Increased blood sugar levels in a person with diabetes have a detrimental effect on overall health. A prolonged increase in blood glucose levels causes nerve damage leading to neuropathy. In simple words, diabetic neuropathy means damage to the nerves. Diabetic neuropathy causes are unknown. Researchers believe that an increase in blood sugar, triglyceride and cholesterol levels causes damage to blood vessels and nerves, which interferes with neural transmissions, causing diabetic neuropathy.
Diabetic neuropathy can involve peripheral nerves that usually affect the legs and feet. It might also involve autonomic nerves, affecting internal organs such as the abdomen, urinary system, blood vessels and reproductive organs. Diabetic neuropathy affecting proximal nerves affects the thighs, buttocks, hips and legs. Another form of diabetic neuropathy involves focal nerves and affects a specific nerve.
Diabetic neuropathy symptoms differ according to the type of neuropathy. Symptoms associated with peripheral neuropathy are tingling, burning and numbness in affected body parts. Autonomic neuropathy symptoms vary from diarrhoea, heartburn, nausea, constipation, low blood pressure and increased heartbeats to emptying the bladder. Proximal neuropathy is associated with pain in the hips, thighs and buttocks. Focal neuropathy symptoms include pain in the eyes, paralysis of one side of the face and double vision.
How to diagnose diabetic neuropathy?
Diabetic neuropathy tests include a physical examination and laboratory tests. Along with these, specific diabetic neuropathy tests include:
- Filament test: This test analyses the sensitivity to touch sensation.
- Sensory test: Analyses response to sensory stimulations such as vibration and temperature changes.
- Nerve conduction test: This test analyses the speed at which the nerves conduct electric signals.
- Electromyography: Electromyography is usually performed in combination with nerve conduction tests and helps measure the production of electric discharge by muscles.
- Autonomic tests: This test analyses autonomic functions, including sweating and blood pressure maintenance.
How to manage diabetic neuropathy?
The human body cannot wholly reverse nervous tissue damage. Hence, if you think diabetic neuropathy can be reversed or stopped, the answer is that it cannot be wholly reversed or stopped. Here are specific ways to manage the condition:
- Keeping blood sugar levels optimal: This can be achieved by reducing intake of highly refined sugar products and increasing intake of fibres and protein. One should monitor blood glucose levels regularly and take medications to maintain optimal blood sugar levels. Physical exercise and a few lifestyle changes such as quitting smoking and reducing alcohol intake can help attain these goals and protect nerves from damage.
- Keeping feet free from any wound, infection and injury: Always check for sores or open wounds. Keeping toenails trimmed and soaking feet in soap and water can also help. These simple steps can be followed as part of a diabetic neuropathy home treatment regime.
- Getting treatment for nerve pain: If the neuropathy is diagnosed early, adequate treatment can minimise the damage.
How to treat diabetic neuropathy?
Diabetic neuropathy treatment includes the management of diabetic neuropathy symptoms and is focused on treating pain. Diabetic neuropathy pain treatment includes physical therapy and medications. Drugs that can be used as treatment modalities include:
- Tricyclic antidepressant
- Opioids for pain relief
- The opioids for diabetic neuropathy pain treatment should be prescribed in low doses as they can cause drug dependency.
In addition, compound creams and lotions like topical capsaicin can also relieve the pain associated with diabetic neuropathy. All these drugs provide relief from the pain associated with diabetic neuropathy but cannot reverse the damage that has already occurred to nerves.
Drug therapy can be used with physical therapy to reduce medication dependency and provide better results for overall treatment.
These physical therapies include:
- Electric nerve stimulation
- Gait training
- Diabetic neuropathy physiotherapy treatment
- Massage to improve blood supply
- Swimming and aerobic exercises help gain muscle strength and mass and are the best options for diabetic neuropathy home treatment.
- Therapeutic ultrasound is a physical therapy that uses high-frequency sound waves to stimulate deep tissues and muscles.
- Hydrotherapy is also beneficial in diabetic neuropathy, as it causes an increase in blood circulation. In this therapy, a body part is immersed in cold and hot water alternatively.
What are the complications of diabetic neuropathy?
Diabetic neuropathy complications depend on the type of neuropathy.
- In Autonomic neuropathy, nerve damage involves internal organs. It can affect the digestive system, leading to poor nutrition and a further increase in blood sugar levels and worsening complications of diabetes neuropathy.
- It can also impact the sexual organs causing erectile dysfunction and reduced vaginal lubrication.
- Peripheral diabetic neuropathy can cause recurring infections and sores, leading to ulcers.
- Nerve damage in neuropathy can ultimately cause swelling, pain and instability in joints.
The most common question about diabetic neuropathy is, “Can diabetic neuropathy be stopped?” Though nerve damage in peripheral and autonomic neuropathy cannot be reversed, nerve damage can be reversed in focal and proximal neuropathy cases. This reversal process requires consistent maintenance of blood sugar levels and improving dietary intake with a plant-based diet. This dietary change helps keep blood sugar levels lower and overcome insulin resistance. However, the process is prolonged and might take years to show improvement.
Diabetic neuropathy, meaning damage to nerves, is irreversible, but the pain and complications can be managed efficiently. Understanding the diabetic neuropathy cause and adapting to a healthy lifestyle to maintain blood glucose levels at optimal levels plays a crucial role. In addition, early identification of diabetic neuropathy with diabetic neuropathy tests and starting medical and physical therapy like diabetic neuropathy physiotherapy treatment, electric nerve stimulation, and hydrotherapy at early stages can limit the damage caused by diabetic neuropathy.
Q1. What is the fastest way to get rid of neuropathy?
Ans. Physical activities like walking, swimming and regular exercise improve muscle strength and also help to control blood sugar levels. It is known to be the fastest way to get rid of diabetic neuropathy.
Q2. Why is diabetic neuropathy worse at night?
Ans. The decreased temperature at night increases the sensation in peripheral nerves and causes an increase in pain. Excessive physical activities and exertion during the day can also increase the pain at night.
Q3. What food should I avoid with neuropathy?
Ans. The management of diabetic neuropathy involves healthy eating. In neuropathy, the food that should be avoided includes gluten, artificial and refined sugar sources, alcohol, refined grains and saturated fats. Salty foods contain sodium that can decrease the blood supply to peripheral organs and must be avoided.
Author : Nidhi Mahajan