What is diabetic neuropathy?
Neuropathy refers to any condition that damages nerve cells. These cells play a critical role in touch, sensation, and movement. Diabetic neuropathy refers to damage of nerves that’s caused by diabetes. Scientists believe that the high content of blood sugar in the blood of a person with diabetes damages nerves over time.
There are several different types of neuropathies. They include:
- Peripheral: Pain and numbness in the extremities including arms, feet, legs, hands, and toes
- Proximal: Pain and numbness in the upper legs, specifically the buttocks, thighs, and hips
- Autonomic: Damage to nerves of the autonomic nervous system which control sexual response, sweating, urinary and digestive function
- Focal: Sudden loss of function in nerves causing pain and weakness of the muscles
Neuropathy is one of the common effects of diabetes. It’s estimated that 60-70 percent of people with diabetes will develop some sort of neuropathy throughout their lives. By 2050, it’s estimated that over 48 million people in the United States will be diagnosed with diabetes. That means in the future, anywhere from 28-33 million Americans could be affected by diabetic neuropathy.
Managing diabetic neuropathy
Nerve damage from diabetes cannot be reversed. This is because the body can’t naturally repair nerve tissues that have been damaged. However, researchers are investigating methods to treat nerve damage caused by diabetes.
While you cannot reverse the damage from neuropathy, there are ways to help manage the condition, including:
- lowering your blood sugar
- treating nerve pain
- regularly checking your feet to make sure they are free of injury, wounds, or infection
Controlling your blood glucose is important because it can help prevent additional damage to your nerves. You can better control your blood glucose through the following methods:
- Avoid foods high in excess sugars, including sodas, sweetened drinks and coffees, fruit juices, and processed snacks and candy bars.
- Eat foods high in fiber. These foods typically help keep blood sugars at a steady state.
- Eat foods that contain healthy fats, like those from olive oil and nuts, and choose lean proteins like chicken and turkey.
- Eat vegetables and plant based proteins regularly, such as beans and tofu.
- Exercise at least five times a week, thirty minutes each time. Include aerobic activity and weight training in your routine.
- Monitor your blood sugar according to your doctor’s recommendation and record your levels. This will help you identify patterns and unusual changes in your blood sugar levels.
- Take insulin or oral medications, such as metformin (Glucophage), as instructed by your endocrinologist or primary care doctor.
In addition to managing your blood glucose levels, it’s important to pay attention to your feet and legs. Nerves in the legs and feet can be damaged, which can lead to reduced feeling. This means that you may not notice it if you cut or injure your foot or leg. To prevent damage:
- regularly check your feet for open wounds or sores
- clip your toenails
- wash your feet with soap and water regularly
- regularly visit a podiatrist
- avoid walking barefoot
How is diabetic neuropathy treated?
According to the current guidelines from the American Academy of Neurology, the most effective medications for treating painful diabetic neuropathy (PDN) include:
Other suggested treatment may options include:
- opioids, also known as narcotics
- topical medications, like capsaicin (Qutenza)
- electrical nerve stimulation
Glucose management is a highly effective way of reducing symptoms and the progression of neuropathy. Managing your glucose levels should always be a part of your treatment plan.
Off-label drug use
Off-label drug use means that a drug that’s been approved by the FDA for one purpose is used for a different purpose that it has not been approved for. However, a doctor can still use the drug for that purpose. The FDA regulates the testing and approval of drugs, but not how doctors use drugs to treat their patients. Therefore, your doctor can prescribe a drug however they think is best for your care.
What are the complications for diabetic neuropathy?
Nerves have many important functions in the body. That is why diabetic neuropathy can lead to many complications.
Nerves damaged by neuropathy can negatively impact organs in your digestive system. This can lead to:
- impaired hunger
Additionally, it can affect how food moves within your stomach and intestines. These problems can lead to poor nutrition and, over time, more difficult-to-control blood sugar levels.
If you have autonomic neuropathy, the nerves that impact sexual organs may be harmed. This can lead to:
- erectile dysfunction in males
- issues with sexual arousal and vaginal lubrication in females
- impaired stimulation in both genders
Infection in legs and feet
Nerves in the legs and feet are often most affected by neuropathy. This can cause you to lose sensation to your feet and legs. Sores and cuts can go unnoticed and lead to infections. In some extreme cases, infections can become severe and lead to ulcers. Over time, this can cause irreparable damage to the soft tissue and lead to the loss of toes or even your foot.
Joint damage in the legs
Damage to the nerves in your legs can lead to something called a Charcot joint. This results in swelling, numbness, and lack of joint stability.
Excess of reduced sweating
Nerves impact the function of sweat glands, so damage to nerves could affect the functioning of your sweat glands. This can lead to anhydrosis, also known as reduced sweating, or hyperhidrosis, also known as excess sweating. This can lead to difficulties regulating body temperature.
Nerves play an important role in managing the bladder and urinary system. If the nerves that affect these systems are damaged, this can lead to the inability to recognize when the bladder is full and poor control of urination.
What else can cause neuropathy?
Neuropathy is most commonly caused by diabetes, but it may be caused by other conditions, including:
- exposure to toxins
- abnormal levels of vitamin B and vitamin E
- trauma that causes pressure to nerves
- autoimmune diseases and infections
What’s my outlook?
Diabetic neuropathy is common and cannot be reversed. However, you can manage it through a variety of ways. These include:
- managing blood glucose levels
- taking medications your doctor has prescribed for the treatment of neuropathy
- regularly self-checking your feet and legs for injury
- talking with your doctor and working with them to manage your condition