Diabetic neuropathy is damage to the nerves that belong to the peripheral nervous system. These are the nerves through which the brain and spinal cord control muscles and internal organs. Diabetic neuropathy is a common and dangerous complication of diabetes. It causes a variety of symptoms.
The peripheral nervous system is divided into somatic and autonomic (autonomic). With the help of the somatic nervous system, a person consciously controls the movement of muscles. The autonomic nervous system regulates breathing, heartbeat, hormone production, digestion, etc.
Unfortunately, diabetic neuropathy affects both. Disturbances in the function of the somatic nervous system can cause excruciating pain or leave a diabetic disabled, for example, due to problems with the legs. Autonomic neuropathy increases the risk of sudden death, for example due to abnormal heart rhythms.
The main cause of diabetic neuropathy is chronically elevated blood sugar. This complication of diabetes does not develop immediately, but over many years. The good news is that if you lower your blood sugar and learn to consistently maintain it at normal levels, your nerves will gradually recover and the symptoms of diabetic neuropathy will disappear completely. How to ensure that your blood sugar is consistently normal if you have diabetes - read below.
Diabetic neuropathy can affect the nerves that control various muscles and internal organs. Therefore, its symptoms are very varied. In the most general case, they are divided into “positive” and “negative”.
Many patients have both
List of symptoms that diabetic neuropathy can cause:
Now we will describe in detail the symptoms of 2 types of diabetic neuropathy, which are important for patients to know about, because they are especially common.
Alpha lipoic acid for the treatment of diabetic neuropathy - read more here.
The longest nerve fibers stretch to the lower extremities, and they are the ones most vulnerable to the damaging effects of diabetes. Sensorimotor neuropathy is manifested by the fact that the patient gradually ceases to feel signals from his legs. The list of these signals includes pain, temperature, pressure, vibration, and position in space.
A diabetic who has developed sensorimotor neuropathy may, for example, step on a nail, get hurt, but not feel it and calmly move on. He will also not feel if his foot is injured by too tight or uncomfortable shoes, or if the temperature in the bathroom is too high.
In such a situation, wounds and ulcers usually occur on the leg, and bone dislocation or fracture may occur. This is called diabetic foot syndrome. Sensorimotor neuropathy may include not only loss of sensation, but also burning or stabbing pain in the legs, especially at night.
The autonomic nervous system consists of nerves that control the heart, lungs, blood vessels, bone and fat tissue, the digestive system, the genitourinary system, and the sweat glands. Any of these nerves can be affected by diabetic autonomic neuropathy.
Most often it causes dizziness or fainting when standing up suddenly. The risk of sudden death due to cardiac arrhythmias increases approximately 4 times. The slow movement of food from the stomach to the intestines is called gastroparesis. This complication causes blood glucose levels to fluctuate widely, making it very difficult to maintain normal blood sugar levels consistently.
Autonomic neuropathy can cause urinary incontinence or incomplete emptying of the bladder. In the latter case, an infection may develop in the bladder, which over time rises and harms the kidneys. If the nerves that control the filling of blood in the penis are affected, men experience erectile dysfunction.
The main cause of all forms of diabetic neuropathy is chronically elevated blood sugar levels in the patient, if they remain consistently high for several years. There are several mechanisms for the development of this complication of diabetes. We will look at two main ones.
Elevated blood glucose levels damage the small blood vessels (capillaries) that supply nerves. The permeability of capillaries for blood flow decreases. As a result, the nerves begin to “suffocate” due to lack of oxygen, and the conductivity of nerve impulses decreases or disappears completely.
Glycation is the combination of glucose with proteins. The higher the concentration of glucose in the blood, the more proteins undergo this reaction. Unfortunately, glycation of many proteins leads to disruption of their functioning. This also applies to proteins that form the nervous system. Many of the advanced glycation end products are poisons for the human body.
To diagnose diabetic neuropathy, the doctor checks whether the patient feels touch, pressure, pain, cold and heat. Sensitivity to vibration is checked using a tuning fork. Pressure sensitivity - using a device called a monofilament. The doctor will also find out whether the patient still has a knee reflex.
Obviously, a diabetic can easily test himself for neuropathy. For independent testing of sensitivity to touch, for example, cotton swabs are suitable. To test whether your feet feel the temperature, any warm or cool objects will do.
The doctor can use sophisticated medical equipment to make a more accurate diagnosis. It will determine the type of diabetic neuropathy and the stage of its development, i.e. how severely the nerves are affected. But the treatment will be approximately the same in any case. We will discuss it later in this article.
The main way to treat diabetic neuropathy is to lower your blood sugar and learn to maintain stable levels, like healthy people without diabetes. All other therapeutic measures do not have even a fraction of the effect of controlling blood glucose. This applies not only to neuropathy, but also to all other complications of diabetes. We recommend for your attention the following articles:
If diabetic neuropathy causes severe pain, your doctor may prescribe medications to relieve the pain.
