What is the best treatment for diabetic neuropathy?

Diabetic neuropathy is one of the most debilitating complications of diabetes. It can cause numbness, pain, and tingling in different body areas, such as feet, hands, and legs. The most common cause of diabetic neuropathy is prolonged high blood sugar or hyperglycemia.

Long-term high blood sugar levels can damage small blood vessels that supply the nerves, leading to nerve damage. Neuropathy affects up to 70% of people with diabetes. In addition, it can lead to other health problems, including foot ulcers or severe instances such as amputation (due to infection or poor wound healing).

Causes of Diabetic Neuropathy

Aside from diabetes and genetic predisposition, these are some of the common causes of diabetic neuropathy:

• Poorly managed diabetes: If diabetes is not well-controlled, high glucose levels can build up in the bloodstream and cause damage to the nerves.
• Autoimmune responses: The body's immune system may mistakenly attack the nerves, leading to nerve damage.
• Nutritional deficiencies: Deficiencies in specific vitamins and minerals, such as B vitamins and vitamin E, can lead to nerve damage.
• Trauma or injury: An injury such as a broken bone or a deep cut can cause nerve damage.
• Certain medications: Some medications, such as chemotherapy, can damage the nerves.
• Infections: Certain infections, such as shingles or Lyme disease, can lead to nerve damage.

People most likely to experience diabetic neuropathy have been diagnosed with diabetes for an extended period and have had difficulty controlling their blood sugar levels. Also, those who have had a history of poor blood sugar control, have a family history of diabetes, or have had a recent trauma or surgery are also at higher risk of developing diabetic neuropathy. 

Additionally, people who have been living with diabetes for a while and are not taking proper care of themselves, such as not exercising regularly, not eating a balanced diet, or not taking their medications as prescribed, are more likely to experience diabetic neuropathy.

Symptoms of Diabetic Neuropathy

Symptoms are different for each type of diabetic neuropathy, but here are some of the common signs that you can watch out for:

• Numbness or decreased sensation in the feet or hands
• Tingling, burning, or sharp pains
• Loss of reflexes
• Weakness in feet or hands
• Loss of coordination
• Muscle cramps or twitching
• Difficulty walking
• Digestive problems
• Sexual dysfunction
• Abnormal sweating
• Excessive urination
• Excessive thirst

In addition, other factors such as aging, smoking, heavy alcohol intake, and certain medications can increase the risk of developing diabetic neuropathy. In some cases, underlying medical conditions such as vitamin deficiencies, kidney disease, and thyroid disorders can also contribute to the development of diabetic neuropathy.

Types of Diabetic Neuropathy

Peripheral Neuropathy

Peripheral neuropathy is a disorder of the peripheral nervous system. It usually affects the legs and feet, caused by myelin sheath damage, the protective coating surrounding the nerves, or the nerve fibers.

Peripheral neuropathy symptoms vary depending on the type but commonly include pain, tingling, numbness, weakness, and balance problems. Peripheral neuropathy can be caused by various conditions, including diabetes, certain infections, exposure to toxins, some medications, and inherited diseases.

Check for early symptoms by:

• Checking your feet and legs daily and use lotion to avoid dryness
• Taking care of your toenails and going to the podiatrist if prescribed
• Wearing well-fitted shoes to avoid injuries

Autonomic Neuropathy

Autonomic neuropathy can cause damage to the autonomic nerves. These nerves are responsible for several involuntary functions. These processes are generally automatic and occur through conscious efforts, such as heart rate, blood pressure, digestion, temperature regulation, and bladder function.

Autonomic neuropathy is a long-term condition, and symptoms can range from mild to severe. Common symptoms include lightheadedness, dizziness, blurred vision, difficulty swallowing, and constipation. More severe symptoms can include fainting, difficulty with urination and bladder control, and difficulty regulating body temperature. 

