Nerve damage from diabetes – self-care
Diabetic neuropathy is a type of nerve damage that can happen with diabetes. Blood sugar, also called glucose, becomes high because of diabetes. Over time, high blood sugar can injure nerves throughout the body. Diabetic neuropathy most often damages nerves in the legs and feet.
Depending on the affected nerves, diabetic neuropathy symptoms may include pain and numbness in the legs, feet and hands. It also can cause problems with the digestive system, urinary tract, blood vessels and heart. Some people have mild symptoms. But for others, diabetic neuropathy can be painful and disabling.
Diabetic neuropathy is a serious health concern. It may affect up to half of people who have diabetes. But diabetic neuropathy often can be prevented. And people who have it can take steps to keep it from getting worse. The key is to tightly manage blood sugar and lead a healthy lifestyle.
Tingling or burning in the feet and legs may be an early sign of nerve damage in them. These feelings often start in your toes and feet, but can also start in the fingers and hands. You may also have deep pain or aching or just a heavy feeling. Some people may have very sweaty or very dry feet from nerve damage.
Nerve damage may cause you to lose feeling in your feet and legs. Because of this, you may:
- Not notice when you step on something sharp.
- Not know you have a blister or small wound on your toes.
- Not notice when you touch something too hot or too cold.
- Be more likely to bump your toes or feet against objects.
- Have the joints in your feet more likely to become damaged which can make it harder to walk.
- Experience changes in the muscles in your feet which can cause increased pressure on your toes and balls of your feet.
- Be more likely to have infections of the skin on your feet and in your toenails.
People with diabetes may have problems digesting food. These problems can make your diabetes harder to control. Symptoms of this problem are:
- Feeling full after eating only a small amount of food.
- Heartburn and bloating.
- Nausea, constipation, or diarrhea.
- Swallowing problems.
- Throwing up undigested food several hours after a meal.
Heart-related problems may include:
- Lightheadedness, or even fainting, when sitting or standing up.
- Rapid heart rate.
Neuropathy may “hide” angina. This is the warning chest pain for heart disease and heart attack. People with diabetes should learn other warning signs of a heart attack. They are:
- Sudden fatigue.
- Sweating.
- Shortness of breath.
- Nausea and vomiting.
Other symptoms of nerve damage are:
- Sexual problems. Men may have problems with erections. Women may have trouble with vaginal dryness or orgasm.
- Not being able to tell when your blood sugar gets too low (“hypoglycemia unawareness”).
- Bladder problems. You may leak urine. You may not be able to tell when your bladder is full. Some people are not able to empty their bladder.
- Sweating too much. Particularly when the temperature is cool, when you are at rest, or at other unusual times.
Treating diabetic neuropathy can make some symptoms of nerve problems better. The best way to keep the problem from getting worse is to have good control of your blood sugar.
Your health care provider can give you medicines to help with some of these symptoms.
- Medicines may help reduce painful symptoms in the feet, legs, and arms. They usually do not bring back loss of feeling. You may have to try different medicines to find one that reduces your pain. Some medicines will not be very effective if your blood sugars are still very high.
- Your provider may give you medicines to help with problems digesting food or having a bowel movement.
- Other medicines can help with erection problems.
Learn how to take care of your feet. Ask your provider:
- To check your feet. These exams can find small injuries or infections. They can also keep foot injuries from getting worse.
- About ways to protect your feet if the skin is very dry, such as using a skin moisturizer.
- To teach you how to check for foot problems at home and what you should do when you spot problems.
- To recommend shoes and socks that are right for you.
To figure out if you have diabetic neuropathy, your healthcare professional gives you a physical exam. You’re also asked questions about your symptoms and medical history.
During the exam, your healthcare professional most often checks:
- Your overall muscle strength and tone.
- The reflexes of your muscles and tendons.
- How sensitive you are to touch, pain, temperature and vibration.
