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How to Deal With Diabetic Peripheral Neuropathy
Diabetes can damage the nerves that transmit signals throughout the body. This nerve damage is known as diabetic neuropathy.
When you have diabetes, you are more likely to have high levels of glucose and triglycerides floating around in your bloodstream. Given enough time, they will damage the nerves that send pain signals to your brain, as well as the tiny blood vessels that supply the nerves with nutrients…causing neuropathy.
Obviously, the best way to prevent or delay the onset of diabetic neuropathy is to control your blood glucose and blood pressure.
Four main types of diabetic neuropathy
Nerve damage caused by diabetes can manifest itself in different parts and functions of your body. Symptoms vary depending on the type of diabetic neuropathy you have.
There are four main types…
Autonomic neuropathy is a group of symptoms that occur when there is damage to the nerves that control daily bodily functions, such as blood pressure, heart rate, sweating, digestion and emptying of the bowels and bladder, and digestion. It causes major disturbances in the functioning of your body.
Mononeuropathy or focal neuropathy is damage to a certain nerve on the face, torso (middle part of the body) or leg. It is most common in the elderly. Mononeuropathy often occurs suddenly and can cause severe pain. However, this usually does not result in any long-term problems.
Proximal neuropathy is a rare, disabling type of nerve damage in the hip, buttock, or thigh. This nerve damage usually affects one side of your body, making it difficult to move, but it rarely spreads to the other side.
Diabetic peripheral neuropathy (DPN) is the most common type of diabetic neuropathy and is the main topic of this essay.
DPN is nerve damage that allows the sensation of pain, heat and cold. It usually affects the feet and legs first, followed by the hands and arms.
Its symptoms can often be worse at night. These may include one or more of the following:
numbness or reduced ability to feel pain or temperature changes
tingling or burning, a bit like “pins and needles”
“electrical” shocks that go through your feet at random intervals (which can cause your feet or legs to twitch)
sharp pains or cramps
increased sensitivity to touch (even the weight of a sheet can be painful)
loss of reflexes, especially in the ankle
loss of balance and coordination
serious foot problems, such as ulcers, infections, and bone and joint pain
If you experience any of these symptoms and the clinic you visit for diabetes has not yet screened for diabetic peripheral neuropathy, you should insist on testing as soon as possible.
However, you may not have symptoms even though your nerves are damaged.
How common is diabetic neuropathy?
About half of the people in North America and Europe who have diabetes also have some type of nerve damage. Indeed, 2 out of 10 people already have diabetic peripheral neuropathy when they are first diagnosed with diabetes.
A person who has prediabetes, is obese, or has metabolic syndrome (three out of four high blood glucose, high blood pressure, high cholesterol, and belly fat) has a much higher chance of developing DPN than a healthy person.
So, if you are diabetic, it is very important that your doctor checks you regularly for DPN… when you are diagnosed with diabetes and then at yearly intervals.
What are the tests for diabetic peripheral neuropathy?
Your doctor will do a series of tests to see if you have DPN.
First, he or she will visually inspect your feet and legs, looking for cuts, sores, and problems with your circulation. He can then watch you walk to check your balance.
After that, he’ll probably want to find out how sensitive you are to temperature changes… usually by asking you.
He or she will also want to know how sensitive you are to light touch. The doctor may hang a thin piece of string or thread over your foot while you look away, occasionally touching your foot with the string to see if you notice. In another test, he can use a tuning fork on your toes and feet to see how sensitive you are to vibrations.
Your doctor will also take some blood and urine tests. They help him monitor the level of glucose and triglycerides in the blood.
These lab tests can also help rule out other causes of neuropathy such as thyroid problems, kidney disease, low vitamin B12 levels, infections, cancer, HIV, and alcohol abuse…neuropathy resulting from such causes may need to be treated differently.
Consequences of diabetic peripheral neuropathy
Some of the symptoms of DPN can be very painful, making it difficult to walk or even sleep comfortably at night.
In addition, DPN increases the likelihood that you could get a severe infection in one of your feet. This is because the reduced ability to feel pain associated with this type of neuropathy means that you may not notice minor cuts, blisters or other injuries on your feet because you cannot feel them.
Because diabetes reduces the effectiveness of your immune system, minor cuts can take longer to heal…these wounds can become serious before you find them. Indeed, they could become seriously infected, meaning that if you don’t get the proper care in time, you could lose a toe or foot through amputation.
Charcot leg… is another threat arising from DPN. Severe neuropathy can weaken the bones in your foot. As a result, bones can crack or break.
Since your feet have no feeling, you could continue to walk on the broken foot and deform it… the arch, for example, could collapse and bulge downwards.
If detected early enough and after a period of rest, a skilled doctor can treat Charcot foot with braces and special shoes. Serious cases, however, require surgery.
How to take care of your feet
Nothing can be done to reverse the damage caused by diabetic peripheral neuropathy to your feet.
However, there are a few things that can be done to ease the pain and prevent DPN from getting worse.
Painkillers… over-the-counter medications are not very good for treating peripheral neuropathy pain. Products you put on the skin to numb it, such as lidocaine, can help mask the pain. Medicines used to treat depression (eg citalopram) and seizures (eg gabapentin) can reduce pain.
Personally, this writer has found Neurostil (gabapentin) to be very helpful in relieving foot pain due to DPN.
Additionally, physical therapy in the form of specific exercises designed to restore your sense of balance and sensation in your feet can get you moving (and improve your mood at the same time). Just google “peripheral neuropathy foot exercises” for tons of suggestions.
Care for your feet… because your feet are insensitive, you may not notice minor injuries that can turn into major problems. So you should thoroughly inspect your feet every day… looking for sores, cuts or burns… and don’t forget to check between your toes. You can use a mirror to see the underside of your soles. If you notice any problems that don’t go away in a day or two, see your doctor.
Keep your feet clean. You should wash them every night in warm water, testing the water to make sure it’s not too hot before putting your feet in it. Be sure to dry them thoroughly afterwards.
When lying down, elevate your legs (say on pillows) to maintain circulation. Wiggling your toes will also help keep your feet healthy.
Appropriate footwear… put on good, comfortable shoes that breathe and have enough room for the toes. The width must fit your feet. Make sure the seller makes an effort to measure your feet correctly. Different types of runners are best, especially those with gel or air cushions in the soles. Consider using inserts or buy special shoes for diabetics.
Show your shoes to the doctor when you go for an examination and ask for his opinion.
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