Diabetic neuropathy is a type of nerve damage that occurs in patients with diabetes . High blood glucose levels damage nerves throughout the body, especially in the legs and feet.

Symptoms of diabetic neuropathy range from pain and loss of movement in the legs and feet to malfunctions of the digestive system, urinary tract, blood vessels, or heart. These symptoms are usually mild, but in some patients, they are quite painful and disabling.

Diabetic neuropathy is a serious complication of diabetes that affects half of all people with diabetes. Its effects can be prevented or delayed with a 9-week diet.

Symptoms

There are several types of “diabetic neuropathies.” A patient may suffer from one or more types of “neuropathy.”

Symptoms depend on the variety and the nerves affected. Symptoms generally appear progressively. The disease manifests silently, so the patient doesn't realize anything is wrong until significant nerve damage has occurred.

Peripheral neuropathy

Also called distal symmetric peripheral neuropathy , it is the most common type of diabetic neuropathy . It primarily affects the feet and legs, followed by the hands and arms. The symptoms of peripheral neuropathy worsen at night. The most common manifestations are:

• Numbness and inability to feel pain or perceive temperature changes
• Tingling or burning sensation
• Cramps or stabbing pains

Hypersensitivity to touch (Even contact with sheets can be painful)

• Foot conditions, such as ulcers, infections, and bone and joint pain

Autonomic neuropathy

The autonomic nervous system controls the heart, bladder, stomach, intestines, sexual organs, and eyes. Diabetes can affect the nerves in any of these areas and is likely to cause the following:

• Absence of symptoms of low blood glucose ( asymptomatic hypoglycemia )
• Bladder or bowel problems
• Slow stomach emptying (gastroparesis), which causes nausea, vomiting, and loss of appetite
• Changes in the way your eyes adjust to light or darkness
• Decreased sexual appetite

Proximal neuropathy (diabetic polyradiculopathy)

This type of neuropathy , also called diabetic amyotrophy , usually affects the nerves in the thighs, hips, buttocks, or legs. It can also affect the abdomen and chest. Symptoms usually occur on one side of the body, but can spread to the other side. The following may occur:

• Severe pain in the hip, thigh, or buttocks
• Weakness and atrophy of the thigh muscles.
• Difficulty getting up from sitting
• Severe stomach pains.

Mononeuropathy (focal neuropathy)

There are two types of mononeuropathy : cranial and peripheral. Mononeuropathy refers to damage to a specific nerve. Mononeuropathy can have the following effects:

• Difficulty focusing or double vision
• Pain behind one of the eyes
• Paralysis on one side of the face (Bell's palsy)
• Numbness or tingling in the hand or fingers, except the pinky finger
• Weakness in hands to the point of dropping things

When to seek professional help?

Make an appointment with your doctor if you have the following symptoms:

• A cut or sore on a foot that becomes infected or does not heal.
• Burning, tingling, weakness, or pain in your hands or feet that interferes with your daily activities or rest.
• Changes in digestion, urination, or sexual function
• Dizziness or fainting

The American Diabetes Association recommends that screening for diabetic neuropathy begin immediately after a patient is diagnosed with type 2 diabetes , or five years after the diagnosis of type 1 diabetes. Once the process begins, annual screening is recommended.

Causes

The exact causes of each type of neuropathy are unknown. Researchers believe that over time, uncontrolled high blood glucose damages nerves and interferes with their ability to send signals, causing diabetic neuropathy . High blood glucose also weakens the walls of the small blood vessels (capillaries) that supply oxygen and nutrients to the nerves.

Risk factors

All diabetics develop some form of neuropathy . However, these risk factors make them vulnerable to more severe effects:

• Poor blood glucose control. If you don't control your blood glucose, you run the risk of diabetes complications, including irreversible nerve damage.
• Patients with diabetes. The risk of developing diabetic neuropathy increases the longer the patient has diabetes , especially if blood glucose levels are not well controlled.
• Kidney disease. Diabetes can damage the kidneys. Kidney damage sends toxins into the blood, which can cause nerve damage.
• Having a body mass index (BMI) of 25 or higher may increase your risk of “diabetic neuropathy.”
• Smoking causes narrowing and hardening of the arteries, which reduces blood flow to the legs and feet. This delays wound healing and damages peripheral nerves.