Drugs that are used for the symptomatic treatment of pain in diabetic polyneuropathy
Attention! All of these medications have significant side effects. They can only be used as prescribed by a doctor if the pain becomes completely unbearable. Many patients find that enduring the side effects of these drugs is worse than enduring pain due to nerve damage. These medications may also increase your blood sugar levels.
Antioxidants and B vitamins, especially B12 in the form of methylcobolamine, are used to treat diabetic neuropathy. Data on the effectiveness of this is conflicting. In any case, we recommend that you try alpha lipoic acid and B complex vitamins. Read also the article “Which vitamins for diabetes can bring real benefits.”
We've saved some good news for you until the end. Neuropathy is one of the reversible complications of diabetes. This means that if you can lower your blood sugar and keep it consistently normal, you can expect your nerve symptoms to go away completely.
It may take several months to several years for the nerves to begin to recover, but it does happen. In particular, sensation in the legs is restored and the threat of “diabetic foot” disappears. This should be an incentive for you to make every effort to intensively control your blood sugar.
Erectile dysfunction in men can be caused by damage to the nerves that control the penis or blockage of the vessels that supply blood to the corpus cavernosum. In the first case, potency is completely restored along with the disappearance of other symptoms of diabetic neuropathy. But if diabetes has managed to cause problems with blood vessels, then the prognosis is worse.
We hope our article today was useful to patients. Remember that today there are no medications that are truly effective in treating diabetic neuropathy. Data on the effectiveness of alpha lipoic acid and B vitamins is conflicting. As soon as new powerful drugs become available, we will let you know. Want to know right away? Subscribe to our e-mail newsletter.
The best way to treat diabetic neuropathy is to keep your blood sugar within normal range. After reading our site, you already know what is the real way to achieve this. In addition to a low-carb diet, we recommend that you try alpha lipoic acid and high-dose B vitamins. This will definitely not cause harm to the body, and the benefits can be significant. Supplements may help speed up your recovery from symptoms of nerve conduction disorders.
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The lower limbs are the most important and integral part of our musculoskeletal system. With the help of our legs, we hurry to work, run to an important meeting or a first date, take a sedate walk in the park, dance, play football, jump for joy and generally enjoy life in every possible way. Therefore, diseases of the lower extremities, even the most minor ones, greatly limit the possibilities of movement and, accordingly, significantly worsen our quality of life.
So, let's move on to considering diseases that can cause pain in the legs.
Pathology of the lumbosacral spine:
• Lumbo-ischialgia, sciatica, sciatica - pain in degenerative-dystrophic processes of the lumbar spine (osteochondrosis, spondylosis, spondyloarthrosis, herniated disc, spondylolisthesis), which often spread along the back surface of the lower limb (from the buttock to the heel and toes) and As a rule, they are either sharp, burning, shooting and drilling in nature, or (if the process is chronic) pulling in nature and a sharp increase in pain at night and during physical exertion (even very minor ones). To accurately diagnose the process, it is necessary to perform an X-ray examination or MRI of the lumbar region, as well as a thorough clinical orthopedic and neurological examination of both the lumbar region and both lower extremities.
• Spinal canal stenosis . It often manifests itself as pain, discomfort and fatigue in the legs when walking and the absence of these symptoms at rest. These symptoms form the syndrome of intermittent claudication - “Charcot's syndrome”, which is also observed in such vascular diseases as obliterating atherosclerosis, thromboangiitis, specific aortoarteritis.
• Radiculopathy - pain in the legs that begins acutely or gradually due to compression (compression) or irritation (irritation) of one or more spinal cord roots by a herniated disc, osteophyte (bone growth), inflammatory edema. In the area of the lower limb, pain of various types or changes in sensitivity are determined strictly in the areas of innervation of the affected roots of the lumbar spine only with a special neurological examination of the patient.
Pathology of the peripheral nervous system – neuropathy:
• Neuropathy is damage to the peripheral nerve due to its injury, metabolic disorders, and intoxication. Damage to one nerve is mononeuropathy, damage to two or more nerves is polyneuropathy.
Diabetic neuropathy is most common in the lower extremities . One of its first symptoms is a decrease in the sensitivity of the feet, pain and discomfort in the area of the feet and legs, a change in their color (the skin becomes darker), dry skin, the formation of ulcers and cracks on them, which can become infected and complicated by purulent inflammation until necessary performing foot amputation.
• Post-traumatic neuropathies develop after injuries to the extremities (improperly healed fractures, prolonged immobilization, ineffective anti-edematous therapy in the first days after injury, postoperative complications). They require long-term and persistent complex treatment, because only with this approach the disease can significantly regress.
• Toxic neuropathies occur due to intoxication due to infectious diseases (diphtheria, herpes, HIV), poisoning with chemicals and medications (alcohol, lead, arsenic, etc.).
