Overview:
Diabetic neuropathy is a type of nerve damage that can occur in people with diabetes. Over time, high blood sugar can injure nerves throughout the body, most often affecting the legs and feet. Symptoms vary depending on which nerves are affected and may include pain, numbness, or problems with the digestive system, urinary tract, blood vessels, and heart. Some people have mild symptoms, while others may experience severe pain and disability.
Symptoms:
Symptoms depend on the type of neuropathy and affected nerves. They usually develop slowly over time.
1. Peripheral Sensorimotor Neuropathy (Distal Symmetric Neuropathy):
• Most common type.
• Affects feet and legs first, then hands and arms.
• Symptoms: numbness, tingling, burning, sharp pain, muscle weakness, sensitivity to touch, serious foot problems like ulcers and infections.
2. Autonomic Neuropathy:
• Affects blood pressure, heart rate, digestion, bladder, eyes, sweating, and sexual function.
• Symptoms: hypoglycemia unawareness, orthostatic hypotension, rapid heartbeat, bladder or bowel problems, gastroparesis, swallowing difficulties, vision changes, abnormal sweating, sexual dysfunction.
3. Proximal Neuropathy (Diabetic Polyradiculopathy):
• Affects thighs, hips, buttocks, or legs (sometimes one side).
• Symptoms: severe pain, muscle weakness and wasting, trouble standing, chest or stomach pain.
4. Mononeuropathy (Focal Neuropathy):
• Affects a single nerve (face, torso, arm, or leg).
• Symptoms: double vision, paralysis, numbness or tingling in hands or feet, weakness in hands, foot drop, pain in shin or front thigh.
Lifestyle Management:
• Blood Sugar Control: Keep blood sugar in a healthy range.
• Diet: Balanced diet with fruits, vegetables, whole grains, lean protein.
• Exercise: Regular moderate activity like walking, yoga, tai chi.
• Quit Smoking: Improves circulation.
• Limit Alcohol: Reduces neuropathy risk.
• Manage Stress: Meditation, relaxation, biofeedback.
Foot Care and Comfort:
• Daily foot inspections for cuts, blisters, calluses.
• Protective footwear and socks.
• Foot protection at night using a semicircular hoop.
• Warm (not hot) baths.
• Moisturize feet regularly.
Pain Relief and Movement:
• Topical treatments: capsaicin cream, lidocaine patches.
• Gentle massage for blood flow and pain relief.
• Stretching exercises: toe scrunches, ankle pumps.
• Supportive devices: insoles or custom orthotics.
Supplements and Complementary Therapies:
• Supplements: B vitamins (B12), alpha-lipoic acid, omega-3, N-acetylcysteine (under doctor supervision).
• Massage and acupuncture may help relieve pain.
Important Considerations:
• Consult your doctor before starting new exercises or therapies.
• Physical therapists can provide guidance for safe exercises, especially if sensation is reduced or foot injuries are present.
Dr. Talib jijan
Al-Mustaqbal University
The First University in Iraq.