About half of individuals with diabetes have some form of neuropathy or nerve damage due to complications of high blood sugar levels. Some have no symptoms at all, but others have numbness, pain, or tingling in the feet or arms. Nerve damage also affects the heart, digestive tract, and sex organs.
Why are nerves damaged in diabetes?
Health experts believe that nerve damage develops due to high blood sugar levels and decreased blood flow to the major organs and tissues in the body. Most cases occur in those who have long-term diabetes (over 25 years), those who don’t have the blood sugar levels under control, or have associated conditions like high blood pressure or abnormal cholesterol levels.
Diabetes affects the metabolism and the body’s cells’ ability to receive nutrients and oxygen. It causes inflammation which leads to nerve damage. Smoking, excess drinking, and increased weight further aggravate diabetic neuropathy.
Different types of nerve damage can affect those with diabetes
- Peripheral neuropathy is the most common form of diabetes related nerve damage. It typically affects the feet and legs during early stages, and later on may progress to hands and arms. Symptoms include numbness, decreased ability to feel pain in the affected areas, tingling, severe pains and cramps, and foot ulcers and infections which can be severe. The symptoms typically aggravate at night. Some people may experience sensitivity to touch and even to light items like the weight of the bedsheet.
- Autonomic neuropathy. In this form of neuropathy, the autonomic nervous system (ANS) is affected. The main roles of ANS are to control the heart, digestive stysel, bladder, sex organs and eyes and includes sympathetic nervous system and parasymphathetic nervous system. When the nerves of the ANS are damaged, a person may have bladder symptoms like unable to urinate or urinate too often, lost control of the bladded or frequent bladder infections. Digestive problems like diarrhea, constipation, vomiting and bloating can also develop. Feeling diziness, decreased sexual response, vision problems (ie having problems adjusting from light to dark) may all suggest autonomic neuropathy. Another sign is lack awareness of low blood sugar levels. This is because the warning signs of hypoglycemia like feeling shaky or nervous are no longer felt.
- Proximal neuropathy typically involves nerve damage in the lower part of the body- buttocks, highs, thighs and legs. Symptoms are usually experienced on one side of the body and include severe pain in the affected areas, weak thigh muscles and problems rising from a sitting position.
- Mononeuropathy associated with diabetes is another form of diabetic neuropathy, characterized by damage to a specific nerve. It can cause vision problems like double vision, numbness and tingling in the hands and fingers except the little finger, weakness in the hands or Bell’s palsy.
Is nerve damage from diabetes reversible?
If diabetes can be reversed, the nerve damage from diabetes could potentially be reversed as well, right?
For a long time, diabetes was considered an irreversible, long-term condition. No known cure, just treatment to keep the blood sugar levels in check.
Yet research found that lifestyle changes can reverse diabetes. For example, one study published in the Lancet Diabetes and Endocrinology found that the majority of the participants had the ability to reverse type 2 diabetes and no longer require medication. They followed an intensive, one-year plan involving a low-calorie diet and physical exercise and the results were compared with a control group. The group who followed the diet-exercise plan lost an average of 26 pounds that year and 61% of them had diabetes in remission and no longer needed medication. In the control group, only 12 % achieved similar results.
The next question is: can diabetic neuropathy be reversed? Again, for a long time, this condition was considered irreversible. The usual answer to this question is: no, diabetic neuropathy can not be reversed.
Yet, some research suggests that the nerve damage can also be reversed. A 2006 study featured in the Age and Aging journal found that diabetic neuropathy was reversed, along with the decreased risk of falls and injuries, using therapy with infrared light. Other studies found improvement in symptoms using vitamin 1(in the form of benfotiamine), vitamin B12 (methylcobalamin), other supplements, or prescription drugs like erythropoietin and WST-057. Larger studies are needed to confirm these findings, but so far the results from preliminary studies are promising. So there is hope that in the future there will be treatments available to reverse diabetic neuropathy.
In the meantime, everyone with this condition can benefit from trying to maintain blood sugar levels within the recommended range, improve their lifestyle and reduce excess weight.
How to prevent or manage diabetic neuropathy
The most important step to prevent or better manage nerve complications is to keep the blood sugar levels well controlled. Diabetes is managed with a combination of prescription drugs, diet, and regular exercise. Some vitamins, minerals, and other supplements could be a great addition to the diabetes plan.
Any other medical conditions associated with diabetes like hypertension and high cholesterol levels also need to be well managed. Smokers need to quit smoking to better manage diabetes and its complications.
Foot care is another key aspect of diabetic neuropathy. Regular inspection of the feet and consultations with foot specialists are important. Lack of sensation due to nerve damage, along with reduced blood flow to the feet increases the risk of injuries, feet sores. A person may injure the foot or have a blister and not feel it at all. These can increase the risk of infections and other complications. More details about diabetes and foot care are in this article.