Along with a physical exam, your healthcare professional may do or order certain tests. The tests can help confirm whether or not you have diabetic neuropathy. They may include:
- Filament testing. A soft nylon fiber called a monofilament is brushed over areas of your skin. This is done to check how sensitive you are to touch.
- Sensory testing. This test is used to tell how your nerves respond to vibration and changes in temperature.
- Nerve conduction testing. This test measures how quickly the nerves in your arms and legs conduct electrical signals.
- Electromyography. Called needle testing, this test is often done along with nerve conduction studies. It measures electrical activity in your muscles.
- Autonomic testing. Special tests may be done to determine how your blood pressure and heartbeat change while you are in different positions. The tests also can help identify whether your sweating is within the standard range.
These measures can help you feel better overall and lower your risk of diabetic neuropathy:
- Keep your blood pressure under control. If you have high blood pressure and diabetes, you have an even higher risk of other medical problems. Try to keep your blood pressure in the range your healthcare professional recommends. Have it checked at every medical visit.
- Make healthy food choices. Eat a balanced diet. Include a variety of healthy foods, especially vegetables, fruits and whole grains. Limit portion sizes to help reach or stay at a healthy weight.
Be active every day. Exercise helps lower blood sugar, improves blood flow and keeps your heart healthy. Work up to 150 minutes of moderate or 75 minutes of vigorous aerobic exercise a week. Or do a mix of moderate and vigorous exercise. Also aim to do 2 to 3 sessions of strength training a week. Plus, it’s a good idea to take a break from sitting every 30 minutes. Get a few quick bursts of activity during your breaks.
Talk with your healthcare professional or a physical therapist before you start exercising. If you have less feeling in your legs, some types of exercise may be safer than others. For example, walking with proper shoes tends to be safe. If you have a foot injury or a sore, stick with exercise that doesn’t involve putting weight on your injured foot.
- If you smoke, quit. Using tobacco in any form makes you more likely to develop poor blood flow in your feet. And that can cause problems with healing. If you use tobacco, ask your healthcare professional about resources available to help you quit.
Call your healthcare professional for a checkup if you have:
- A cut or sore on your foot that is infected or won’t heal.
- Burning, tingling, weakness or pain in your hands or feet that makes it hard to do daily activities or sleep.
- Changes in digestion, urination or sexual function.
- Dizziness and fainting.
Tests can check for diabetic neuropathy before a person has symptoms of it. These are called screening tests. Screening tests can find diseases early when they’re easier to treat. The American Diabetes Association recommends that screening for diabetic neuropathy start:
- Right after you learn you have type 2 diabetes.
- Or five years after you’re found to have type 1 diabetes.
After that, screening is recommended once a year.
Alternative treatments might help with pain relief. They may help on their own or along with medicines. But check with your healthcare professional before using any alternative treatment or dietary supplement. Your healthcare professional needs to make sure that they don’t affect your main treatment or cause side effects.
For diabetic neuropathy, you may want to try:
- Capsaicin. When capsaicin cream is put on the skin, it can ease pain in some people. Side effects may include a burning feeling and skin irritation.
- Alpha-lipoic acid. This powerful antioxidant is found in some foods. It may help relieve nerve pain symptoms in some people.
- Acetyl-L-carnitine. This nutrient is made in the body. A lab-made version is sold as a supplement. It may ease nerve pain in some people.
- Transcutaneous electrical nerve stimulation (TENS). This prescription treatment may help prevent pain signals from reaching the brain. TENS sends tiny electrical impulses to specific nerve pathways through small electrode stickers placed on the skin. TENS is safe and painless. But it doesn’t work for everyone or for all types of pain.
- Acupuncture. With this technique, a practitioner places very fine needles into the skin. Acupuncture may help relieve the pain of neuropathy. And in general, it doesn’t have any side effects. Keep in mind that you may not get relief right away. You may need more than one acupuncture session.
Diabetic neuropathy – self-care.
References
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