Nerve injury due to diabetes
DIABETIC NEUROPATHY
Diabetic Neuropathy refers to injury to nerves either
directly due to the magnitude and duration of hyperglycemia or
The onset refers to how long it takes for the insulin to start lowering your blood sugar.
indirectly due to the damage to blood vessels that supply oxygen and nutrients to the nerves (also because of prolonged periods of hyperglycemia)
Most types of diabetic neuropathy develop slowly, and one may not notice problems until considerable damage has been done. This is why people living with diabetes must take all steps necessary to delay or prevent diabetic neuropathy before the symptoms set, or seek medical advice if the symptoms have already set in.
Types of Diabetic Neuropathy
Depending on the nerves that have been affected, there are four main types of diabetic neuropathy
- Peripheral neuropathy – mostly affects the nerves that connect the brain and spinal cord to the arms, legs, feet and organs. Part of the peripheral nervous system known as the sensory nerves that transmit information such as the feeling of a light touch, temperature, and pain. It is the most common form of diabetic neuropathy. The effects are mostly felt in the feet and hands.
Common signs and symptoms of peripheral neuropathy include:
Numbness or reduced ability to feel pain or changes in temperature, especially in your feet and toes
A tingling or burning feeling
Sharp, jabbing pain that may be worse at night
Muscle weakness in the hands and feet
Serious foot problems, such as ulcers, infections, deformities, and bone and joint pain
For this reason, Diabetes foot care is of extreme importance
- Autonomic neuropathy – mostly affects the nerves that control automatic or involuntary functions in like digestion, breathing, urination, and heart rate. These nerves are distributed in all major organs such as the heart, bladder, lungs, stomach, intestines, sex organs and eyes.
Common signs and symptoms of peripheral neuropathy include:
A lack of awareness that blood sugar levels are low (hypoglycemia unawareness)
Bladder problems, including frequent urinary tract infections or urinary incontinence or urinary retention
Constipation, uncontrolled diarrhea, or a combination of the two
Slow stomach emptying (gastroparesis) leading to nausea, vomiting, sensation of fullness and loss of appetite
Difficulty swallowing
Erectile dysfunction in men
Vaginal dryness and other sexual difficulties in women
Increased or decreased sweating
Sharp drops in blood pressure when you rise from sitting or lying down, that may cause you to feel lightheaded or faint (orthostatic hypotension)
Problems regulating your body temperature
Increased heart rate when you are at rest
- Proximal neuropathy – Instead of affecting nerves in the feet, legs, hands and arms like peripheral neuropathy, proximal neuropathy affects nerves in the thighs, hips, or buttocks. It usually affects one side of your body and may rarely spread to the other side.
Common signs and symptoms of peripheral neuropathy include:
- Sudden, severe pain in your hip and thigh or buttock
- Weakness and atrophy of the thigh muscles
- Difficulty rising from a sitting position
- Focal or Mono Neuropathy – damage to any individual nerve. It is usually less common than peripheral or autonomic neuropathy.
Common signs and symptoms of peripheral neuropathy include:
- Entrapped nerves – pain, tingling and numbness in the fingers, outside the lower leg and weakness in the big toe.
- Pain in the hands, legs, foot and torso that begins suddenly and improves after several weeks or months
- If the nerves in the head are affected it may cause symptoms such as
- aching behind one eye
- Double vision
- Paralysis on one side of the face
Management/Prevention of Diabetic Neuropathy
There are three main components of Diabetic Neuropathy Management or prevention
Tight Blood Sugar Control – This of utmost importance! It will involve a combination of the right diet; taking medication as prescribed; engaging in regular physical activity and constant monitoring.
Take good care of your feet. Check your feet every day. If you no longer can feel pain in your feet, you might not notice a foot injury. Instead, use your eyes to look for problems. Use a mirror to see the bottoms of your feet. Use your hands to feel for hot or cold spots, bumps or dry skin. Look for sores, cuts or breaks in the skin. Also check for corns, calluses, blisters, red areas, swelling, ingrown toenails and toenail infections. If it’s hard for you to see or reach your feet, get help from a family member to look, or ask your doctor to the next time you go for your check-up.
Protect your feet. If your feet are dry, use a lotion on your skin, but not between your toes. Wear shoes and socks that fit well and wear them all the time (Do not walk barefoot). After washing your feet, dry them carefully, especially between the toes.
Be physically active – engage in physical activity that is safe for people experiencing neuropathy
Limit alcoholic drinks to no more than one drink per day for women and no more than two drinks per day for men.
Quit smoking
Lose weight if overweight or obese
- Increased or decreased sweating
- Sharp drops in blood pressure when you rise from sitting or lying down, that may cause you to feel lightheaded or faint (orthostatic hypotension)
See the doctor for a foot exam at least once a year
See a doctor to control the pain; a doctor is best placed to make your pain prescription.