What you should do:

• Eat smaller portions
• Prevent standing up too fast
• Wear neuropathy socks
• See the doctor
• Take prescribed medications for treatment

Focal Neuropathies

Focal neuropathies are a group of neurological disorders caused by damage to part of the peripheral nervous system. These disorders can affect any nerve, or group of nerves, in the body and can cause various symptoms depending on the location and severity of the nerve damage. Symptoms may include pain, weakness, numbness, tingling, or paralysis.

The most common focal neuropathy type is mononeuropathy, which affects a single peripheral nerve. Mononeuropathy can be caused by direct trauma, such as a car accident, or by a more insidious process: a pressure ulcer or a tumor pressing on the nerve. Mononeuropathy can also be caused by diabetes, which can damage nerves in a variety of ways.

What you should do:

• See the doctor and inform them about your symptoms
• Since it can be unpredictable and improve over a few weeks, you can use home remedies as prescribed.

Proximal Neuropathy

Proximal neuropathy or Diabetic Amyotrophy causes damage to the nerves in the thighs, hips, buttocks, or lower legs, resulting in weakness and pain in the affected areas.

This type of neuropathy is usually seen in people with diabetes, although it can occur in anyone. It is more common in people with type 2 diabetes, caused by poor glucose control, high glucose levels in the blood, or nerve damage.

Pain treatment:

• Effective medication
• Physical therapy

What is the best treatment for diabetic neuropathy?

Here are multiple treatments available for diabetic neuropathy, including medications, lifestyle changes, physical therapy, and acupuncture.

Exercise

Exercise can help to reduce the symptoms of diabetic neuropathy by improving blood flow and circulation. It can also help to lower blood sugar levels, making them less likely to damage the nerves. Here are some exercises to help reduce pain and improve mobility.

Walking: Walking is one of the most effective exercises for diabetic neuropathy. It is low-impact, easy to do, and can be done almost anywhere. Start with short walks and slowly increase the distance and intensity over time.

Strength Training: Strength training exercises can help build muscle and improve balance. Yoga and Pilates are also great for people with diabetic neuropathy, as they focus on stretching and strengthening muscles.

Aerobic Exercise: Regular aerobic exercise can help improve circulation, reduce pain and improve mobility. Swimming and cycling are excellent aerobic exercises for people with diabetic neuropathy.

Stretching: Stretching can help with flexibility and reduce pain. Focus on stretching the muscles in your arms, legs, and back.

Balance Exercises: Balance exercises can help improve coordination, reduce falls, and improve balance. Try standing on one foot or walking heel-to-toe.

Overall, exercise can have a positive effect on diabetic neuropathy. Regular exercise can help to improve blood flow and circulation, reduce inflammation and pain, and improve overall mental health. However, speaking with a doctor before beginning any exercise program is crucial to ensure it is safe and effective.

Medication

Medications are available to help manage neuropathy symptoms -- blocking the pain signals sent from the nerves to the brain, decreasing inflammation, and promoting nerve healing.

The most commonly used medications for neuropathy are anticonvulsants, antidepressants, and analgesics. 

• Anticonvulsants such as gabapentin and pregabalin help reduce nerve pain by preventing nerve signals from reaching the brain.
• Antidepressants like amitriptyline and duloxetine work by blocking the release of neurotransmitters that cause pain.
• Analgesics such as tramadol and oxycodone work by blocking the transmission of pain signals to the brain. It is crucial to speak with your doctor before taking any medications.

Healthy diet

Lifestyle changes can also help reduce symptoms of diabetic neuropathy. For example, eating a healthy diet and exercising can help regulate your blood sugar and keep them at normal levels. Avoiding smoking and alcohol can also help reduce symptoms.

A balanced diet is essential for people who suffer from diabetic neuropathy. A healthy diet can help manage blood glucose levels and reduce the risk of further complications, such as nerve damage.

