Diabetes and nerve damage
Diabetes and nerve damage is also known as Diabetic neuropathy, Diabetes - neuropathy, Diabetes - peripheral neuropathy.
Causes :
People who have diabetes, their body's nerves can be damaged by reduced blood flow and a high blood sugar level. This condition is more probable when the blood sugar level is not properly controlled over time.
About one half of people with diabetes get nerve damage. Symptoms frequently do not start until many years after diabetes has been diagnosed. Some of the people with diabetes that develops steadily they already have nerve damage when they are diagnosed first.
People with diabetes are also at greater risk for other nerve problems not caused by their diabetes. These other nerve problems would not have the same symptoms and will process in a different manner than nerve damage caused by diabetes.
Symptoms :
Symptoms frequently develop slowly over many years. The types of symptoms you have depend on the nerves that are affected.
The Nerves in the feet and legs are most frequently affected. Symptoms frequently begin in the toes and feet, and include tingling or burning, or deep pain. Over time, nerve damage can also take place in the fingers and hands. As the damage gets worse, you will probably lose feeling in your toes, feet, and legs. Your skin can also become numb. Because of this, you can :
Not aware when you step on something sharp
Not know that you have a swelling or small cut
Not aware when your feet or hands touch something that is too hot or too cold
Have feet that are cracked and very dry
When the nerves that control digestion are affected, you can have trouble in digesting food (gastroparesis). This can make your diabetes even more harder to manage. Damage to nerves that control digestion almost always take place in people with serious nerve damage in their feet and legs.
Symptoms of digestion problems include:
Feeling full after eating only a small amount of meal
Heartburn and bloating
Nausea, constipation, or diarrhea
Swallowing problems
Throwing up undigested food a few hours after having a meal.
When nerves are damaged in your heart and blood vessels , you can :
Feel faint when you stand up (orthostatic hypotension)
Have a fast heart rate
Not observe angina, the chest pain that warns of heart disease and heart attack
Other symptoms of nerve damage are:
Sexual problems, which lead to trouble getting an erection in men and vaginal dryness or orgasm problems in women.
Not able to tell when your blood sugar gets too low.
Bladder problems, which lead to an urine leakage or not able to empty the bladder.
Sweating more, even when the temperature is cool, when you are at rest, or at other unusual times.
Feet that are more sweaty (early nerve damage).
Exams and Tests :
The health care team will do a physical exam. The exam can find that you have the following:
Dont have reflexes or weak reflexes in the ankle
Loss of feeling in the feet (this is checked with a brush-like instrument known as a monofilament)
Changes in the skin, including dry skin, thick or discolored nails and hair loss
Loss of the capacity to sense movement of your joints (proprioception)
Loss of the capacity to sense vibration in a tuning fork
Loss of the capacity to sense heat or cold
Lowering of blood pressure when you stand up after sitting or lying down
Tests that can be ordered include:
Electromyogram (EMG), a recording of an electrical activity in muscles
Nerve conduction velocity tests (NCV), a recording of the speed at which signals travel with nerves
Gastric emptying study to look for how fast food leaves the stomach and enters the small intestine
Tilt table study to look at the nervous system wheather it is properly controlling blood pressure or not.
Treatment :
Follow your health care team advice on how to slow diabetic nerve damage.
Control your blood sugar (glucose) level by:
Eating healthy foods
Getting regular exercise
Checking your blood sugar as often as instructed and keeping a record of your numbers so that you know the types of foods and activities that affect your blood sugar level
Taking oral or injected medicines as suggested by your health care team
To treat the symptoms of nerve damage, your health care team can prescribe medicines to treat:
Pain in your feet, legs, or arms
Nausea, vomiting, or other digestion problems
Bladder problems
Erection problems or vaginal dryness
If you are recommended medicines for symptoms of nerve damage, be aware of the following:
The medicines are frequently less beneficial if your blood sugar is usually high.
After you start the drug, tell your provider if the nerve pain doesn't improve.
When you have nerve damage in your feet, the feeling in your feet can be reduced. You may not have feeling at all. As a result, your feet can not heal properly if they are injured. Taking care of your feet can cure minor problems from becoming so serious that you end up in the hospital.
Caring for your feet includes:
Checking your feet every day
Getting a foot test each time you see your health care team Wearing the right kind of socks and shoes (ask your provider about this)
Outlook (Prognosis)
Treatment relieves pain and controls some symptoms.
Other problems that may develop include:
Bladder or kidney infection
Diabetes foot ulcers
Nerve damage that hides the symptoms of the chest pain (angina) that warns of heart disease and a heart attack
Loss of a toe, foot, or leg through amputation, frequently because of a bone infection that does not heal
When to Contact a Medical Professional
Call your provider if you develop any symptoms of diabetic neuropathy.