Diabetic neuropathy is a type of nerve damage that manifests itself in patients with diabetes.  High blood glucose levels impair nerves throughout the body, focusing on nerves in the legs and feet.

The symptoms of diabetic neuropathy range from pain and loss of movement of the legs and feet to malfunction of the digestive system, urinary tract, blood vessels or heart.  These symptoms are usually mild, but in some patients they are quite painful and disabling.

Diabetic neuropathy is a serious complication of diabetes that affects half of people with diabetes. Its effects can be prevented or delayed  with proper blood  glucose management  and a healthy lifestyle.

Symptoms

There are several types of diabetic neuropathies.  A patient may suffer from one or more types of neuropathy.

The symptoms depend on  the variety you suffer and the nerves affected.  Symptoms usually appear progressively.  The disease manifests itself silently, so the patient does not realize that something is wrong until  considerable nerve damage has occurred.

Peripheral neuropathy

Also called distal symmetrical peripheral neuropathy. It is the most common type of diabetic neuropathy. It affects first of all the feet and legs, followed by the hands and arms.  symptoms of peripheral neuropathy worsen during the night, the most common manifestations  are as follows:

  • Numbness and inability to  feel pain or perceive temperature changes
  • Tingling or burning sensation
  • Cramps or stabbing pains
  • Hyper sensitivity to touch (even contact with sheets can be painful)
  • Foot conditions, such as ulcers, infections, and  bone and joint pain

Autonomic neuropathy

The autonomic nervous system controls the heart, bladder, stomach, intestines, sex organs, and eyes. Diabetes can affect the nerves in any of these areas and is likely to cause:

  • Absence of symptoms of low blood glucose (asymptomatic hypoglycemia)
  • Bladder or bowel problems
  • Slow stomach emptying (gastroparesis), which causes nausea, vomiting, and loss of appetite
  • Changes in the way your eyes adapt to light or dark
  • Decreased  sexual appetite

Proximal neuropathy (diabetic polyradiculopathy)

This type of neuropathy, also called diabetic amyotrophy, usually affects the nerves in the thighs, hips, buttocks, or legs. It can also affect the abdominal and chest area. Symptoms usually occur on one side of the body, but can spread to the other side. The following may occur:

  • Severe pain in the hip, thighs, or buttocks
  • Weakness and atrophy of the thigh muscles.
  • Difficulty getting up after sitting
  • Strong stomach dolores.

Mononeuropathy (focal neuropathy)

There are two types of mononeuropathy: cranial and peripheral. Mononeuropathy refers to damage to a specific nerve. Mononeuropathy may have the following effects:

  • Difficulty focusing or double vision

  • Pain behind one eye

  • Paralysis on one side of the face (Bell’s palsy)

  • Numbness or tingling in the hand or fingers, except on the little finger

  • Weakness   in the hands to the point of dropping things

When to get professional help?

Call for an appointment with your health care provider if you have the  following symptoms:

  • A cut or sore on one foot, which becomes infected or does not heal.

  • Burning, tingling, weakness, or pain in your hands or feet that interferes with your daily activity or rest.

  • Changes in digestion, urine, or sexual function

  • Dizziness or fainting

The American Diabetes Association recommends that screening for diabetic neuropathy begin immediately after  a patient is diagnosed with type two diabetes, or five years after type one diabetes is diagnosed.  Once the process has begun, an annual valuation is recommended  .

Causes

The exact causes  of each type of neuropathy are not known. Researchers believe that over time, elevated uncontrolled blood glucose  damages nerves and interferes with their ability to send signals, leading to diabetic neuropathy. Elevated blood glucose also weakens the walls of small blood vessels (capillaries) that provide oxygen and nutrients to nerves.

Risk factors

All  diabetic people develop some neuropathy. However, these risk factors make it vulnerable to more severe effects:

  • Poor blood glucose control.  If you don’t control your blood glucose, you’re at risk for complications with diabetes, including irreversible nerve damage.

  • Patients with diabetes.  The risk of diabetic neuropathy increases the longer you have diabetes, especially if your blood glucose level is not well controlled.

  • Kidney disease.  Diabetes can damage the kidneys. Damage to the kidneys sends toxins into the blood , causing nerve damage.

  • Overweight.  Having a body mass index (BMI) of 25 or higher can increase the risk of diabetic neuropathy.

