Saturday 18 March 2023

What to know about diabetic neuropathy

Diabetic neuropathy is a complication of diabetes that results in damage to the nervous system. It is a progressive disease, and symptoms get worse over time.

Neuropathy happens when high levels of fats or sugar in the blood damage the nerves in the body. It can affect virtually any nerve in the body, with a wide range of symptoms.

Nerves are essential to how the body works. They enable peopleTrusted Source to move, send messages about how things feel, and control automatic functions, such as breathing.

There are several types. Some involve the peripheral nerves, while others damage the nerves that supply the internal organs, such as the heart, the bladder, and the gut. In this way, it can affect many body functions.

Between one-third and a halfTrusted Source of people with diabetes have neuropathy, according to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).

In this article, we explore the different types, effects, and risks of diabetic neuropathy.

Peripheral neuropathy

Autonomic neuropathy

Other types

Not all of the symptoms of peripheral neuropathy are visible, but people should be aware of any wounds on their feet.

A physician will carry out a physical exam and foot exam to check for:

  • ankle reflexes
  • loss of sensation
  • changes in skin texture
  • changes in skin color

Other tests may include a check of blood pressure and fluctuations in heart rate.

If the doctor suspects diabetic neuropathy, they may run some diagnostic tests, such as:

  • an electromyogram (EMG), which records electrical activity in the muscles
  • a nerve conduction velocity test (NCV) which records the speed at which induced signals pass through the nerves

Most types of diabetic neuropathy gets worse over time.

The first step for people with any type is to bring blood sugars within a target range agreed with a doctor and manage high blood pressure and cholesterol levels.

Managing glucose levels will minimize the risk of diabetic neuropathy. A key part of treatment focuses on reducing pain and managing some of the symptoms.

Certain medicationsTrusted Source and types of physical therapy can help to control the pain of diabetic neuropathy, alongside other treatments. However, they cannot repair the nerves.

People should also avoid or stop smoking and limit their alcohol intake to a maximum of one drink a day for women and two for men.

Medications

Drugs that can help to manage pain include:

  • anticonvulsant drugs
  • tricyclic antidepressants
  • opioids and nonopioid pain relief medication

Opioid use can lead to dependency, so doctors should prescribe as low a dose as possible.

A person with diabetic neuropathy might use other types of antidepressants, such as serotonin-norepinephrine inhibitors, to target other painful symptoms of diabetic neuropathy.

Topical lotions, compound creams, and some supplements, such as ALA or topical capsaicin, may also provide relief.

Capsaicin cream is available for purchase online.

Physical therapy

Physical therapy, used in combination with medications, might help relieve pain and reduce the risk of dependency on opioids.

It may also help alleviate:

  • burning and tingling sensations in the legs and feet
  • muscle cramps
  • muscle weakness
  • sexual dysfunction

Electrical nerve stimulation is a painless type of physical therapy that might help to reduce feelings of stiffness and enhance the healing of foot ulcers.

Gait training involves relearning how to walk. It helps to prevent and stabilize foot complications, such as ulcers and injury. This type of physical re-education is crucial for people using prosthesis after losing limbs if diabetic neuropathy leads to an amputation.

A good physical therapist will ensure that exercises for people with diabetic neuropathy do not hurt the feet, which can be sensitive.

Other therapies include devices that a person can use to keep painful or sensitive extremities from touching the bed or chair.

A chiropractor, massage therapist, or osteopath can carry out regular massages or manual therapy to stretch the muscles. Massage can inhibit muscle contractions, spasms, and atrophy due to poor blood supply.

Specific exercises, such as swimming or aerobics, can help an individual develop and maintain muscle strength and reduce the loss of muscle mass.

Therapeutic ultrasound is another type of physical therapy that uses very high-frequency sound waves to stimulate the tissue beneath the skin. This can help some people to regain sensitivity in their feet.

Diabetic neuropathy can contribute to a number of high-risk complications, ranging from heart rate changes to visual disturbances.

Possible complications include losing sensation in the feet.

This can lead to an inability to feel cuts or sores, and infection might occur as a result. Untreated infection in a limb can result in the need for amputation.

Severe bladder and kidney infections might also occur, causing health problems.

To prevent the complications of diabetic peripheral neuropathy, good foot care is essential.

People with the condition should inspect their feet every day for injuries or sores.

Smoking also increases the risk of foot problems in people with certain types of diabetic neuropathy. A podiatrist can help with foot care, and a healthcare provider can give advice on quitting smoking.

Q:

A:

The best way to minimize diabetic neuropathy is by maintaining good blood sugar control and regular foot care. If you take Metformin for a long time, which is a commonly used medication in the treatment of type 2 diabetes, consider having a Vitamin B12 level checked as well, as Metformin can lower the B12 level which can also cause neuropathy.

Source - Medical News Today


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