Diabetic peripheral neuropathy is a serious and common complication of diabetes. Currently there are 29 million cases of type 2 diabetes that have been diagnosed and another 8.1 million cases that are undiagnosed, reported by the CDC (Center for Disease Control and Prevention).
According to the U.S. Department of Health and Human Services, between 60 and 70 percent of people with diabetes have some form of neuropathy.
If you don’t know that you’re diabetic, you may be unaware of what’s causing some of the strange sensations you’re experiencing. Patients sometimes report painful symptoms and other times minor or no symptoms at all. Nerve damage can even develop 10 years or longer after you have been diagnosed with diabetes.
What Causes Nerve Damage?
Diabetic neuropathy is often caused by years of high, unregulated blood glucose causing injury to the vessels that supply the body’s nerves with adequate nutrition and oxygen. After years of deprivation, due to poor blood replenishment, the nerves become impaired. Neuropathy symptoms can vary depending on the severity and extent of nerve damage.
The U.S. Department of Health and Human Services reports that most people with diabetes have moderate or severe nerve damage. Symptoms, usually, first appears in the feet and legs, and later, may occur in the hands and arms.
Symptoms Of Neuropathy
Peripheral neuropathy can manifest with a wide variety of symptoms and will differ from person to person. The symptoms experienced are dependent upon where the nerve is damaged and how severe the damage may be. Here are common symptoms:
Numbness or Tingling
A common symptom of diabetic peripheral neuropathy is numbness in the feet (or hands), resulting in the inability to feel your feet while walking. This can lead to puncture wounds in your feet when walking barefoot. One of our patients stepped on his wife’s sewing needle, while walking barefoot through the house. He never felt the needle embed all the way in his foot. His wife discovered it when she noticed a long thread hanging off the bottom of his foot. This resulted in a trip to the ER.
Other times, your hands and/or feet will tingle. This sensation can feel the same as when one of your limbs falls asleep. It may also feel like you’re wearing a sock or glove when you’re not.
Risks from foot injuries are especially dangerous to diabetics since the combination of neuropathy and poor blood circulation makes wounds tougher to heal. Longer healing times can leave injuries prone to infection. In extreme cases, infection can lead to amputation.
Many neuropathy sufferers will report burning pain, especially in their feet. The burning sensation is often described as being bitten by fire ants or worse, patients will state that their feet feel- literally- like they are on fire. Many patients will soak their feet in an ice bath in order to get some relief.
Shooting Pain and Cramping Pain
Sometimes pain will be sudden and sharp, like an electrical current. Other times, you may feel severe cramping in the muscles. This can occur in the muscles of the feet, calves, hands or forearms. This pain can also cause muscular weakness resulting in you dropping items you’re holding as a result of your symptoms.
Loss of Balance
Loss of balance and coordination is a common sign of diabetic peripheral neuropathy. This is the single largest issue resulting in life threatening falls, especially amongst the elderly. Often, muscle weakness affects the ankle, which can affect your gait.
Extreme Sensitivity to Touch
Diabetic peripheral neuropathy can also result in exaggerated sensations. Many people can’t tolerate the weight of bed sheets on their legs or even the sensation of clothing against their skin. Holding a cup of warm coffee may feel painfully hot. Or, it could actually hurt if a person with cold hands touches you. Also, your hands or feet may feel hot or cold for no reason.
When Pain Prevents Sleep
Since diabetic peripheral neuropathy often worsens at night, it can interfere with your ability to fall asleep or stay asleep. This occurs for two reasons. First, typically you have been very active during the day which exacerbates or creates more inflammation on the nerve. This will cause heightened levels of pain. Secondly, when you climb into bed, stimulus (distractions) on your body is decreased causing the pain signals to be much louder or more pronounced. This will cause your pain perception to be much more intense.
Neuropathy is an umbrella term for several types of nerve damage.
Peripheral neuropathy is nerve damage that affects the feet, toes, legs, hands, and arms. With type 2 diabetes, nerve damage due to peripheral neuropathy usually affects the feet and legs before the arms or hands. Symptoms are varied based on which part of the peripheral nerves have been damaged. Damage to the motor portion of the nerve can cause cramping, muscle weakness or muscle wasting. This often leads to changes in a person’s mobility, gait, and balance.