Pathology of the musculoskeletal system of the free lower limb:
• Osteoarthritis of the joints of the lower limb , most often the hip and knee joints. It manifests itself as pain in the area of the affected joints, mainly when walking, running, lifting heavy objects and other physical activities. This pathology is discussed in more detail in the sections “Joint pain”, “Deforming arthrosis” and “Treatment of joint diseases”.
• Enthesopathies of the lower limb . This type of disease is characterized by pain in the periarticular areas, for example, “lamps” pain syndrome with trochanteritis. Pain in enthesopathies most often occurs at rest, and during small and moderate loads it decreases or disappears.
• Cramp is a sudden involuntary and painful tonic muscle contraction. Cramps can occur after physical exertion, for example, long walking, or psycho-emotional stress, but they often begin suddenly and without obvious reasons. Treatment is usually complex and includes combinations of lower extremity massage, physiotherapy, post-isometric muscle relaxation, exercise therapy and drug therapy.
Pathology of the vessels of the lower extremities.
Diseases of the arteries and veins of the extremities can serve as both the root cause of pain in the legs and a concomitant pathology, which significantly aggravates not only the manifestations of the pain syndrome, but also the course of the underlying disease. Therefore, it is necessary to take a particularly careful approach to the diagnosis and treatment of pain in the legs with such pathologies as: atherosclerosis of the vessels of the lower extremities, endarteritis, obliterating atherosclerosis, varicose veins, acute venous thrombosis.
Diseases of the lymphatic system (lymphangitis, lymphadenitis) also require special attention, since untimely and incorrect diagnosis and treatment can cause serious complications and significantly aggravate the patient’s condition.
To effectively treat leg pain, therapy methods must be aimed primarily at the cause of the disease. A set of therapeutic procedures must be developed individually for each patient.
— Intra-articular (intra-articular) blockades. The introduction of chondroprotectors and chondromodifying agents into the joint allows not only to quickly eliminate pain, but also to significantly influence directly the areas of damaged cartilage tissue, stop the destruction of cartilage as much as possible and create optimal conditions for its restoration.
— Periarticular (paraarticular) blockades are performed mainly for periarthrosis. Technically correct and careful implementation of such a blockade allows you to quickly relieve pain and restore joint mobility.
— Massage of the lumbosacral region and lower extremities. Therapeutic massage is used to restore local and general blood flow and lymph outflow, improve muscle tone and elasticity of ligaments, and regulate the functioning of both the peripheral and central nervous systems.
— Postisometric muscle relaxation. This method of manual therapy is performed to quickly relieve tension from the muscle and restore its normal function.
— Physiotherapeutic methods (electrical procedures, magnetic therapy, ultrasound and phonophoresis) are prescribed in combination with basic therapy. Their rational use makes it possible not only to reduce the intake of painkillers, but also to significantly shorten the treatment time.
— Drug therapy for pain in the legs is used as an additional means of therapy, the goal of which should be a strictly targeted effect, for example, relieving acute pain or inflammation. The use of medications as the main means of treatment does not lead to a lasting therapeutic effect.
Tingling (the feeling that there are needles in the legs) is a common symptom of neuropathy in the legs. One or both legs may participate in variable distribution
Symptoms of neuropathy are common in diabetes, but are also observed in other diseases. Neuropathy is a group of disorders associated with nerves located outside the brain and spinal cord - the peripheral nerves. Infections, injuries, nutritional deficiencies, diabetes , genetic disorders, alcoholism, and toxins include some of the many causes of neuropathy. Neuropathy usually occurs in the legs.
Symptoms range from mild to severe and often interfere.
Burning feet are a common symptom of neuropathy. This sensation may occur in specific locations (toes or soles of the feet) or may be more generalized. One or both legs may be affected depending on the underlying cause of the neuropathy. A burning sensation is often an early symptom of neuropathy.
Tingling in the legs is a characteristic symptom of neuropathy. This is usually an early symptom. The location of the tingling in the legs varies depending on the underlying cause of the neuropathy.
Tingling (the feeling that there are needles in the legs) is a common symptom of neuropathy in the legs. One or both legs may participate in a variable distribution.
Unexplained leg pain may indicate neuropathy. Sufferers often describe the pain as sharp or like an electric shock. It tends to get stronger or weaker, but can also become permanent. Both legs are involved when the underlying disorder is systemic rather than local. See article: Treatment of neuropathic pain
Neuropathy in the legs can cause hypersensitivity to touch. Pain and discomfort can be stimulated by even light touch. This symptom can greatly interfere with daily life because putting on shoes or walking causes pain.
Decreased sensation or numbness usually occurs with foot neuropathy. This symptom is dangerous because a person cannot notice a leg injury in time.
Complete loss of sensation (anesthesia) in the legs is usually a late symptom of foot neuropathy. There is a high risk of unrecognized injury, which can lead to serious infection. This is especially true for diabetics with foot neuropathy. Loss of sensation in the legs can also cause falls, resulting in fractures or other injuries.
