For people with permanently high blood sugar level that damages nerve tracts, they can suffer a significant loss of quality of life. Nerve issues, pain and sensation disorders and irreversible damage to internal organs are all possible side effects of diabetes. How does diabetic neuropathy develop, how do you recognise it, how can you prevent and treat it?
What is diabetic neuropathy?
The term neuropathy covers a large number of diseases and disorders of the peripheral nervous system – e.g the nerve tracts and centres that run throughout the body. Diabetic neuropathy (or polyneuropathy in the case that many nerves are affected) is a specific type of disorder that only affects people who have diabetes (diabetes mellitus). The excessively high sugar content in the blood damages the nerve cells, causing dysfunction and even death of the nerves. Depending on which nerve tracts are affected, diabetic neuropathy can manifext itself through very different symptoms. Nerves that control organs such as the liver, heart or kidneys or pass on sensory stimuli can be affected and cause corresponding functional disorders as well.
What types of diabetic neuropathy are there?
A basic distinction is made between peripheral and autonomic neuropathy. The peripheral neuropathy nerve fibres that are affected include the skin, arms and legs, all pulling from the spinal cord.. They essentially consist of nerve fibres for tactile and temperature sensation, pain-conducting nerve fibres and motor nerve fibres that that are responsible for guiding your movement and actions on a daily basis. Autonomic neuropathy involves the nerves which control the so-called autonomic functions of the body. These include the heart and circulation, digestion, hormonal balance, kidney and liver activity, blood pressure and other functions that run autonomously, all run by our brain without conscious thought.
How do you confirm diabetic neuropathy?
Nerves travel all over the body, serving a wide range of roles. From movement control, sensory perception and pain response to organ function, damage report and temperature sense, they are crucial for daily life. As diverse as the roles of these nerves are, the appearance of diabetic neuropathy can be just as varied.
- In the case of damage to nerve fibres that transmit environmental and tactile stimuli you can get the following symptoms:false or reduced sensation, tingling, itching, burning, pins and needles or numbness, reduced or changed temperature sensation.
- With damaged pain fibres:pain for no apparent reason or lack of pain sensation, exaggerated sense of pain.
- In case of damage to organ nerves (autonomic neuropathy):cardiac arrhythmia or digestive disorders, fluctuations in blood pressure, nausea, vomiting, bladder weakness, swallowing disorders or impotence.
- With damage to motor nerves:muscle weakness, muscle wasting, paralysis, unsteady gait or stumbling
If the nerve fibres of the eye are affected (diabetic retinopathy), this is most noticeable through visual disturbances; in severe cases, partial or full blindness can occur.
How does polyneuropathy affect your mental health?
The symptoms and effects of diabetic neuropathy aren’t just physical, they also affect your state of mind. Self-help groups, phsychology and counselling all can help provide a distinct effect on the treatment and stabilisation of such a condition. Maintaining healthy relationships and seeking professional help is a crucial part of preventing the development of mental health disorders. About one in four people with diabetes suffer from depressive moods, depression and other mental health issues due to their prognosis. This can cause social withdrawal and a sense of helplessness, leading to a diminished social life and overall poorer quality of life. By talking with others, especially those who also struggle with diabetes, the mental health effects can be countered and overcome.
How can diabetic neuropathy be treated?
There is no current cure or clear treatment of diabetic neuropathy that stops it occurring. The main treatment is primarily patient education and strict diet and blood sugar control to prevent worsening of the condition. What’s most important is the patient following the steps required.
Independent monitoring of blood sugar levels and blood pressure as well as a healthy lifestyle without nicotine and alcohol is essential. Depending on the symptoms, various measures can be taken to improve the quality of life of those affected:
- Losing weight to get to a healthy level.
- Pain management.
- Medical therapy and regular treatment.
- Insoles, orthopedic shoes or shoe splints.
- Physiotherapy (heat or cold therapy, electrotherapy, movement therapy such as gymnastics or gait school, massage).
- In the case of functional disorders of internal organs, targeted therapies to compensate for the functional disorder (for example ACE inhibitors or antiarrhythmics for cardiac arrhythmias or implantation of a gastric pacemaker for severe gastric disorders).
- Accompanying psychology, counselling or self-help groups.
How can insoles help with diabetic neuropathy?
Diabetic neuropathy is often associated with impaired pain perception. If the pain-conducting fibres are damaged in a polyneuropathy, those affected do not notice small injuries or damage to the foot, as well as poor healing which can lead to chronic wounds. This can be prevented by using suitable footwear, “comfort shoes” and insoles. Bauerfeind's soft padding ErgoPad soft Diabetes prevents damage and the reduces consequences of overloading the foot by evenly distributing the pressure when walking and moving. This particularly relieves the parts of the foot, in particular the heel and base of the toes, which are under most strain.