Damage to the sensory portion of the nerves can result in numbness, tingling, burning sensations, or extreme sensitivity to touch. Many patients report not being able to tolerate bed sheets on their legs.
Autonomic neuropathy relates to damage of the nerves that regulate automatic and semi-automatic functions of the body such as, digestion, bladder, and bowel functions, as well as heart and sexual function. In this type of nerve damage, the “automatic” nerve responses of the body’s internal organs are affected. Type 2 diabetics with autonomic neuropathy may have problems digesting food, breathing, trouble urinating or incontinence, and/or sexual problems, such as impotence.
Problems with autonomic neuropathy may make it difficult to determine when your blood glucose levels are too low. Normally, symptoms associated with hypoglycemia like sweating and heart palpitations are obvious, but those symptoms may be masked by nerve damage.
Nerve damage to the digestive system may cause constipation, trouble swallowing, or gastroparesis, a disorder that causes a delay in digestion. Gastroparesis may worsen over time until a person is debilitated by frequent nausea and vomiting. Delayed digestion often makes keeping track of glucose levels more difficult. In severe instances of gastroparesis, a person may subsist on a liquid diet or be fed via feeding tube.
Nerve damage to the cardiovascular system can cause changes in a person’s heart rate and blood pressure. For instance, type 2 diabetics with autonomic neuropathy may experience a drop in blood pressure after sitting or standing, causing them to feel dizzy and light headed.
Nerve damage to the urinary tract and sex organs can cause difficulty controlling urination and sexual function. For instance, neuropathy in the bladder may cause incontinence or make it more difficult to fully empty. Autonomic neuropathy may also decrease sexual function, leaving men without the ability to become erect , and women with vaginal dryness and difficulty achieving orgasm.
This type of neuropathy commonly affects type 2 diabetics, especially older adults. It predominantly affects the hips, thighs, buttocks, or legs and typically begins on one side of the body. Proximal neuropathy can weaken the legs, and in severe cases, a person may lose enough muscle tone to no longer have the ability to go from a sitting to a standing position without assistance. Nerve damage of this type is often painful.
Sourced through Scoop.it from: www.healthline.com
NEUROPATHY HELP…What Should You Do?
29.1 million Americans have been currently diagnosed with diabetes in the U.S., according to the CDC (Center for Disease Control and Prevention). CDC has also estimated that 38% of Americans have pre-diabetes.
These statistics are horrifying when you realize that 70% Of All Diabetics Will Develop Peripheral Neuropathy, so it is important for you to be proactive.
Even if you currently lack symptoms of neuropathy, you may fall into the 70% ratio of diabetics that develop nerve damage. Remember it can take as long as one or two decades after diagnosis to develop neuropathy, so don’t wait to be diagnosed. Take action now!
Eat Low Glycemic Index Foods. This will allow your glucose levels to decrease, substantially. (click on this link to learn more about Glycemic Index)
Minimize grain and other starch (potatoes) consumption to no more than 2 servings per day. For instance, you may have a small serving of oatmeal for breakfast (men- 1 cooked cup / women 1/2 cup, cooked) and rice with lunch (same portion size as oatmeal). Eliminate any starches at dinner time. Eat only protein, non-starchy vegetables and good fat.
If you are closely adhering to dietary plan in #1 and #2 you can have 1 cheat day per week. This will give you something to look forward to, while still allowing your glucose levels to drop. (note: glucose levels will elevate on cheat days but then will drop again).
Avoid Trans fats (hydrogenated and partially hydrogenated oils) and vegetable oils (sunflower, safflower, soybean oil, corn oil, canola oil, peanut oil). Use Ghee (clarified butter), coconut oil or extra virgin olive oil.
Start exercising. You don’t necessarily have to find a gym. Start by walking around your neighborhood. If your balance and stability is poor, make sure to take your cane or walker with you and stay on even surfaces or begin with these chair exercises (click here). Exercising will help increase your insulin sensitivity.
