How common is Diabetic Neuropathy? If you have diabetes, then you probably know it’s very common. I come from a long line of relatives with type 2 diabetes on my mother’s side. They have all had serious complications from diabetes, such as amputations, heart disease, and infections, etc.
The American Diabetes Association (ADA) estimates that half of everyone that has diabetes, whether type 1 or type 2, has some neuropathy or nerve damage.
So now we’ll look at signs and symptoms, diagnosis, treatment, and how to delay serious complications. In addition, trying to stay active when in pain.
What is Diabetic Neuropathy?
There is two types of neuropathy commonly known with diabetes:
- Peripheral Neuropathy: Peripheral neuropathy can cause tingling, pain, numbness, or weakness in your feet and hands.
- Autonomic Neuropathy: Autonomic neuropathy affects the nerves throughout your body.
Peripheral neuropathy is the most common in people with diabetes. So this is the one we will be focusing on.
Peripheral neuropathy also known as diabetic neuropathy is nerve damage with limited blood flow to your toes, feet, and legs.
Risk of experiencing neuropathy if
The number one cause of neuropathy is high blood sugar levels.
If your A1c levels are consistently above 8 percent all the time, well then this increases your risk of neuropathy. If your level is above 10 percent year after year, then you are guaranteed to rapidly increase your chances of developing neuropathy.
Anyone that has been living with elevated blood sugar for years or in people that have had diabetes for years are at a much greater risk of getting neuropathy.
Most people with healthy blood sugars can experience neuropathy, however, it is not common. But, even these cases can have a mild to moderate neuropathy.
In addition, people with diabetes, neuropathy is closely related to obesity and high blood pressure.
As if that’s not enough, even people with non-diabetes related conditions can have neuropathy. These are conditions such as lacking nutrients in your diet, chemical exposure, and alcoholism, etc.
Ways to Prevent Diabetic Neuropathy
The simplest way to prevent neuropathy is to reduce your A1c. You need to keep your blood sugars under control and below the 8 percent that we talked about earlier. In an ideal world, it would be better to keep it below 7 percent.
Limiting the amount of alcohol you drink. Allowing yourself just a couple of drinks per week would be good.
If you are a smoker, quit right now.
Stay active, exercise increases the blood flow to your toes and feet. Losing weight, control blood sugars, and reduce your blood pressure.
At mealtime eat healthily. It all boils down to eating more homecooked meals and not fast foods.
Be sure to take your insulin and medications as prescribed daily. Talk to your healthcare provider if your blood sugars are especially high or low consistently. At times your insulin or medication dosages may need to be changed.
Be sure to check your blood sugars regularly!
Neuropathy Symptoms if you have Diabetes
The early signs of diabetic neuropathy are very easy to recognize. These are some of the symptoms that you will have:
- Sharp pain
- Sensitive to touch
- At some point no feeling
- Loss of balance and weakness in the muscles
In the early stages, your symptoms may not happen all the time. Symptoms are much worse in the evening. Sometimes these symptoms can be mistaken for something else. Be sure that you mention these symptoms to your healthcare provider.
Catching these symptoms early can stop your neuropathy from getting much worse.
Getting a Diagnosis for Neuropathy
There is a couple of ways to discover if you do indeed have neuropathy.
A neurological examination is one of the tests to see if you have neuropathy. Your healthcare provider will touch areas of your feet and legs with a plastic filament gadget.
You will keep your eyes closed during this test. You will tell your doctor what you can feel as he moves the instrument in different areas of your feet.
In addition, you will be asked to demonstrate the balance and strength in your feet. This will include muscle tone and posture.
Your examination for detecting neuropathy will involve examining for signs of injury in your feet.
Additional scans may be necessary after the examination.
The second test involves using a probe that sends electrical signals to a nerve. This records the reaction in the nerve to the signal. This test is known as electromyography, which can involve some light pricking or tingling sensations. The electromyography is not painful.
Often additional testing may not be necessary for people with diabetes.
Neuropathy can be more puzzling for people without diabetes. Non-diabetics may require more testing to rule out causes such as pinched discs, etc.
Finding Pain Treatment for Neuropathy
Neuropathy treatment can be easy for some and difficult for others depending on the intensity. This is why it is important to get an early diagnosis.
Acetaminophen can be used for mild to moderate pain. But, large doses of acetaminophen can lead to liver damage if taken long-term.