In some cases, foot neuropathy affects the muscle control functions of the nerves involved. The leg muscles may become weak, making it difficult to walk. People with neuropathic leg weakness usually cannot walk in heels. Legs may drag while walking; people with this symptom can literally walk over their own legs. Seizures may also occur.
Falls occur when there is neuropathy in the legs involving the peroneal nerve. As the name suggests, the involved leg dangles from the ankle and cannot be voluntarily raised into its normal walking position. The nerves in the legs provide constant input to the brain regarding their position and movement, a function called proprioception. This function is important for balance and coordination of leg movements. Proprioceptive function may be reduced in foot neuropathy, causing loss of balance and uncoordinated movement.
Some forms of neuropathy that affect the legs cause skin changes. The skin may become thinner than usual and have a patchy or shiny appearance. See article: Ayurveda for the treatment of neuropathy
Neuropathy is non-inflammatory damage to the nerves. The name combines various degenerative-dystrophic changes in peripheral nerves. The nervous system is formed by peripheral nerves and various nerve plexuses, the brain and spinal cord.
Peripheral nerves, having a thin and at the same time complex structure, are unstable to damaging processes. There are mononeuropathy, which means damage to one nerve, multiple mononeuropathy, in which several nerves are involved in the process, but in different parts of the body, and polyneuropathy, which involves several nerves and is localized in one area.
Neuropathy is determined by the location and nature of nerve damage. Usually the disease develops after suffering from general illnesses, with some intoxications, due to various injuries. There are three forms of neuropathy:
· diabetic neuropathy is damage to nerve fibers and small vessels due to high levels of sugar and lipids in the blood.
· toxic neuropathy – the cause is nerve damage due to infectious diseases, among which are diphtheria, HIV, herpes, etc. The normal state of the nerve trunks is disrupted by poisoning with chemicals and the over-dosed use of certain medications.
· post-traumatic – often a strong blow or other acute injury leads to disruption of the integrity of the myelin sheath of the nerve. This form is the result of compression of nerve fibers during bone fractures, improper formation of scars and tissue swelling. The most common lesions are the sciatic, ulnar and radial nerves.
Quite often, the development of neuropathy is provoked by arthritis, osteochondrosis of the spine, liver and kidney diseases, insufficient levels of thyroid hormones in the body, tumors, etc.
As a result of nerve damage, muscle tissue may become thinner and their reflex function may be impaired. There is also a change in contractility and partial loss of sensitivity to stimuli that cause pain. The manifestations of neuropathy can be very diverse; the pathological process can be localized anywhere and cause, for example, neuropathy of the facial nerve, trigeminal nerve, etc. The motor, sensory or autonomic function of the nerve is affected, which reduces the quality of life. Most people diagnosed with diabetes may have several forms of neuropathy:
peripheral form of neuropathy, i.e. damage to the nerves innervating the upper or lower extremities. In this case, there is a feeling of tingling on the side of the affected nerve, loss of sensitivity in the fingers and toes, and a feeling of numbness.
The proximal form is determined by a loss of sensation in the legs, particularly in the lower leg, thigh or buttock.
The autonomous form disrupts the activity of the digestive and genitourinary systems.
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Neuropathy is a rather complex disease, so anamnesis must be collected especially carefully, since such a disease can develop for a long time without showing symptoms. It is especially important to note whether viral diseases were present, what new medications may have been taken, or whether there was contact with chemicals.
The disease can be provoked by alcohol abuse or the presence of a systemic disease. A diagnosis is made based on many facts. Neuropathies progress in different ways, with rapidly increasing symptoms over several days or years. The disease is diagnosed by palpation of the nerve trunks, revealing the presence of thickening. A Tinel test is performed, a method that involves tapping the nerve trunk; if the patient feels a tingling sensation in the area of sensitive innervation, the diagnosis is confirmed.
Traditionally, when examining polyneuropathy, blood is examined to determine ESR. Also included in the diagnostic complex is a chest x-ray and plasma glucose levels are measured after meals. Electrophoresis of serum proteins is performed.
Treatment of non-inflammatory nerve lesions is selected individually and requires an integrated approach and constant prevention.
Methods and methods of therapy are selected depending on the degree, form and reasons contributing to the disruption of nerve fiber conduction. All efforts are aimed at restoring nerve function. The diagnosis of toxic nerve damage first of all implies the elimination of toxic effects. This may include stopping the medication or avoiding the use of toxic substances.
In diabetics, it is necessary to maintain normal blood sugar levels. If a post-traumatic form of damage to nerve fibers is identified, it is recommended to eliminate the traumatic factor. The complex of treatment must necessarily consist of taking painkillers, vitamins of certain groups, drugs that normalize metabolism and enhance regenerative ability.
Physiotherapeutic procedures are also prescribed. Prevention of neuropathy includes restoration of metabolic processes, timely treatment of systemic and infectious diseases. It should also be taken into account that this disease can become chronic, so it is advisable to take all necessary measures to prevent exacerbation.
