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Diabetic Neuropathy: Causes, Symptoms, Prevention, and Cure

Diabetic Neuropathy: Causes, Symptoms, Prevention, and Cure

Diabetic Neuropathy: Causes, Symptoms, Prevention, and Cure

 

Diabetic Neuropathy (a.k.a: Diabetic Nerve Damage) is a microvascular complication of diabetes. It is a major health concern as it is associated with decrease in quality-of-life of the patient. About 60% limb amputations (not associated with trauma) occur in patients with diabetes. The main contributing factor for this incidence is poor management of diabetes.

 

What is Diabetic Neuropathy?

Diabetic Neuropathy is a condition in which nerves are damaged gradually due to history of diabetes.

 

Types of Diabetic Neuropathy:

Diabetic neuropathy is classified based on the site at which nerves are damaged. They are:

  • Peripheral – Affects legs and feet
  • Autonomic – Affects digestive system, urinary system, blood vessels, and reproductive system
  • Focal – Affects specific nerves of head, torso, and leg
  • Proximal – Affects hips or thighs
  • Diffuse – Affects nerves of different body parts at once

Among the four types, peripheral neuropathy is common and proximal neuropathy is rare and disabling.

 

What Causes Diabetic Neuropathy?

High blood glucose levels cause oxidative stress that in turn leads to damage of the blood vessels. Decrease in supply of oxygen and nutrients to the nerves due to endothelial dysfunction leads to damage of nerves (neuropathy). Other causes that may lead to neuropathy are:

  • Inflammation in nerves
  • Mechanical injury to nerves
  • High triglyceride levels
  • Vitamin B12 deficiency

 

What are the Symptoms of Diabetic Neuropathy?

Symptoms depend on the type of neuropathy or the nerves that are affected. Symptoms of each type are given below:

 

Peripheral neuropathy:

 

Autonomic neuropathy:

  • Decreased sweating
  • Tachycardia
  • Constipation
  • Loss of appetite
  • Nausea and vomiting
  • Erectile dysfunction

 

Focal neuropathy:

  • Muscle weakness
  • Pain

 

Proximal neuropathy:

  • Pain in hips or thighs
  • Weakness of legs
  • Pain on one side

 

Risk Factors of Diabetic Neuropathy:

The major risk factor for diabetic neuropathy is chronic diabetes and its poor management. Factors that may also influence diabetic neuropathy are:

 

Complications of Diabetic Neuropathy:

As there will be loss of sensation in the feet and legs, there may be unnoticed foot injuries such foot ulcers and infections. Other potential complications that are associated with diabetic neuropathy are:

  • Severe neuropathic pain
  • Emotional distress
  • Decreased activity
  • Physical disability due to loss of limb
  • Erectile dysfunction in men

 

Diabetic Neuropathy Diagnosis:

Diabetic neuropathy is diagnosed based on the clinical examination of foot and the symptoms. Feet are examined for pain, tenderness, and ulceration.

Tuning fork Testing: A tuning fork is placed on the bone on the tip of the great toe. It is then tapped to vibrate. If vibrate does not last for more than 8 sec, then it may be a sign of diabetic neuropathy.

Monofilament Screening Test: A filament is used to touch the foot (for stimulation of the foot) to determine the sensation of touch.

Tendon Reflexes: Tendon reflex test is performed by striking the bone with a percussion hammer.

Nerve Conduction Studies: Responses and nerve conduction velocity are measured by electrical stimulation of nerves. This study helps to determine the function and ability of electrical conduction of nerves.

Blood Tests: Blood tests are performed to determine the glucose levels, electrolyte levels, vitamin B12 levels, and urea levels in the blood. Kidney and Liver function tests are also performed.

 

Stages of diabetic neuropathy:

  • Stage 0 – No signs or symptoms
  • Stage 1 – Asymptomatic neuropathy but abnormalities can be detected in nerve conduction test
  • Stage 2 – Symptomatic neuropathy
  • Stage 3 – Polyneuropathy with physical disability

 

Treatment for Diabetic Neuropathy:

The first intervention should be treating the high glucose levels. This helps in resuming the blood flow and prevents further damage.

There is no specific cure for neuropathy, but treatment can be given to relieve the symptoms. Pain killers such as aspirin, paracetamol, or ibuprofen can be taken.

First-line medications for neuropathic pain are amitryptiline, gabapentin, and pregabalin. These medications are prescribed for longer duration.

The healthcare provider may also advise you to undergo physiotherapy for speedy recovery. Advantages of physiotherapy are:

  • Reduces pain
  • Improves balance
  • Improves muscle strength

This in turn improves quality-of-life of the patient by helping them to manage their daily activities.

Psychological therapy might be required for some patients who are suffering with low self-esteem. Educating about the neuropathic pain, making them to accept their diagnosis, and understanding the physical limitations are very essential. Cognitive and behavioral therapy would help to relieve from stress and control emotions. Meditation and relaxation therapies also might help.

Being active, exercising regularly, being social, and taking the medications as per prescription would help in speedy recovery.

 

Prevention and Cure for Diabetic Neuropathy:

Along with medical and nonmedical management, following natural remedies also helps in relieving from neuropathic pain. Certain home remedies might help in relieving from neuropathic pain. Home remedies and foods that may help in reducing diabetic neuropathy are:
Warm water bath helps to reduce pain and stress.

  • Ginger helps in reducing blood sugar levels and also has anti-inflammatory properties.
  • Alpha-lipoic acid, present in foods such as broccoli and peas, repairs the damaged nerve cells.
  • Regular massaging with mustard or olive oil also helps in reducing pain.

Blood sugar control, proper foot care, and maintaining healthy life style would help to prevent and cure diabetic neuropathy. Maintaining normal blood sugar levels is the first and foremost measure to prevent and cure diabetic neuropathy.

  • Take the medications as per prescription.
  • Undergo screening tests regularly.
  • Avoid consumption of sweets, fruit juices, dried foods, and fruits such as banana.

Foot care is also very essential to prevent damage to the feet.

  • Check your feet daily.
  • Keep the feet clean and dry.
  • Trim the nails regularly.
  • Wear properly fitted shoes.
  • Do not go barefoot.

Maintaining a healthy lifestyle also helps in prevention.

  • Consume healthy diet rich in fruits and vegetables.
  • Limit alcohol consumption.
  • Quit smoking.
  • Reduce stress.

 

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