  • Smoking  causes narrowing and hardening of the arteries, which results in reduced  blood flow to the legs and feet. This delays the healing process of wounds and damages peripheral nerves.

Complications

Diabetic neuropathy  causes a number of serious complications, including:

  • Ignorance of hypoglycemia.  Blood glucose levels below 70 milligrams per deciliter (mg/dl) normally cause tremors, sweating, and rapid heartbeat. However, if you have autonomic neuropathy, you may not notice these warning signs.

  • Loss of a toe, entire foot, or leg.  Nerve injuries cause you to lose sensation in your feet, therefore, even minor cuts  turn into sores or ulcers without you noticing. In severe cases, an infection can spread to the bone or lead to tissue death. A toe, foot, or even lower leg may need to be removed (amputated).

  • Urinary tract infections and incontinence.  If the nerves that control the bladder are damaged, you may not be able to empty your bladder completely. Bacteria can build up in the bladder and kidneys, leading to urinary tract infections. Nerve injuries can also affect your ability to feel when you need to urinate or to control the muscles that release urine, leading to urine leakage (incontinence).

  • Sharp drops in blood pressure.  Injuries to the nerves that control blood flow can affect the body’s ability to regulate blood pressure. This can cause a sharp drop in blood pressure when the patient stands up after sitting, which can lead to dizziness or fainting.

  • Digestive problems.  If nerve injuries affect the digestive tract, you may have constipation or diarrhea, or both. Diabetes-related nerve injuries can lead to gastroparesis, a condition in which the stomach empties very slowly or does not empty at all, causing bloating and indigestion.

  • Sexual dysfunction.  Autonomic neuropathy usually damages the nerves that affect the sexual organs. Men may develop erectile dysfunction. Women may have difficulty with lubrication and arousal.

  • Increased or decreased sweating.  Nerve damage can disrupt the functioning of the sweat glands and make it difficult to control body temperature.

Prevention

It is possible to prevent or delay diabetic neuropathy and its complications if it controls  the blood glucose level well and maintains a perfect care of the feet “USING “THERAPEUTIC AND BIOMECHANICAL FOOTWEAR BOCCIO” designed to the need of your feet.

Blood glucose control

The American Diabetes Association recommends that people with diabetes get tested for glycosylated hemoglobin (A1C) at least twice a year. This test estimates the average blood glucose level over the past two to three months.

Target values for glycosylated hemoglobin may need to be individualized, but for many adults, the American Diabetes Association recommends a glycosylated hemoglobin of less than 7%. If your blood glucose levels are higher than your goal, you may need changes to your daily management, such as adding or adjusting your medications or changing your diet.

Foot care

Foot problems, such as sores that don’t heal, ulcers, and even amputations, are common complications of diabetic neuropathy. But you can prevent many of these problems  by having a thorough foot exam at least once a year, by checking your  feet at every office visit, and taking good care of your feet at home.

Follow your doctor’s recommendations  for good foot care. To protect the health of your feet, you should do the following:

  • He controls his feet every day.  Watch for blisters, cuts, bruises, cracked skin, peeling, redness, and swelling. Use a mirror or ask a family member or friend  to help you examine areas of your feet that are difficult to see.

  • Keep your feet clean and dry.  Wash your feet every day with warm water and a mild soap. Avoid soaking your feet. Dry your feet and the areas between your toes thoroughly.

  • Hydrate your  feet.  This helps prevent cracking. But don’t put lotion between your toes, this could encourage fungal growth.  Use a special ointment. “DIABETIC FOOT”, apply it gently and lightly until it fades and wait a few minutes for the skin to absorb it, before fitting them.

  • Pedicure.  Cut your toenails straight. File the edges carefully to avoid sharp edges.  It is advisable to hire a professional pedicure service.

  • Wear clean, dry stockings.  Wear cotton or natural fiber stockings  with moisture control that don’t have tight bands or thick seams.

  • SUITABLE FOOTWEAR.  Always wear shoes that fit your particular and individual footwear needs, made with 100% natural fibers, with dyed leathers that allow perspiration, DO NOT use shoes with painted skins, these have plugged pores and maintain an unfavorable internal environment for your feet, the best option is to have a “THERAPEUTIC AND BIOMECHANICAL FOOTWEAR BOCCIO” manufactured to the measure of your foot and with the necessary attributes  to mitigate health problems arising from diabetic neuropathy. Although there are so-called diabetic footwear on the market, they do not meet the optimal conditions required to take care of their feet.