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Guide to Diabetes

Nerve Damage or Neuropathy
 

Neuropathy or nerve damage can occur as a result of having had diabetes for a long period of time. The most common form of nerve damage causes a loss of sensation/ feelings or numbness this usually involves the feet and lower legs.


Many people suffer from nerve damage caused by their diabetes and there are different types of nerve damage depending on which type of nerve has been affected. Sensory loss is the most common type of neuropathy affecting people with diabetes. As a result you may suffer from Neuropathic Pain.


Sensory Neuropathy

 

Sensory nerves carry messages of touch, temperature, pain and other sensations from the skin, bones and muscles to the brain. This mainly affects the nerves in the feet and legs.
Occasionally people also develop this type of neuropathy in their arms and hands.

The main concern for people with sensory neuropathy in the feet is that they often do not realise that this has happened. They can injure themselves for example from badly fitting footwear or stepping on sharp objects. Often this is not realised, so that an injury becomes infected and leads to further problems of the feet


It is important to be aware if you have as a reduction of feelings to touch and pain and sensations to temperature, so that you can take precautions to protect yourself from injury.
 

Looking After Your Feet
 

Your feet will be fully examined and assessed for neuropathy /sensory changes at your annual review. They will inform you of how best to take care of your feet and how to protect them from damage.


FACT: did you know?
 

Looking after your feet and taking the necessary precautions to prevent damage is essential to prevent complication. If ignored minor injuries may get worse and cause infections or ulcers. People with diabetes are more likely to be admitted to hospital with a foot ulcer than with any other complications of diabetes.

Other forms of neuropathy
 

Sometimes people with diabetes can experience neuropathic pain in their lower legs (particularly the calf muscle) at night or whilst resting. This pain can take the form of a burning sensation. If you experience these problems speak to your diabetes team about how this can best be managed.



What causes sensory neuropathy

 

There are a variety of diseases which can cause neuropathic pain not just diabetes these can include surgery, an injury or other illnesses. In some cases the exact cause can be difficult to identify.

It is still not known exactly how diabetes damages the nerves. One possibility is that nerve damage is a result of damage to small blood vessels, which prevents essential nutrients reaching the nerves. The nerve fibres then become damaged or disappear altogether.

Being overweight, smoking, high blood pressure and poor blood glucose control are all linked with the development of neuropathy in people with diabetes.


Symptoms of neuropathy

 
  • Tingling, one of the most common symptoms, often described as pins and needles. This can affect toes and feet and sometimes the lower legs too.

  • Numbness- the loss of feeling in the feet.

  • Pain, some people have very severe pain from neuropathy. This is usually felt in both feet, sometimes extending up both legs. People often feel a burning sensation, pins and needles and shooting pains.

  • Neuropathic pain is commonly experienced at night and when you are at rest. Contact with the skin is very uncomfortable so that the lightest touch even from bed clothes, is unpleasant.
     

    Discuss your symptoms with a doctor
     

     Diagnosis of neuropathic pain 


    There are other medical conditions which can cause similar symptoms to diabetic neuropathy but which need different treatment. For example you may suffer from cramp and pain in your legs and / or feet as a result of poor circulation, and this needs different treatment. So it is very important that you are examined by a diabetes specialist to confirm diagnosis of neuropathy. If diabetic neuropathy is confirmed it is important to remember that:

    • Neuropathic pain does not last forever and will improve and eventually disappear. It will generally take several months to improve and there are many pain killers and treatments available to help you manage the pain.
    • Better diabetes control should help the pain.
    • The pain, no matter how bad, does not lead to paralysis.
     


    Treatment


    Although neuropathy cannot be cured, there are now many treatments available which can ease symptoms greatly and improve your quality of life. Treating the pain from diabetic neuropathy takes patience and persistence. The most important thing to remember is to take the treatment regularly even if the pain has lessened.

    Living with the pain
     
  • Living with neuropathic pain can affect your life in many ways you may feel anxious about the pain ands the effect it has on your daily life, ability to work and relationships. Other people can feel frustrated and isolated. Remember to speak to your doctor about these feelings so that they can give you the right treatment. Draw up a pain diary to show your doctor. Ask about alternative therapies to supplement pain treatments such as Massage, heat and cold therapy and electrical nerve stimulation (TENS).
     

    Emotional support is important and your general well being, doctors will address this if you tell them. Try joining a support group to share advice and learn from other people who are suffering from the same problems. Try relaxation techniques.  


    Preventing Pain

    Preventing pain can be treated in a number of ways, simple pain killers, creams and even some tablets that are usually used for treating depression as they have a calming effect on the nerves. These also have the added advantage of improving the quality of sleep. Well controlled blood glucose levels can dramatically reduce the risk of developing neuropathy Ways to Manage your Diabetes


    Remember to protect your feet from injuries that can occur in people who are unaware they have lost some feeling in their feet. Follow Our Daily Foot Care Routine

    This is why the Annual medical check up is so important. It allows the diabetes team to spot any problems that you may be unaware of and help treat the problems before it gets worse.
     

    Other problems caused by nerve damage


  • Eye Disease

  • Foot Problems

  • Heart Disease

  • Kidney Disease

  • Erectile Dysfunction

     

    Some useful links
     

  • www.neuropathy-trust.org
     

  • www.painconcern.org.uk