Know the Early Signs of Diabetic Nerve Damage

Diabetic neuropathy or nerve damage is a debilitating complication of diabetes mellitus. It affects about 50 percent of patients with diabetes, significantly affecting quality of life as well as contributing to morbidity and mortality. Between 20 to 30 percent of the patients also develop neuropathic pain. ^[1]

Diabetic neuropathy develops from damage to nerves due to high blood glucose or blood sugar levels. High blood sugar in the bloodstream causes nerve damage in several ways. One is oxidative stress, which is an imbalance of free radicals and antioxidants in the body that leads to cell damage. Further injuring nerve fibers and contributing to the progression of nerve damage, high blood sugar also promotes inflammation. And high glucose levels can lead to the formation of Advanced Glycation End Products (AGEs). These harmful compounds accumulate in tissues and can directly damage nerves and blood vessels that supply nerves.^[2]

There are several types of diabetic neuropathies:

·         Peripheral: Peripheral neuropathy affects the peripheral nervous system, resulting in pain and numbness in the extremities, including arms, hands, legs, feet, and toes. Because of numbness, someone with diabetes might not feel a foot injury, cut or even a blister that could result in an ulcer. Left untreated due to diminished sensation, a diabetic foot ulcer can get worse over weeks or months without someone knowing because they do not feel the pain

·         Proximal: Pain and numbness in the upper legs, specifically the buttocks, thighs, and hips. This type of nerve damage typically affects one side of the body and may rarely spread to the other side.[3]

·         Autonomic: This nerve damage disturbs signal processing between the autonomic nervous system (The autonomic nervous system (ANS) is responsible for regulating involuntary bodily functions and the brain.) Injured autonomic nerves can affect blood pressure, heart rate, bladder, digestive system and perspiration.[4]

·         Focal: Focal neuropathy damages a single, specific nerve, which may be in the head, torso, arm or leg. Focal or mononeuropathy also can affect single nerves in different parts of the body at the same time.

Watch for signs of diabetic neuropathy

Among the early signs of diabetic neuropathy are:

Tingling or numbness in extremities: One of the earliest signs of neuropathy is the gradual onset of numbness, prickling or tingling in the fingers and toes. The sensation can feel like pins and needles. It can spread upwards to arms and legs.

Sharp, burning pain: Another early sign of diabetic neuropathy is a sudden sharp pain or burning sensation in the feet and hands. Pain may be intermittent or constant. The sensations often spread to the legs and arms as the condition evolves.

Extreme sensitivity to touch: Exaggerated sensitivity is another early diabetic neuropathy symptom. A light towel dropping on someone can cause pain or a warm cup of coffee may feel painfully hot.

Loss of balance and coordination: Peripheral neuropathy can impact sensory signals from the feet affecting balance and making someone may be more susceptible to falls. Stumbling may be one of the early signs of diabetic neuropathy.

Muscle weakness: Muscle weakness in hands, arms, feet and legs may be the result of deterioration of nerves that control muscles.

Feeling like wearing invisible gloves or socks: Sensory nerve damage can affect hands and feet and result in people feeling like they are wearing gloves and socks when they are not.

Blood pressure abnormalities: Drops in blood pressure are another of the signs of diabetic neuropathy symptoms. The result is dizziness or lightheadedness.

Managing pain

You cannot reverse neuropathy caused by diabetes because the body cannot naturally repair damaged nerve tissues. Despite extensive research, effective treatments to halt or reverse the progression of the condition remain hard to achieve. Alleviating diabetic neuropathy symptoms and controlling pain are currently the main strategies for managing diabetic neuropathy. ^[5]

Pain medications, anti-seizure medications, antidepressants, relaxation training, acupuncture, transcutaneous electronic nerve (TENS) therapy, hypnosis, biofeedback training, and topical creams are some of the types of treatments to manage diabetic nerve pain and complications. [6]

Slowing down diabetic neuropathy

In addition to alleviating pain, managing diabetes to keep blood glucose levels within target range can help slow down the progression of the condition. Diabetes management starts with healthy eating. A healthy diabetes meal plan includes when, what and how much to eat to ensure getting the necessary nutrition and at the same time keeping blood sugar levels on target. Diabetes meal planning also takes into consideration particular tastes and lifestyle, as well as needed medications.

Diabetic neuropathy self-care and management also involves:^[7]

• Keeping blood pressure under control
• Maintaining a healthy weight
• Staying active. The American Diabetes Association says getting 150 minutes of moderate intensity exercise each week can help manage diabetes. ^[8]
• Quit smoking
• Managing stress
• Limiting alcohol consumption
• Watching for and taking care of injuries and infections
• Attending physical therapy
• Compensating for weakness and loss of balance by wearing orthopedic braces
• Improving vitamin deficiencies

Watch for the early signs of diabetic neuropathy. Since you cannot reserve it, you want to make sure to keep it from getting worse.