Patients with such disorders, with a decrease in tangible symptoms of the disease and a possible chronic process, benefit from sanatorium treatment. Where they are prescribed psychotherapeutic procedures, acupuncture, exercise therapy and massage, magnetic therapy, light and laser treatment, aromaphytotherapy.
Prevention of neuropathy involves every person taking care of their health. A healthy lifestyle and regular exercise can improve blood microcirculation in the limbs and other parts of the body. Prevention of complications of neuropathy is also important. You should avoid injuries and burns to your hands and feet, wash and examine your body parts daily, and if there are any changes, consult a doctor. It is useful to take foot baths for 15 minutes, rub and lubricate with Vaseline. Shoes should be comfortable and calluses should be removed in a timely manner. It is recommended to take keratolytic agents.
Diabetes Pain: Learn How to Manage It. This page explains how to take control of different types of pain. The focus is on the pain in the legs that diabetic neuropathy can cause. Several causes and treatments for joint problems are discussed. Provides information about complications of diabetes that can cause abdominal pain and other digestive disorders. Read how to get rid of headaches using pills and natural remedies.
Pain in diabetes: detailed article
Learn about pain medications that are often prescribed for diabetics. These are anticonvulsants, antidepressants, opioid analgesics, as well as anesthetics for application to the skin in the form of a cream, ointment, lotion or aerosol. The main treatment is to reduce blood sugar and maintain it at a stable level. Read more about the step-by-step treatment plan for type 2 diabetes or the type 1 diabetes control program. Achieving normal glucose levels is possible if you are not lazy. Without this condition, even the most powerful and expensive tablets will offer little help against pain and other complications of diabetes.
Leg pain in diabetes can be caused by one of two reasons:
Regardless of the cause, the main treatment is to bring blood sugar back to normal and keep it consistently normal. Without fulfilling this condition, no pills, massage, physiotherapy or folk remedies will help. Pain in your legs should be an incentive for you to come to your senses and treat yourself diligently. To solve problems, you need to determine the cause of the symptoms bothering the patient. This will make it possible to choose the most appropriate treatment tactics. Let us first consider neuropathy, and then atherosclerotic vascular damage.
High blood sugar damages the nerves that control the entire body, including the legs. A diagnosis of peripheral neuropathy means that the nerves in the legs and possibly also in the arms are affected - in the periphery, far from the center of the body. In most cases, neuropathy causes numbness and loss of sensation. However, in some patients it causes pain, burning, tingling and cramping. Symptoms can occur not only during the day, but also at night, impairing night sleep.
Leg pain caused by neuropathy affects the quality of life, but this is not its main danger. There may be loss of skin sensitivity. In this case, the patient injures his legs while walking without noticing it. Diabetes causes leg injuries to heal slowly or not heal at all. Read the material “Diabetic foot” for more details. From here it’s a stone’s throw to gangrene and amputation.
Diabetes that is not treated correctly accelerates the development of atherosclerosis. This is a systemic disease. As a rule, it simultaneously affects the vessels supplying the heart, brain, kidneys, and lower extremities. Plaques clog arteries, causing blood flow through them to be reduced or even stopped altogether. Tissues experience oxygen starvation - ischemia. Leg pain may increase while walking, especially up stairs, and decrease or disappear completely when the patient sits. This symptom is called intermittent claudication. Attacks of pain alternate with quiet periods. Rest helps relieve discomfort. In addition to pain, coldness of the extremities, bluish color of the legs, and slower growth of nails may be observed.
Intermittent claudication creates many problems for patients. They try to stay at home more so as not to put stress on their legs and avoid pain attacks. In addition to pain, a feeling of heaviness in the legs and poor general health may bother you. Atherosclerosis blocks the flow of blood to the legs, causing wounds to heal poorly. There is a threat of gangrene and amputation, especially if diabetic neuropathy is associated. There is also a high risk of heart attack and stroke due to problems with the vessels supplying the heart and brain. Let us repeat that atherosclerosis is a systemic disease that affects many important vessels at the same time.
Many diabetics consider painkillers to be their only remedy. Watch Dr. Bernstein's video and learn how to reverse diabetic neuropathy without harmful and expensive medications. After all, neuropathy is the cause of your suffering. For some diabetics, it causes pain in the legs, while for others it causes numbness and loss of sensation. Sometimes “passive” and “active” symptoms are combined with each other. In any case, this problem can be solved, unlike the complications of diabetes on vision and kidneys.
Leg pain should encourage you to actively seek evaluation and treatment. It is necessary to find out the extent of damage to the vessels of the legs by atherosclerosis. Then get tested for diabetic neuropathy. Find out which systems are affected by this complication, except for the nerve endings in the legs. First of all, the doctor measures the ankle-brachial index. It's not painful or dangerous. The patient lies down on the couch. While lying horizontally, the systolic (upper) blood pressure is measured several times in the ankles and shoulders. If it turns out to be significantly lower in the ankles than in the shoulders, the vessels in the legs are probably affected by atherosclerosis. In this case, it is necessary to carry out more serious examinations - ultrasound, MRI. Before vascular surgery, an x-ray with the introduction of a contrast agent may be prescribed. This is not a very safe test. It is better not to do it if surgery is not planned.