The following dietary tips can help those with diabetic neuropathy maintain a healthy diet:

• Choose complex carbohydrates, such as whole grains, vegetables, and legumes, instead of simple carbohydrates like white bread, white rice, and processed sugars. Complex carbohydrates help manage blood glucose levels and provide fiber, vitamins, and minerals essential for nerve health.
• Choose lean proteins, such as skinless poultry, fish, beans, and low-fat dairy products. These help to provide essential amino acids that are necessary for nerve health.
• Include healthy fats, which can be found in nuts, seeds, avocados, and olive oil. These fats can help to improve blood glucose management and reduce inflammation.
• Reduce sodium intake. High sodium levels can affect blood pressure and worsen nerve damage.
• Drink liquids, especially water, to keep yourself hydrated.
• Avoid processed and fried foods, often high in sugar, sodium, and unhealthy fats.
• Nutritional supplements can also help reduce pain and inflammation. Omega-3 fatty acids, vitamin B12, and alpha lipoic acid can help symptoms subside.

Therapy and Acupuncture

Various kinds of therapy can help improve strength and mobility in the affected areas. Massage and heat therapy can help reduce pain and improve circulation. Other treatments, such as physical therapy, occupational therapy, and acupuncture, can help manage neuropathy symptoms.

Physical therapy

Physical therapy can help reduce symptoms of diabetic neuropathy, such as numbness and tingling, pain, and weakness. It can also improve balance and coordination, reduce the risk of falls, and improve the overall quality of life.

Physical therapists will work with you to create an individualized treatment plan based on your specific needs. Treatment may include exercises to strengthen muscles, improve balance, and increase flexibility. Other treatments may include electrical stimulation, massage, ultrasound, and cold laser therapy.

Occupational therapy

Occupational therapy can help improve daily activities and functioning. For example, occupational therapy can help reduce the risk of falls and fall-related injuries by improving balance, strength, coordination, and flexibility. It can also help improve daily activities and mobility and teach compensatory strategies for managing activities of daily living.

Therapists may also educate patients on modifying activities to reduce the risk of injury or further damage. In addition, occupational therapists can help to provide assistive devices such as canes and walkers to improve mobility and reduce injuries. They may also provide patient education and instruction on using assistive devices safely and effectively.

Acupuncture

Acupuncture is an ancient practice by the Chinese involving needles inserted into the skin that causes stimulation to specific points in the body to promote healing and reduce pain. It can help reduce pain and improve nerve function. It's because of its ability to stimulate the release of hormones and neurotransmitters to help reduce inflammation and pain. Acupuncture can also improve blood flow, which can help reduce the risk of nerve damage.

In addition to reducing pain, acupuncture can also help improve sleep quality and reduce fatigue associated with diabetic neuropathy. Aside from that, it can also help with your digestion and relieve stress, which can help manage diabetes.

Additionally, acupuncture can be an effective treatment for diabetic neuropathy. Although it is best to consult a qualified acupuncturist for proper treatment

Compression stockings

Another way is by wearing neuropathy socks. They function by giving your feet the pressure and support they require. Lightweight, moisture-wicking, and snug-fitting socks are ideal for those with nerve injuries. Put the discomfort and tingling associated with neuropathy behind, for neuropathy socks can help you live a better quality of life.

High-quality neuropathy compression stockings contain the following qualities:

• Material that wicks away moisture to reduce the risk of infection
• Comfortable, seamless fit
• Offers flexibility for everyday wear
• Minimum seams to avoid irritation
• Maintain your feet warm and dry

Using neuropathy socks is an excellent approach to protect your feet. Wear neuropathy socks, and you are considerably less likely to be awakened during the night by the pain from your nerve damage.

Overall, the best treatment for diabetic neuropathy depends on the severity of the condition. In severe cases of diabetic neuropathy, surgery may be deemed necessary. Other treatments may include medications to reduce pain and inflammation, physical therapy, lifestyle changes, and nutritional supplements.