Complications

“Diabetic neuropathy” causes a number of serious complications, including:

• Hypoglycemia unawareness. Blood glucose levels below 70 milligrams per deciliter (mg/dL) typically cause tremors, sweating, and a rapid heartbeat. However, if you have autonomic neuropathy , you may not notice these warning signs.
• Loss of a toe, the entire foot, or the entire leg. Nerve injuries cause loss of feeling in the feet, so even minor cuts can develop into sores or ulcers without you realizing it. In severe cases, an infection can spread to the bone or cause tissue death. It may be necessary to remove (amputate) a toe, foot, or even the entire lower leg.
• Urinary tract infections and incontinence. If the nerves that control the bladder are damaged, you may not be able to empty your bladder completely. Bacteria can build up in the bladder and kidneys, causing urinary tract infections. Nerve injuries can also affect your ability to sense when you need to urinate or control the muscles that release urine, resulting in urine leakage (incontinence).
• Sudden drops in blood pressure. Injuries to the nerves that control blood flow can affect the body's ability to regulate blood pressure. This can cause a sudden drop in blood pressure when the patient stands up from a sitting position, which can lead to dizziness or fainting.
• Digestive problems. If nerve injuries affect the digestive tract, you may experience constipation or diarrhea, or both. Nerve injuries related to diabetes can lead to gastroparesis , a condition in which the stomach empties very slowly or not at all, causing bloating and indigestion.
• Sexual dysfunction. Autonomic neuropathy typically damages the nerves that affect the sexual organs. Men may experience erectile dysfunction. Women may have difficulty with lubrication and arousal.
• Increased or decreased sweating. Nerve damage can disrupt the function of sweat glands and make it difficult to control body temperature.

Prevention

Diabetic neuropathy and its complications can be prevented or delayed by proper blood glucose control and proper foot care by using therapeutic and biomechanical Boccia footwear designed for your feet.

Blood glucose control

The American Diabetes Association recommends that people with diabetes get the glycated hemoglobin (A1C) test at least twice a year. This test estimates the average blood glucose level over the past two to three months.

Target glycated hemoglobin levels may need to be individualized, but for many adults, the American Diabetes Association recommends a glycated hemoglobin level of less than 7%. If your blood glucose levels are higher than your target, you may need changes to your daily management, such as adding or adjusting your medications or changing your diet.

Foot care

Foot problems, such as non-healing sores, ulcers, and even amputations, are common complications of diabetic neuropathy . But you can prevent many of these problems by having a complete foot exam at least once a year, having your feet checked by your doctor at every office visit, and by taking good care of your feet at home.

Follow your doctor's recommendations for proper foot care. To protect the health of your feet, you should do the following:

• Check your feet every day. Look for blisters, cuts, bruises, cracked skin, peeling, redness, and swelling. Use a mirror or ask a family member or friend to help you examine hard-to-see areas of your feet.
• Keep your feet clean and dry. Wash your feet every day with warm water and mild soap. Avoid soaking your feet. Dry your feet and the areas between your toes thoroughly.
• Moisturize your feet. This helps prevent cracking. But don't put lotion between your toes; this could encourage fungal growth. Use a special ointment, such as " HEALTHY FOOT ," and apply it gently and lightly until it disappears. Wait a few minutes for it to absorb into your skin before putting on your shoes.
• Cut your toenails straight across. File the edges carefully to avoid sharp edges. It's recommended to have a professional pedicure service.
• Wear clean, dry socks. Wear cotton or natural fiber socks with moisture management that don't have tight bands or thick seams.
• APPROPRIATE FOOTWEAR. Always wear shoes that fit your particular and individual footwear needs, made with 100% natural fibers, with dyed leathers that allow perspiration, DO NOT use shoes with painted leathers, these have clogged pores and maintain an unfavorable internal environment for your feet, the best option is to have a " THERAPEUTIC AND BIOMECHANICAL BOCCIO FOOTWEAR " made to measure for your foot and with the necessary attributes to mitigate health problems derived from a "diabetic neuropathy" . Although in the market there are the so-called "shoes for diabetics" , these do not meet the optimal conditions required for the care of your feet.