Nsaids (aka…Advil, Motrin, Aleve) reduces inflammation and reducing pain. However, long-term use of these may result in stomach ulcers and nausea.
Creams (topical medicine) with ingredients such as capsaicin may provide temporary relief for burning and pain.
A common way of treating nerve pain is with gabapentin. The side effects are mild. Gabapentin was originally prescribed for anti-seizure medication. The primary side-effect is drowsiness, so, for this reason, it is taken at night before bed.
A drug specifically used for diabetic neuropathy is duloxetine, but its also an antidepressant. The long-term use of this medication is uncertain. Duloxetine has many side-effects, including dizziness, nausea, constipation, and no appetite.
Approved by the FDA for use in treating diabetic neuropathy is pregabalin. Very similar to gabapentin it was intended for use as an anti-seizure medication. Pregabalin can be addicting, which needs a careful decision to prescribe to patients.
There are a few other drugs on the market for diabetic neuropathy, such as lidocaine, alpha-lipoic acid, and lastly narcotics.
Narcotics should not be used long-term for many conditions because it is highly addictive and a dangerous form of pain medication.
Risks of Nerve Damage
There are many worries that come with diabetic neuropathy. That loss of feeling in your feet and toes. Sometimes cuts, scrapes, and blisters can go unnoticed.
If you have high blood sugar levels, that cut or scrape can turn into an infection very fast. The earlier an infection is detected the faster it can be healed. If the infection spreads it can put you at risk of losing a toe or your entire foot. Sometimes it can be an entire leg.
Most people that have a toe or foot amputation had some form of neuropathy caused by diabetes before surgery.
Preventing Infection and Amputation
Never go barefoot, always wear socks and shoes. If barefoot you may step on something and cut your skin. Because of the loss of feeling in your foot or toes, you may not notice.
To prevent moisture, change your socks if they feel damp. Damp feet are a breeding ground for bacteria. The bacteria makes it difficult for cuts and blisters to heal.
Check your feet every day, either in the morning or in the evening before bedtime. Look for any cuts, scrapes, or blisters. If needed ask someone to help you if you have a hard time seeing the bottom of your feet.
Trim your toenails. Bacteria love overgrown toenails and dirty feet. So take care of your toenails!
If you have diabetes and neuropathy you want to wear good shoes especially when exercising. Your shoes should be the right size and type for the exercise you are doing. Your feet deserve a new pair of shoes at least once a year.
Call your healthcare provider as soon as possible if your cut or scrape is not healing. If your cut or scrape has any sign of infection, like redness, pus, pain, or swelling, this may require a trip to urgent care.
Now, this is important, the better your blood sugars are controlled it is unlikely that your blister will turn into an infection. So, less sugar in the blood, less chance of infection.
Neuropathy and Exercising
Diabetes and neuropathy should not stop you from exercising. Staying active is good for everyone. Being active on a regular basis is part of taking care of yourself.
Here are some ways that regular exercise can benefit neuropathy:
- Increases blood flow to the feet and toes
- It lowers insulin resistance
- Lowers glucose levels while exercising
- Keeps your heart healthy
- Reduces the risk of cardiovascular disease
- And it is good for you
At the same time, it can be hard to exercise when you are in pain. Here are a few exercises you can do. Before starting any routine talk to your healthcare team.
Low Impact Aerobic Exercises
Water aerobics, swimming, stationary bike, rowing are all great exercises. They get the blood flowing. These exercises do not have a lot of impact on your feet.
Walking could be a good aerobic exercise depending on how your feet are feeling. But make sure to wear socks and a pair of good shoes. Your doctor may not want you to walk or exercise on your feet if you are healing.
Use Strength Training Machines
If you have a membership at a gym take advantage of their strength training machines. You can work almost every muscle with these machines. Strength training helps lower blood sugar levels and insulin resistance. Its low impact and doesn’t require much from the bottom of your feet.
There are strength training exercises you can do at home, but the gym has a much greater benefit if you have neuropathy. It gets better, the more muscle you have, the more calories you burn when resting.
Exercising while watching TV
At every commercial on the television stand up and do some balance and stretching exercises. Maintaining balance is important as you manage your neuropathy. Yes, some exercises are boring, but take advantage of your television time. Your body will thank you!
It all boils down to this, neuropathy can be a mind-blowing diagnosis. Use that diagnosis to help make better decisions, so you can improve the way it controls your life.