction test, the heart’s response to deep breathing, and to changes in blood pressure and posture. Ultrasound tests are used to see internal organs.
Treatment options for diabetic neuropathy
The main goal is pain relief, which can be from oral medications, topical applications and devices based on the condition of the nerve damage.
Can neuropathy in diabetes be prevented?
One of the main ways to prevent or delay nerve damage in diabetes is by keeping blood sugar levels on target. Even if you already have diabetic neuropathy, here are some ways to slow down its progress and lessen the symptoms:
1. Make sure blood glucose levels are in your target range.
This means planning your meals, exercise and medications, besides keeping track of your blood sugar with a blood glucose meter.
2. Get our tests done as scheduled
Diabetics are advised to get an HbA1c test twice a year to monitor blood sugar levels and control them. This will tell you whether you need to make any changes to your routine, diet, or medication to help you manage your diabetes better.
3. Proper foot care
If you see symptoms of nerve damage, let your doctor know immediately so that treatment can be started. The sooner it is treated, the better as it can avoid future problems.
4. See a foot infection? Attend to it
Ignoring it can lead to amputation! If you smoke, quit, as smoking can increase the risk of foot problems and amputation.
5. Check your feet carefully every day
The problem with nerve damage is, even if there is an injury, you can’t feel the pain, and it can become easy to ignore. Look for nicks, cuts, bumps, sores, and any skin breaks. Especially check for corns, blisters, and any swelling and red patches, ingrown toenails, and toenail infections, which are common in diabetes. Use a mirror to see under your feet or request someone close to you to check and tell you.
6. Keep your feet protected
Care for dry skin. Use a moisturizing lotion on the skin, but avoid the area between the toes. Wear well-fitting shoes and socks. While washing your feet, use warm water and then, dry them thoroughly.
Check with your doctor about which exercises are okay to do, especially if nerve damage has already set in.
7. Talk to your doctor if you see any symptoms of nerve damage
If you see symptoms of nerve damage, let your doctor know immediately so that treatment can be started. The sooner it is treated, the better as it can avoid future problems.
Type 2 diabetes brings its own set of health problems and your doctor may not diagnose peripheral neuropathy as soon as the symptoms are apparent. It is best to be alert and talk to your doctor if you have pain.
3 comments
This is very useful information. I mentioned previously that I’m paranoid about Mma’s feet; want to amke sure that the feet are attended to. So far the doctor has not told us that Mma has neuropathy, but I would be suprised if it was not an issue. They’ve given her meds before for pain in the hands and later in the shoulders, and her legs also had some issues.
Very good article mam…
R u a dcotor..??
Welcome, Dr.Tushar. No I am not a doctor. Just a patient who enjoys being informed. 🙂 And sharing what I learn with the world.