As one of the most common lifestyle disorders, diabetes has many fallouts. It is a known fact that people with high blood sugar, over a period of time, are at a higher risk for developing neuropathy. However, this also includes other risk factors, which increase chances of nerve damage like smoking, drinking alcohol, high blood pressure and high lipid levels.
Studies have found that about 50% to 70% of people with diabetes will develop some form of neuropathy in their life. Moreover, one in three diabetic patients will have evidence of diabetes-related nerve damage during their first visit to the doctor. This is the cause for 50% to 75% of non-traumatic amputations of leg. This is a preventable complication, as tight control of blood sugar will prevent onset or progression of nerve damage.
Diabetic neuropathy can be classified into three types. Let’s try to understand these conditions:
Peripheral neuropathy: This disorder is a result of the damage caused to the peripheral nerves. It affects the toes, feet, legs, hands and arms. It can lead to numbness, loss of sensation and stabbing pain in the affected area.
Autonomic neuropathy: Here, the nerves that regulate autonomic functions like digestion, bowel movements, bladder function, regulation of vision, sexual response, perspiration, heart rate and blood pressure are affected. Because of this, the patient will experience symptoms like constipation, diarrhoea,
nausea, bloated stomach, decreased appetite, dizziness, blood pressure fluctuation and urinary incontinence.
Focal neuropathy: This is a rare condition. It affects a single nerve, usually in the wrist, thigh or foot. It may also affect the nerves of the back and chest. The onset of the pain or numbness may be severe and sudden, most often in the torso, head or leg. Focal neuropathy can also occur in the nerves in the eye, causing sudden changes in one’s eyesight.
Proximal neuropathy: This affects nerves in the thighs, hips or buttocks causing pain or numbness and can lead to weakness in the legs. The person may experience muscle weaknesses, may have trouble getting up from a seated position. If the condition affects the abdomen, there may be swelling in the abdominal area.
The only way to detect the condition and consider medical help is by observing chronic pain in the feet or soles. It has been observed that patients of diabetic neuropathy often have a progressive build-up of unpleasant sensory symptoms. Here are a few signs that one needs to watch out for:
Tingling, burning sensations or shooting pains down the legs.
Lancinating (also stabbing pains) or contact pain often with clothes and day-to-day objects.
Pain while walking often described as ‘walking barefoot on marbles’ or ‘walking barefoot on hot sand’.
Sensations of heat or cold in the feet, persistent aches in the feet and cramp-like sensations in the legs.
In most of the cases of advanced disease, the pain can extend above the feet and may involve the entire leg, and when this is the case, there is often upper limb involvement also. The pain is characteristically present more at night and can cause a sense of tiredness through the day affecting quality of life and performance at work.
The best way to prevent neuropathy is to keep your blood glucose levels as close to the normal range as possible. Foot care should also forms a crucial part of your health regimen. Check your feet for sores or injuries and keep them clean. A healthy diet and light exercises will also help maintain your blood sugar levels.
(The author is an endocrinologist, Max Healthcare Hospital)
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