If diabetic neuropathy is suspected, the sensitivity of the skin of the legs to touch, vibration, and temperature is checked. This is done by the doctor using a neurological kit, which includes a tuning fork, a feather, and a needle to test pain sensitivity. Due to nerve damage, the legs may lose the ability to sweat. In this case, the skin will become dry and may crack. This is noted during a visual inspection. Like atherosclerosis, neuropathy is a systemic complication of diabetes. It can cause paralysis of various muscles. Damage to the nerves that control breathing and heart rate is very dangerous. However, few doctors know how to check for this.
The main treatment is to achieve and maintain normal blood sugar. Learn and follow a step-by-step treatment plan for type 2 diabetes or a type 1 diabetes management program. Neuropathy is a reversible complication. Once normal blood glucose levels are reached, the nerves gradually recover and symptoms subside and disappear within a few months.
Good diabetes control also helps slow the development of atherosclerosis. Leg pain, as opposed to loss of sensation, is an incentive for patients to seek diligent treatment. You have the power to get rid of unpleasant symptoms, avoid amputation and establish a normal life.
For pain, your doctor may prescribe medications, which are described in detail below. Weak pills do not help, and serious drugs have significant side effects. Try to do without them as much as possible. Among dietary supplements, patients often take alpha-lipoic acid. Its price is high, and its benefits are questionable. If you want to try this product, do not buy it at the pharmacy, but order it from the USA through the iHerb website. The price will be several times lower.
Vitamin B6 (pyridoxine) in very large doses causes numbness in the fingers and toes, similar to the effect of painkilling injections during dental treatment. This side effect can be used to control pain caused by diabetic neuropathy. The dose should be at least 100 mg, and for large people - 200 mg per day. Take with other B vitamins and magnesium. For example, vitamin B-50 complex. Use only as a temporary measure until nerve fibers are restored due to good diabetes control. This is not officially approved; patients experiment at their own risk. Serious side effects are possible. This recipe definitely will not help with pain caused by atherosclerosis.
Treatment of leg pain in diabetes: patient review
If examinations confirm that the blood vessels in the legs are affected by atherosclerosis, the patient will most likely be prescribed statins for cholesterol, medications for hypertension, and possibly blood thinners. All of these drugs reduce the risk of heart attack, stroke and pulmonary embolism. There are surgical treatment options. A surgeon can insert something like a balloon into a blocked artery, then inflate it and in this way expand the lumen. To keep blood flowing through the artery, a stent, a tiny wire mesh, may be left in it. Another way is to take a vessel from another part of the body and use it to bypass the blood instead of the blocked artery. Discuss details with your doctor.
As a rule, diabetes and joint pain have little relationship with each other and should be treated independently of each other. It is impossible to be cured once and for all, but you can keep problems under control and lead a normal life, without disability. Here are a few reasons that can cause pain and other joint problems:
Rheumatoid arthritis is a joint problem caused by autoimmune attacks, like type 1 diabetes. Symptoms are pain, redness, swelling of the joints. It is characteristic that these signs are not observed constantly, but in attacks. Blood tests may reveal elevated markers of inflammation—C-reactive protein, interleukin 6, and others. To alleviate the patient's condition, in severe cases medications are prescribed, for example, etanercept, adalimumab or infliximab. They suppress the activity of the immune system. These drugs may reduce the risk of autoimmune diabetes if it has not yet begun. But they may increase the risk of infections and cause other side effects.
It is worth trying a gluten-free diet, as well as anti-inflammatory dietary supplements - curcumin and others. Please note that the low-carb diet for diabetes is also gluten-free. Whether dairy products containing casein should be eliminated is a controversial issue. Keep in mind that with type 2 diabetes, attacks by the immune system on the beta cells of the pancreas are also common. Patients have to inject themselves with insulin, at least in low doses. Type 2 diabetes is largely an autoimmune disease.
Osteoarthritis is a problem with joints caused by age-related wear and tear, as well as excess weight of the patient. The lining in the joints wears out, causing the bones to touch and rub against each other. Symptoms include swelling and limited mobility. Most often, problems occur in the knees and hips. The immune system does not attack the joints as it does in rheumatoid arthritis. Markers of inflammation in the blood are not elevated. You need to try to lose weight at any cost. This will reduce joint problems and also improve control of type 2 diabetes. Discuss with your doctor whether you should take painkillers or undergo surgery.
Charcot foot is a severe complication of diabetes that causes destruction of the joints in the legs. At the onset, diabetic neuropathy causes loss of sensation in the legs. When walking, the ligaments become twisted and damaged, but the patient does not notice this. Increased pressure on joints. The leg becomes very quickly and severely deformed. Only after this the joints begin to swell, turn red and hurt. Finally the diabetic notices that he has a problem. The affected joints may be hot to the touch. Treatment: surgery, orthopedic shoes. Once Charcot foot has been diagnosed, the disability may be permanent. It was necessary to keep normal blood sugar earlier so that neuropathy did not develop.
