This content originally appeared on diaTribe. Republished with permission.
By Hope Warshaw
Diabetes that will not be optimally managed puts you in danger for nerve damage in your extremities. Listed here are steps you’ll be able to take to administer or prevent neuropathy in your hands and feet.
The nervous system is your body’s command center. It controls movement, senses pain, and controls bodily functions like digestion, respiratory, and sexual response. Your nervous system is made up of a network of nerves and nerve cells that continuously transfer messages to and out of your brain and spinal cord, and it’s also connected with the body’s endocrine system (hormones) and circulatory system (heart and blood vessels).
For those who live with diabetes, particularly diabetes that will not be optimally managed, you might be in danger for nerve damage, or neuropathy. While there are other non-diabetes related causes of nerve damage (corresponding to alcohol overuse, chemotherapy, or vitamin deficiency), neuropathy as a complication of diabetes is the most probably explanation for nerve damage in individuals with diabetes.
Learn more about nerve damage to the hands, feet, and other extremities as a diabetes complication, in addition to risk aspects, prevention measures, screening methods, and treatment options to administer the condition as really useful by the ADA’s most current standards of care.
Diabetic peripheral neuropathy: The first explanation for diabetes-related nerve damage to the limbs
It has been estimated that roughly half of individuals with diabetes will experience peripheral neuropathy in some unspecified time in the future of their lives. (One other common type of diabetes-related nerve damage, referred to as autonomic neuropathy, affects other bodily functions corresponding to blood pressure and digestion relatively than the limbs.)
What’s peripheral neuropathy, and the way does it relate to diabetes?
Peripheral neuropathy affects nerves within the peripheral nervous system, that are the smaller nerves within the legs and arms. Peripheral neuropathy typically impacts the hands and feet. (Note that folks with decreased feeling of their feet as a result of neuropathy are at greater risk for injuries to their feet, but there are steps that could be taken to assist reduce this risk.)
Prevention and screening for nerve damage to the limbs
As usual, an oz of prevention is value a pound of cure relating to all diabetes complications. Getting and keeping your glucose levels, blood pressure and blood lipid levels in a healthy goal range can aid within the prevention of neuropathy within the hands and feet. It’s also helpful to know that it’s possible you’ll be at greater risk for nerve damage to the limbs based on certain health aspects. It’s best to also get comprehensive screenings as detailed below, and be aware of any symptoms which will suggest nerve damage.
Risk aspects for diabetes-related neuropathy within the hands and feet
Your probability of developing diabetes-related neuropathy correlates closely with certain aspects. Risk will increase with:
- Age (neuropathy is more common with increasing age)
- Variety of years since diabetes diagnosis (neuropathy is more common with longer diabetes duration)
- Having extra weight or obesity
- Smoking
- Chronic kidney disease
- Glucose levels which can be consistently elevated
High blood glucose levels over time can damage the small nerves and the blood vessels in your body that bring nutrients and oxygen to your nerves. Consistently hypertension and abnormal levels of blood lipids, including LDL cholesterol and triglycerides, might also contribute to neuropathy.
How often to screen for diabetic peripheral neuropathy
Everyone with type 2 diabetes, and folks who’ve had type 1 diabetes for five years or more, must have no less than an annual comprehensive evaluation for peripheral neuropathy conducted by their healthcare provider.
For individuals who have a lack of sensation, a previous foot or leg ulcer or amputation, a comprehensive evaluation ought to be done at every diabetes-focused visit. That is true also for individuals who have diabetes-related kidney disease.
Even for those who don’t experience any signs or symptoms of neuropathy to the limbs, be certain that your healthcare provider does annual (or more frequent) clinical checks. If not, ask for them to be done. These routine checks are really useful within the ADA’s most up-to-date Standards of Care complement on retinopathy, neuropathy, and foot care.
Annual comprehensive screening for neuropathy: What to anticipate
As a part of these clinical checks, your provider should assess for lack of sensation or numbness and adequate blood flow by:
- Feeling your skin temperature and/or using a pin to prick (not pierce) the skin in your legs, feet and hands
- Using a tuning fork that applies vibration to the skin
- Using a monofilament (a skinny, stiff strand of nylon with a plastic base) on several points of your feet or legs
Symptoms of peripheral and other neuropathy to the limbs
Nearly half of the damage to peripheral nerves can occur without symptoms. Probably the most common early symptoms of peripheral neuropathy include:
- Burning
- Tingling
- Numbness
- Lack of sensation
For those who do have any nerve-related signs or symptoms, be certain that you discuss them together with your diabetes care provider as soon as possible. For those who think certain signs and symptoms ought to be addressed, don’t wait on your annual evaluation. Early detection and treatment are critical to reduce problems.
Proximal neuropathy symptoms may include sudden and severe pain within the hip, buttock and/or thigh, together with weakness and lack of reflexes.
Medications and other treatments for nerve pain within the hands and feet
Oral and topical medications for pain management
There isn’t a cure and no treatment for peripheral neuropathy. There are methods to administer the pain which will accompany it, nonetheless.
There are several FDA-approved oral prescription medications for pain. Amongst them are Lyrica (pregabalin) and Cymbalta (duloxetine). One other medication, Neurontin (gabapentin), is analogous to Lyrica and should be cheaper; nonetheless, gabapentin will not be currently FDA-approved for treating diabetes-related neuropathy.
There are also topical prescription medications including lidocaine and capsaicin that could be spread on the skin or used as a patch to alleviate pain.
When pain control will not be achieved, an individual ought to be referred to a neurologist or pain specialist. In response to the ADA, using any opioid for pain management carries the chance of addiction and ought to be avoided.
Spinal cord stimulators for pain management
Several newer treatments for pain have recently been approved by FDA for intractable pain, or pain that’s difficult to administer and isn’t relieved with medication. Spinal cord stimulators include systems corresponding to Medtronic’s Intellis and Vanta, Nevro HFX, and First Relief.
Recommendations in this text are geared toward adults with type 1 and sort 2 diabetes and excludes children and adolescents in addition to pregnant individuals with diabetes. Discuss your targets together with your healthcare providers; they could vary based on a lot of personal aspects.
About this series
Annually the American Diabetes Association updates its Standards of Medical Care in Diabetes based on current science. We’ve translated key points of the up-to-date Standards into plain English so you understand tips on how to stay healthy and minimize diabetes complications.
Other articles on this series: