Is Diabetes-Related Neuropathy? Let's find out about it.

Are you someone who has diabetes? So, do you feel numbness, tingling, burning, or sometimes pain in your hands and feet? These may be signs that your nerves are gradually being damaged by diabetes. Don't worry, this is a condition that affects many people. Today, we will talk about this nerve disease caused by diabetes, called `(Diabetes-Related Neuropathy)`.

Simply put, what is neuropathy?

Think of the nervous system in our body as being like the electrical wiring in a house. These nerves carry messages from the brain to every corner of the body, and these nerves carry messages from other parts of the body back to the brain. These nerves receive nourishment and oxygen from very fine, tiny blood vessels.

Now, when you have diabetes, which means your blood sugar level is high (Hyperglycemia) for a long time, these delicate blood vessels start to get damaged. Just like when water with a lot of sugar goes through pipes, the pipes start to rust. When the blood vessels get damaged in this way, the nerves, which are like electrical wires, don't get the nutrition and oxygen they need. Then those nerves gradually get weak, damaged, and even start to die. That's what we call Diabetes-Related Neuropathy .

This can happen to people with both ``Type 1'' diabetes and ``Type 2'' diabetes. However, it does not happen to everyone with diabetes. Also, neuropathy can happen for other reasons. For example, it can be caused by a nerve injury, a nutritional deficiency, or an accident. However, if a doctor finds that you have diabetes and cannot find another cause for these symptoms, they will diagnose it as diabetes.

What are the types of nerve diseases caused by diabetes?

This nerve damage can affect nerves in different parts of the body. It is divided into several main types depending on where it is affected. Let's take a look at what they are.

What could be the symptoms of these neurological diseases?

The symptoms you experience depend on what type of neuropathy you have. Let's look at the symptoms associated with each type separately.

Symptoms of Peripheral Neuropathy

Because this mostly affects the legs, you may experience things like:

• Tingling in the limbs , a feeling of ants running around, a feeling of being pricked by needles (Paresthesia).
• A sharp pain, like a burning sensation, stabbing, or electric shock.
• An abnormal response to touch. For example, feeling severe pain when a bed sheet rubs against the leg (Dysesthesia).
• Muscle weakness.
• Wounds on the legs or feet take a long time to heal .
• Sometimes, you lose all feeling in your feet. Then, even if you get pricked by a thorn or get injured by a shoe, you can't feel it.

This nerve damage happens gradually over many years, so you may not notice any major symptoms in the early stages.

Symptoms of Autonomic Neuropathy

Because it affects several systems in the body, symptoms can vary widely.

Another dangerous thing that can happen with this neurological disease is that you may not notice the warning signs of hypoglycemia, such as shakiness, excessive hunger, and anxiety. This can be dangerous.

What things increase the risk of this condition?

If you have diabetes, there are several factors that increase your risk of developing this neuropathy:

• Duration of diabetes: The longer you have diabetes, the greater the risk of nerve damage.
• Age: This risk also increases with age.
• Poor blood sugar control: If your blood sugar levels are consistently high, that's the main risk factor. Having an A1C above 7% for more than three years significantly increases your risk.
• High blood pressure (Hypertension): If blood pressure is high, it can also damage delicate blood vessels.
• High cholesterol: Increased cholesterol levels in the blood are also not good for blood vessels.
• High body weight (High BMI): Obesity is also related to this.
• Kidney disease: If the kidneys are damaged due to diabetes, the risk of neuropathy is also higher.
• Smoking and drinking alcohol: Both of these habits directly damage blood vessels and nerves.

How does the doctor diagnose this?

If you have these symptoms, the first thing you should do is see your doctor. He or she will ask you about your symptoms and how you manage your diabetes. Then, they will perform a physical exam. There are several tests that can be done to confirm the diagnosis.

• Diabetes foot exam: Here, the doctor will carefully examine your feet for any wounds, cuts, or ulcers. Then, using a small instrument (like a monofilament), they will touch different areas of your feet and see if you can feel them. This will help determine how much sensation has been lost in your feet.
• Nerve Conduction Studies (NCS): This measures the speed at which electrical signals travel along your nerves. If the nerves are damaged, this speed will be reduced.
• Electromyography (EMG): This test looks at the health of your muscles and the nerves that control them.

Tests to diagnose autonomic neuropathy vary depending on the system affected. For example, if there is a problem with the bladder, an ultrasound scan may be done.

What are the treatments for this?

Your doctor will help you maintain healthy blood sugar levels and treat any symptoms you may have, especially pain.

• Pain-relieving medications: Medications like `Pregabalin` and `Gabapentin` are often prescribed for nerve pain. Sometimes, `(Capsaicin)` patches applied to the painful area or certain medications for depression `(Antidepressants)` are also used for this pain.
• Physical Therapy: This helps strengthen muscles, prevent walking difficulties, and maintain balance.
• Occupational Therapy: Provides advice and assistive devices to make daily tasks easier.
• Other treatments: Some people may find pain relief through things like acupuncture. It is also important to see a nutritionist to learn about a healthy diet.

Can this nerve damage be reversed?

This is a question that many people ask. If blood sugar levels are well controlled, early symptoms like tingling may decrease or disappear within a year or so. However, if the damage to the nerves is severe , it is difficult to completely reverse it. That is why it is important to recognize the symptoms as soon as possible and start controlling your sugar.

What should we do to prevent it?

The best thing to do is to prevent this from happening. There are a few things you can do to do that:

• Keep your A1C below 7%. This is the most important thing.
• Maintain blood pressure below 140/90 mmHg or at the target level recommended by your doctor.
• Follow a healthy diet and exercise plan.
• Maintain a healthy body weight.
• If you smoke, stop immediately.
• Limit or stop drinking alcohol completely.
• See your doctor at least once a year for a complete checkup, especially a foot exam .
• Check your feet daily for blisters, cuts, sores, skin cracks, and redness. Because you have less sensation, you can injure yourself without realizing it.