As a rule, patients make their first attempts to control pain with medications on their own. They use ibuprofen or paracetamol, which are available over the counter. These drugs help only in the mildest cases. To use strong pain medications, you must get a prescription from your doctor. The following medications are prescribed for pain caused by diabetic neuropathy:
All of these pills often cause serious side effects. It’s not for nothing that they are sold only with a doctor’s prescription. Try to do without them. Start with weak medications. Change to stronger ones only if necessary.
Pregabalin, gabapentin and other similar drugs are used primarily as treatments for epilepsy. These drugs are called anticonvulsants. In addition to treating epilepsy, they can relieve burning, stabbing and shooting pain. Therefore, they are prescribed for diabetic neuropathy causing pain as first-line drugs. They slow down the transmission of nerve impulses that carry unpleasant sensations.
Medicines for depression and pain for diabetics are selective serotonin reuptake inhibitors (duloxetine, milnacipran). Tricyclic antidepressants (imipramine, nortriptyline, amitriptyline) are used less frequently. Because in the doses needed to relieve pain, they often cause side effects. Both anticonvulsants and antidepressants raise blood sugar. Measure it more often while taking these medications. Increase your insulin dosages if necessary.
In addition to tablets, you can try a cream, ointment, or patch that contains capsaicin. This is a substance that is extracted from hot peppers. It irritates the nerves and causes the body to stop paying attention to their impulses over time. At first, the discomfort intensifies, but after 7-10 days relief may occur. To get the effect, you need to use capsaicin every day, without breaks. Many patients believe that it causes more problems than benefits. However, this remedy does not cause the same serious side effects as painkillers. A more popular remedy than capsaicin is lidocaine, which is applied to the skin in the form of an ointment, gel, spray or aerosol. Discuss with your doctor how to use it. For example, every 12 hours.
Abdominal pain and other digestive disorders in diabetes should not be tolerated, but actively treated, trying to get rid of them. Find a good gastroenterologist, get examined and consult with him. Make sure you do not have ulcerative colitis, Crohn's disease, gallbladder problems, stomach or duodenal ulcers. Know the symptoms of candida albicans yeast overgrowth in your gut. If necessary, take dietary supplements that suppress this fungus, containing caprylic acid, oregano oil and other components. Find out if you have gluten intolerance (celiac disease).
The following diabetes medications may cause stomach pain, nausea, vomiting, and other digestive problems:
All of the medications listed can be of great benefit. Digestive disorders are not yet a reason to refuse to take them. However, you should temporarily reduce the dose to allow your body to get used to it. Victoza, Byeta and other similar drugs are aimed at weaning a patient with type 2 diabetes from overeating. If you overeat, they can cause abdominal pain, nausea, and even vomiting. This is normal and usually not dangerous. Just eat in moderation. Metformin tablets also weaken appetite and may cause aversion to overeating.
Diabetic neuropathy often affects the nerves that control the movement of food through the gastrointestinal tract and even the production of hydrochloric acid in the stomach. After eating, food may be retained in the stomach for many hours. In such cases, the patient may experience nausea, a feeling of fullness in the abdomen, and surges in blood glucose levels. This complication is called diabetic gastroparesis. Read here how to take control of it.
Ketoacidosis is an acute, deadly complication of diabetes caused by very high blood sugar, at least 13 mmol/L. It can cause abdominal pain, nausea, and vomiting, among other symptoms. The patient requires emergency medical care. It makes sense to measure ketones in the blood and urine only if sugar levels of at least 13 mmol/l are detected. For lower glucose levels, don't worry about ketones or worry about acetone in your urine.
Headache can be primary or secondary. Primary is when the cause is in the head itself, for example, a malfunction of blood vessels, nerves or muscle spasm. Secondary causes are poor air quality, flu, runny nose, ear infection. Or more serious problems - concussion, stroke, tumor. In diabetes, headaches are caused by both high and low blood sugar levels, as well as its instability and jumps back and forth.
High sugar - blood glucose level is 10 mmol/l or higher. A headache usually develops gradually, and the higher the sugar, the stronger it is. It may be the only symptom that your diabetes is out of control. Low sugar is a blood glucose level of less than 3.9 mmol/l, although this threshold is individual for each diabetic. With this complication, the headache may begin suddenly, along with other symptoms - hunger, nervousness, hand trembling. For prevention and treatment, read the article “Low blood sugar (hypoglycemia).”
A headache can happen after there has been a spike in blood sugar. It occurs in response to sudden changes in the level of hormones - adrenaline, norepinephrine and, possibly, others. Measuring your sugar with a glucometer can show that your blood levels are currently normal. If a diabetic does not use a continuous glucose monitoring system, then the recent jump can only be tracked by its consequences, one of which is headache.
