You’ve been feeling that numbness at your toes for more than a couple of weeks now. The numbness comes with a peculiar feeling of tingling burning sensation. At night, a sharp jabbing pain at your feet wakes you up. You have difficulty in walking due to pain. Worse, you can’t distinguish between cold or hot and your extremities don’t have any feeling at all. It can be terrifying! Actually, it’s one more complication of your diabetes.
Peripheral Neuritis (pronounced /new.righ’tis/)
Peripheral neuritis is the most common type of neuropathy (pronounced /new.rop’uth-ee/) occurring among diabetics. It affects your toes, feet and later your arms and hands. As you lose your capacity to feel any pain in your extremities serious complications set in. You can hurt your foot on something without knowing it. An open wound results. Too much sugar in your blood sets the stage for infection. Then, it leads to ulceration and deformities. When necrosis or tissue death occurs, your leg will have to be amputated.
The manifestations of other types of neuropathy depend upon what types of nerves are affected. Apart from peripheral neuritis other types of diabetic neuropathy are autonomic (pronounced /aw”tuh.nom’ick/) neuropathy, radiculoplexus (pronounced /ra.dick”yoo.lo.pleck’sus/) neuropathy and mononeuropathy (pronounced /mon”o-new.rop’uth-ee/).
Autonomic neuropathy affects the nerves controlling the functions of your body organs. Your autonomic nervous system is responsible in the functioning of your heart, lungs, stomach, intestines, sex organs, bladder and eyes. When the nerves of your bladder are affected you’ll experience urinary incontinence. On the other hand, when your stomach nerves are involved you’ll feel slow stomach emptying termed as gastroparesis with nausea, loss of appetite and vomiting. Constipation or uncontrolled diarrhea can also be symptoms.
When the nerves of sex organs are involved, males suffer erectile dysfunction while females sexual difficulties.
The nerves of your heart can be affected too and your body will have difficulty in adjusting to blood pressure and heart rate. You’ll feel a fast heart rate at rest. You’ll undergo a sudden drop in blood pressure from a sitting to a standing position that can cause faintness or lightheadedness.
There would be problems regulating your body temperature. If your eye nerves are affected, you’ll have trouble adjusting from light to dark. Dangerously, your body might not detect low blood sugar levels. When this happens, weakness or fatigue sets in. In extreme cases, hypoglycemic coma can occur.
Radiculoplexus neuropathy is also termed as diabetic amyotrophy (pronounced /am”eye.ot’ruh.fee/), femoral neuropathy or proximal neuropathy. It affects the nerves in your thighs, hips, buttocks or legs. The symptoms appear suddenly and severely. The muscles affected become weak then atrophy and you’ll have to struggle rising from a sitting position. If your abdomen is affected swelling occurs. Over time, weight loss ensues.
Mononeuropathy involves damage to a specific nerve. When your facial nerve is affected, paralysis of one side of your face occurs termed as Bell’s palsy. Other symptoms include pain in your foot, shin and front of thigh; difficulty focusing your eyes, double vision and pain behind your eye; chest or abdominal pain. Compression neuropathy can happen such as in carpal tunnel syndrome. You’ll feel numbness and tingling especially in your thumb, index, middle or ring fingers plus weakness in your hand.
Why Neuropathy Occurs
Diabetic neuropathy slowly ensues from years of uncontrolled blood sugar levels that destroy the nerves. In some cases, smoking and alcohol abuse contribute to the development of neuropathy. Medical experts say a genetic disposition is to blame and sometimes the cause is totally unknown.
Management of Neuropathy
According to the Mayo clinic the goals in the management of neuropathy is to slow the progression of the condition, to relieve pain, manage other complications that may arise and to restore the function of the body area affected.
The best way to slow progression is to tighten control of your blood sugar levels. Monitor your blood sugar levels daily. Your blood sugar levels should be between 70- 130 mg/dl before meals and no less that 180 mg/dl two hours after meals. Undergo Hemoglobin A1C testing every three months and your values shouldn’t be more than 7 percent.
Take your anti-diabetic medications as prescribed by your health care provider. Couple this with the right diet, exercise and healthy lifestyle habits.
To relieve pain, your doctor will recommend medications such as anti-seizure medication, anti-depressants, topical anesthetics or opioids which have been shown to work well.
Antispasmodics can ease incontinence. Consuming smaller but frequent meals can alleviate digestive problems. The incidence of low blood pressure on standing can be avoided by standing up slowly and drinking extra fluids.
Medications can restore functions of organs such as in erectile dysfunction. When they aren’t effective men can resort to vacuuming. In women, lubrications can help.
Alternative treatments work well too such as transcutaneous electrical nerve stimulation, acupuncture and biofeedback. Alternative treatments such as food supplements can complement medications. Clinical studies had proven that they can help in alleviating symptoms and slowing the progress of neuropathy. Alpha lipioc acid, evening primrose oil, acetyl L-carnitine, B complex vitamins, quercetin, bromelain, capsaicin and black currant seed oil are some of them.
The best way to prevent diabetic neuropathy is to maintain normal blood glucose levels daily. Continue your diabetic medications or insulin as instructed by your doctor, pay attention to your diet, weave in exercise in your daily routine and maintain healthy lifestyle habits.