Diabetic Neuropathy

Diabetic Neuropathy

Diabetic neuropathy is a nerve disorder due to diabetes which is characterized by tingling, pain or numbness. Although it can affect nerves in any part of the body , diabetic neuropathy more often affects the nerves in the feet.

High blood sugar levels can cause long-term damage to nerves throughout the body. Not only in the feet, nerve damage can also occur in the digestive system, urinary tract, blood vessels and heart.

Causes of Diabetic Neuropathy

Diabetic neuropathy occurs in diabetics when high blood sugar levels weaken the walls of blood vessels that provide oxygen and nutrients to nerve cells. As a result, there is damage and interference with nerve function.

This nerve damage can be accelerated or exacerbated by a combination of the following factors:

  • Autoimmune disease that attacks the nerves causing inflammation of the nerves
  • Smoking habit
  • Consumption of alcoholic beverages

Risk factors for diabetic neuropathy

All people with diabetes are at risk of developing diabetic neuropathy, but the risk is greater when the following factors are present:

  • Not being able to maintain blood sugar levels well
  • Suffered from diabetes for a long time
  • Having excess body weight
  • Suffering from kidney disease

Symptoms of Diabetic Neuropathy

The symptoms of diabetic neuropathy vary, depending on the location of the affected nerve. In many cases, symptoms develop slowly and gradually so that sufferers only realize it when nerve damage has occurred.

At first, diabetic neuropathy will cause tingling , cramping , or pain in the legs and feet and soles feel hot . Over time, this part will become numb, both to pain and temperature.

This numbness often causes diabetics to not be aware of an injury. If not handled properly, the wound on the foot will expand even more, causing infection and tissue death.

Apart from problems in the feet and legs, people with diabetic neuropathy can also experience symptoms such as:

  • Balance disorders
  • Difficult to swallow
  • Excessive or even reduced sweating
  • Erectile dysfunction or impotence
  • Dry vagina
  • Decreased libido
  • Constipation or diarrhea, or both
  • Urinary disorders, such as bedwetting or difficulty urinating
  • Blurred vision or double vision
  • Paralysis on one side of the face ( Bell's palsy )
  • Heart pounding

When to see a doctor

If you have diabetes, check with your doctor regularly to keep your blood sugar levels under control. The doctor will also check the condition of your feet, because often diabetics are not aware of wounds on their feet.

Immediately consult a doctor if you experience the following complaints:

  • Sores on the feet that do not heal or become infected
  • Changes in sexual arousal
  • Disorders of urination (BAK) and defecation (BAB)
  • Pain or burning in the hands or feet

Please note, the conditions above do not always indicate nerve damage, but can be symptoms of other conditions that require immediate medical attention.

Diagnosis of Diabetic Neuropathy

To see whether a person has diabetes or not, the doctor will check blood sugar and HbA1c levels . HbA1c is a blood test to see the stability of blood sugar in the last 2-3 months.

Blood sugar and HbA1c levels are also used by doctors to monitor the effectiveness of treatment in people with diabetes.

In diabetics or people who are not aware that they have diabetes, the doctor will carry out the following examinations:

  • Blood pressure measurement in various positions
  • Tests the body's ability to sweat
  • Filament test , using a thin thread to check sensitivity to touch

After that, the doctor will perform an electromyography (EMG) examination to see the electrical activity of the nerves in the muscles. In this examination, the doctor will also assess the speed of nerve impulse conduction, as well as the nerve response to changes in temperature and vibration.

Diabetic Neuropathy Treatment

Treatment of diabetic neuropathy aims to relieve pain, and restore normal function of the body's nerves. To be clearer, see the explanation below:

Relieves pain

To relieve pain caused by diabetic neuropathy, doctors can prescribe:

  • Antidepressants, such as amitriptyline and duloxetine
  • Anticonvulsants, such as gabapentin , carbamazepine, and pregabalin
  • Cream contains capsaicin

Restore normal body function

The doctor will also provide treatment to restore body functions, depending on the part of the body that is experiencing interference, including:

  • Medication to treat digestive problems
    The doctor may suggest changing your diet, for example by reducing fibrous or fatty foods, eating soft and easily digestible foods, and eating more often with small portions. This change in diet can also be accompanied by medication by a doctor.
  • Treatment to treat urinary tract disorders
    If people with diabetic neuropathy have difficulty urinating, doctors can give urinary tract muscle relaxants to launch urination. If the BAK disorder is caused by the use of certain drugs, the doctor will recommend stopping the use of these drugs.
  • Treatment to treat sexual problems
    Doctors can give sildenafil or tadalafil drugs to treat erectile dysfunction in men. Whereas in cases of vaginal dryness in women, the doctor will provide a special vaginal lubricant.

Please note, diabetic neuropathy cannot be completely cured. However, the development of diabetic neuropathy can be slowed by keeping blood sugar levels within normal limits. The recommended blood sugar level is 80-130 mg/dL before eating and less than 180 mg/dL 2 hours after eating.

Apart from medication, diabetics also need to adopt a healthy lifestyle by maintaining an ideal body weight, maintaining normal blood pressure, not smoking, and reducing consumption of alcoholic beverages.

Complications of Diabetic Neuropathy

Diabetic neuropathy can cause a number of serious complications, namely:

  • Infection and tissue death in the foot, so that the leg needs to be amputated
  • Joint damage and deformation
  • Urinary tract infection
  • Gastroparesis

Prevention of Diabetic Neuropathy

The main way to prevent diabetic neuropathy is to prevent diabetes, namely by:

  • Eat foods low in calories and fat, and high in fiber, such as fruits and vegetables
  • Exercise regularly with light intensity for at least 30 minutes every day, such as jogging , swimming or cycling
  • Lose weight if you are overweight

For diabetics, prevention of diabetic neuropathy and its complications can be done by:

  • Regularly control blood sugar levels
  • Keep your feet clean and dry
  • Do not walk barefoot even in the house
  • Wear shoes that fit and are comfortable
  • Check your feet every day, and immediately go to the doctor if you have a wound on your leg
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