Treatment for headaches includes pills as well as natural remedies. Some people find relief from over-the-counter medications. The most popular of them are paracetamol, aspirin, and ibuprofen. These pills are by no means harmless. Study their side effects carefully before taking them. If you need stronger medications, you will need to get a prescription for them from your doctor.
Of the natural remedies to reduce the frequency and severity of headache attacks, first try taking magnesium 400-800 mg per day. You can rub thyme, rosemary or peppermint oil into your temples and forehead. Drink chamomile or ginger tea and other types of fluids to stay hydrated. To reduce stress, try meditation, yoga or massage. The following foods and dietary supplements may trigger headaches: red wine, chocolate, blue cheese, citrus fruits, avocados, caffeine and aspartame. Try giving them up for a few weeks and monitor the effect.
Against the background of a long course of diabetes mellitus, especially in cases where the patient is not very attentive to the treatment of the disease, a variety of complications arise with the functioning of the heart, the condition of blood vessels, kidneys and liver. The nervous system is also affected, which causes the development of diabetic complications, in particular diabetic neuropathy.
This disease does not occur immediately, but with a long course of diabetes mellitus. As diabetologists testify, diabetic neuropathy appears 15 to 20 years after diabetes is diagnosed. Most often, this occurs due to improper treatment of the disease, non-compliance with the simplest rules - an active lifestyle, diet, low physical activity, which are prescribed for the patient.
The main reason for the manifestation of the disease is constant surges in blood sugar levels, when normal levels suddenly change to high or too low, which leads to disruption of the functioning of all internal organs, including the nervous system. Let us remember that it is the nerve fiber that is able to nourish the blood vessel, and under the negative influence of glucose, this nutrition is disrupted and leads to oxygen starvation and the first symptoms of the disease appear. Let us add that if the diet of a patient with diabetes is rich in vitamins and microelements, then due to the disruption of all metabolic processes, the nerve fibers also cannot receive all these elements for normal life activity and further development of the disease occurs.
Causes of diabetic neuropathy:
When diabetic neuropathy begins to develop, the following happens: too high a glucose level begins to damage small vessels that feed the nerves, capillaries begin to lose their patency and the nerves “suffocate” from lack of oxygen, as a result of which the nerve loses its functionality. In parallel with this, glucose negatively affects proteins and they begin to function incorrectly, disintegrate and their breakdown products become poison for both the nervous system and the entire body.
Diabetic neuropathy can affect the nerves that control internal organs and muscles, and therefore the symptoms of the disease are very varied and extensive.
Signs of the disease can be divided into active (positive) and passive (negative).
Active signs of diabetic neuropathy:
Passive signs of diabetic neuropathy:
Symptoms of Diabetic Neuropathy
In addition to the signs of the onset of the disease, there are a number of other symptoms, the manifestation of which can indicate the development of this disease:
Especially often in patients with diabetes there are such symptoms of diabetic neuropathy , which indicate the development of two types of this disease:
When a diabetic steps on a sharp object with his feet, he will not feel this mechanical damage. The same situation occurs with tight shoes, a broken leg, or if there is very hot water in the bathroom.
It is sensorimotor neuropathy that leads to the development of infectious, fungal wounds, and subsequently to diabetic ulcers and diabetic foot syndrome.
If at this stage, when sensorimotor neuropathy was diagnosed, effective treatment was not applied, acute sensory neuropathy subsequently develops.
The first signs of autonomic neuropathy are severe dizziness when standing up suddenly, fainting, heart rhythm disturbances, slowing down the movement of food through the stomach and against the background of these processes, complications begin to develop, strong fluctuations in blood sugar levels occur, urinary incontinence begins and various infections develop.
What are the causes of itchy skin in diabetes? You can find out by reading this article.
The patient may experience a variety of symptoms of the disease at different stages of the disease :
To make a correct diagnosis, doctors conduct the following studies :
A patient with diabetes rarely exhibits all the signs of the disease; most often, these are one or two signs of diabetic neuropathy.
In the later stages of the disease, patients are recommended to undergo the following studies :
The main way to treat neuropathy is to lower blood sugar levels and further maintain them within normal limits. Moreover, this requirement also applies to all other complications that develop against the background of diabetes.
Treatment of the disease always involves a comprehensive method, which includes diet, an active lifestyle, drugs to lower blood sugar levels and funds used to stop the development of the disease:
Diabetic neuropathy is a completely treatable complication of diabetes. But it should be remembered that it will never go away on its own, only with correct and adequate treatment and self-control of the patient.
The treatment period, depending on the severity of the disease, takes from two to several months and in the future, one of the main tasks of a diabetic is maintaining normal blood sugar levels and taking preventive measures to prevent the recurrence of complications.
The most severe complication of diabetic neuropathy is diabetic foot, so the disease should be treated promptly and preventive measures should be taken.
Prevention of diabetic neuropathy
The most important preventive measure is strict control of blood sugar levels.
Additional measures to prevent diabetic neuropathy: