Diabetic neuropathy can affect various parts of the body and living with it may be difficult and frustrating. Medical student Yimeng Zhang takes a look at different neuropathies and how it is possible to reduce their debilitating effects.
Fifty per cent of diabetics are likely to suffer from diabetic neuropathy, which is a form of nerve damage that affects several areas of the body but predominantly the feet.
Most neuropathies develop gradually and the problems are normally noticed when considerable damage has already occurred.
The prolonged high sugar concentration in the blood can injure nerve fibres throughout the body by different mechanisms such as interfering with the function, reducing oxygen and nutrient supply and causing inflammation of the nerves. These are contributed to by genetic factors plus smoking and alcohol abuse, which damage both the nerves and blood vessels.
The signs and symptoms of diabetic neuropathy vary, depending on the affected nerves and the type of neuropathy. For certain individuals, symptoms can be mild and for others it can be painful, disabling and even fatal.
Peripheral neuropathy is the most common form of diabetic neuropathy. The feet and legs are often affected first, followed by the arms and hands. Symptoms include increased or decreased sensation, tingling or painful feeling in the affected areas, as well as muscle weakness and difficulty walking. These can cause serious problems such as ulcers and infections, most commonly in the feet. Sometimes, the small sores on the feet do not heal properly and, in severe untreated cases, the tissues of the foot can die.
Another type of neuropathy is known as autonomic neuropathy. This affects organs such as the heart, bladder, lungs, stomach, intestines, sex organs and eyes. Sufferers can have higher chances of urinary tract infections or incontinence; constipation or uncontrolled diarrhoea; nausea, heartburn, vomiting and reduced appetite; trouble swallowing; erectile dysfunction in men; feelings of faint and light-headedness and also changes in eyesight.
Diabetic neuropathy can lead to serious health complications while affecting one’s enjoyment of life
Other types of diabetic neuropathy can present with sudden pain in the hip, thigh or buttock; weight loss; double vision; chest or abdominal pain; paralysis on one side of the face; and weakness in muscles such as the hand, along with reduced feeling in the fingers.
Notify your doctor if you notice:
• Unusual sensations in your hands or feet such as tingling, burning, pain or weakness, especially if it is affecting your daily activities or sleep;
• Sores or cuts on your feet that are taking a long time to heal, could be infected or getting worse;
• Dizziness or fainting sensations;
• Changes in your bowel habits, urination or sexual function.
These symptoms do not always indicate nerve damage but can be signs for other problems that also need medical care. Therefore, it is best to seek early diagnosis and treatment to avoid future problems.
Living with diabetic neuropathy can be difficult and frustrating as people often find it hard to understand what is happening. Sufferers can often feel down, so they should speak to a doctor, therapist or a support group.
Good foot care is essential. Sores that don’t heal, ulcers and even amputation are common complications of diabetic neuropathy. Check feet daily if there are any concerns and look for blisters, cuts, bruises, skin changes, redness or swelling. Keep feet clean and dry, trim toenails carefully and wear comfortable cushioned shoes that fit well. When washing, always test the water temperature using the palms of your hands first, as people can suffer scalds if they are unable to judge water temperature. When in doubt, seek advice from a podiatrist or physician to prevent more serious problems.
Diabetic neuropathy is very common and it can lead to serious health complications while affecting one’s enjoyment of life. The good news is that neuropathy can be easily prevented or slowed down by effective control of blood sugar and a healthy lifestyle.
Keeping diabetes in check
Anyone who has diabetes can develop neuropathy. However, poor blood sugar control, kidney disease and smoking increase the risks. Possible measures to decrease the likelihood of developing neuropathy are:
Good blood sugar control: this is the most important factor in reducing neuropathy and other complications of diabetes. Constant monitoring is required to keep it as close to normal as possible. Consistency is important as shifts in blood sugar levels can speed up nerve damage.
Keep blood pressure under control: this reduces the damage to the blood vessels, which help to keep the nerves healthy. Check it regularly whenever possible and aim to keep it under 130/80mmHg.
Healthy eating: eating a balanced diet with a variety of fruits, vegetables and whole grains, limiting portions to achieve or maintain a healthy weight.
Be active: exercise not only helps to achieve a healthy weight, blood pressure and blood sugar, it also protects the heart and improves blood flow. Thirty minutes of moderate exercise a day, five times a week, is what is normally recommended; however, consult a doctor if you have doubts on what you should be doing.
Stop smoking: tobacco in any form increases the likelihood of a heart attack and stroke in diabetics as well as in non-diabetics. There is also an increased chance of getting circulatory problems and makes it more difficult for wounds to heal. Tobacco also causes damage to the nerves in the body.