Get adequate sleep (7-8 hours). Even one night of inadequate sleep can raise your insulin resistance. This is because the stress hormone, cortisol, is elevated. This will cause you to crave more carbs, but even when you eat them, you will feel worse afterward because your glucose tolerance has been reduced. If you’ve had a poor nights sleep, it’s especially important to make to eat Low Glycemic Index Foods
In addition to keeping glucose levels in a healthy range, studies now show that controlling blood pressure to ward off complications from diabetes is just as important. In 2010, the British Medical Journal reported, “In patients with type 2 diabetes the risk of diabetic complications was strongly associated with raised blood pressure.” Any reduction in blood pressure is likely to reduce the risk of complications, with the lowest risk being in those with systolic blood pressure less than 120 mm/Hg. The good news…if you follow these steps above, your blood pressure will naturally begin to decrease. We have had patients who no longer need their blood pressure medication.
Diabetic Peripheral Neuropathy Can Be Reversed
Most doctors do not know how to successfully treat peripheral neuropathy. They tell patients that there is no cure and that they will have to live with this condition for the rest of their lives. As a result, patients have their hopes crushed and many times enter into a state of depression.
Doctors most commonly prescribe medications like Gabapentin, Lyrica, Cymbalta and even Tramadol to control pain. These medications, unfortunately, do not aid in nerve repair but merely mask the symptoms, at best.
The reality is that peripheral neuropathy does not have to be a death sentence. There are many clinical studies published in widely respected journals, such as, the Journal of Neurology and the British Medical Journal that show effective treatments that reverse the damage to peripheral nerves.
In fact, here at the San Antonio Neuropathy Center, we have been using just such treatment protocols as have been developed by Harvard Medical School, Massachusetts General Hospital and the University of Maryland and we have been able to help thousands of patients recover from peripheral neuropathy.
If you’ve been told, “You Just Have To Live With Your Neuropathy.”, and you’re tired of suffering, then schedule a consult with one of our neuropathy experts today. You can request an appointment by Clicking Here.
San Antonio Neuropathy Center
13150 NW Military Hwy.
San Antonio, TX, 78231�
American Diabetes Association. Diabetes Statistics. (2011) Data from the 2011 National Diabetes Fact Sheet. National Diabetes Fact Sheet, 2011.http://www.diabetes.org/diabetes-basics/diabetes-statistics/
Amanda I. Alder, Epidemiologist et al. (2000) Association of systolic blood pressure with macrovascular and microvascular complications of type 2 diabetes. British Medical Journal, 321(7258): 412. http://www.bmj.com/content/321/7258/412.full?sid=c446d05f-e1c9-4721-8f0f-b4b2764324d9
Dyck, P., et al. (1993). The prevalence by staged severity of various types of diabetic neuropathy, retinopathy, and nephropathy in a population-based cohort: the Rochester Diabetic Neuropathy Study. Neurology, 43(4), pp. 817.
Dyck, P., et al. (1995). Variables influencing neuropathic endpoints: the Rochester Diabetic Neuropathy Study of Healthy Subjects. Neurology, 45(6), pp. 1115.
Edwards, J., et al. (2008). Diabetic neuropathy: mechanisms to management.
Pharmacology & Therapeutics, 120(1), pp. 1.
National Diabetes Information Clearinghouse (NDIC). 2009. National Institute of Diabetes and Kidney Diseases/Institutes of Health. Diabetic Neuropathies: The Nerve Damage of Diabetes. http://diabetes.niddk.nih.gov/DM/pubs/neuropathies/
Mayo Clinic Writing Staff. (2010) Pain Relief Difficult With Neuropathies. Living With Diabetes. http://www.mayoclinic.com/health/neuropathies/MY01379
National Institutes of Health. (2011) Diabetic Neuropathy. A.D.A.M, Medical Encyclopedia. http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001713/?report=printable
Diabetes Teaching Center at the University of California at San Francisco. (2011) Nerve Complications. Living With Diabetes http://dtc.ucsf.edu/living-with-