Diabetic neuropathy is one of the major complications of diabetes, and it is considered a form of nerve damage. There are four types of this condition, and it can impact nerves throughout the body. The most common form of diabetic neuropathy affects the legs and feet. Symptoms generally include tingling and burning sensations, numbness, sharp pain, and increased sensitivity to touch. Some patients may experience a decreased ability to feel hot or cold temperatures. Muscle weakness, balance problems, and coordination difficulties may also be present. Diabetic neuropathy can have particularly severe effects on the ankles and feet. Foot ulcers and infections may occur, and patients may have pain in the bones of their feet. When reflexes are tested, they may be diminished or absent, particularly in the ankle.
The major causes and risk factors for diabetic neuropathy are outlined below.
Poor Control Over Blood Sugar
Poor control over blood sugar is one of the main causes of diabetic neuropathy. Patients may have trouble controlling their blood sugar due to lifestyle habits and medication problems. For example, some patients do not check their blood sugar as often as their doctor recommends, and this means they cannot take action to correct potentially high numbers. If a patient's diet is high in fast food and processed food items, they may experience large swings in sugar readings throughout the day, and these can be very difficult to manage. To achieve better control over blood sugar and reduce the risk of neuropathy, diabetes patients may need to take a combination of tablets, injections, and insulin to control their glucose. Consultations with a nutritionist may help patients with meal planning and educate them about dietary changes that may stabilize their glucose readings.
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Kidney disease is a complication of diabetes that can lead to nerve damage, eventually causing neuropathy. In diabetes patients, kidney disease develops because elevated blood sugar leads to high blood pressure. This high blood pressure also increases the pressure within the filtering system of the kidneys, which is comprised of clusters of blood vessels that remove toxins. Symptoms of kidney disease include itching, shortness of breath, insomnia, loss of appetite, muscle cramps, and swelling in the legs and feet. Patients with kidney problems are often advised to eat a diet low in protein to reduce the waste products in the bloodstream. Doctors typically begin by using medications that reduce blood pressure and swelling in the lower limbs. Patients may also be given medicines to treat anemia and protect against bone damage. For later stages of kidney disease, patients will need dialysis, and some patients may ultimately need to have a kidney transplant.
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Nerve And Blood Vessel Damage
Nerve and blood vessel damage are associated with all types of diabetic neuropathy. In addition to the painful foot symptoms that are common with peripheral neuropathy, the autonomic type of diabetic neuropathy can lead to more serious problems with the nerves and blood vessels. For example, patients with this form of the condition may have cardiovascular, bladder, eye, and gastrointestinal concerns. Urinary tract infections, bladder incontinence, nausea, constipation, and bloating may develop. Some patients experience an elevated heart rate, problems with blood pressure regulation, and swallowing difficulties. This type of damage to nerves and blood vessels cannot be reversed, and treatment focuses on pain relief and slowing down or halting the progression of damage. For example, patients who have urinary tract infections or blood pressure changes will be given medication to treat these concerns. Specific pain relievers designed to treat pain from diabetic neuropathy can be prescribed as well. To slow the progression of nerve and blood vessel damage, diabetes patients will be given specific blood glucose targets. Keeping glucose readings between eighty and 130mg/dL prior to meals is considered ideal for reducing the risk of nerve complications. If readings are taken within two hours of eating a meal, doctors recommend they measure less than 180mg/dL.
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Obesity can make the symptoms of diabetic neuropathy worse, as excess weight places increased strain on the bones, joints, blood vessels, and organs. Patients are considered obese if they have a body mass index (BMI) of thirty or more. Doctors recommend overweight or obese patients to try to lose weight through a combination of dietary changes and exercise. Eating a primarily plant-based diet that is low in saturated fat and refined sugar may help patients lose weight effectively. Exercise can boost the patient's metabolism so they burn more calories throughout the day. In particular, obese patients are advised to avoid fast food, fried food, processed food, and soda. Patients who have trouble losing weight may wish to have a consultation with a nutritionist or join a local or online support group for weight loss. Individuals planning to start a new exercise program should consult their physician, and they may wish to start with gentle activities such as swimming, yoga, and walking. If necessary, several prescription medications are available that may enable patients to lose weight, and surgical interventions may be appropriate for individuals who have struggled with their weight for a long time.
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Length Of Time With Diabetes
A patient's length of time with diabetes is a strong risk factor for diabetic neuropathy. The longer a patient has had diabetes, the more likely they are to develop neuropathy. To reduce this risk and detect neuropathy as early as possible, patients should examine their feet daily to look for sores, bruises, cuts, and redness. It is recommended that patients have an annual foot examination with a doctor as well. In addition to looking after their feet, patients should be vigilant for any signs of tingling, numbness, shooting pains, or weakness, particularly in the extremities. These signs and any new or worsening symptoms should be evaluated by a physician as soon as possible.