Understanding Diabetes: Diabetic Neuropathy
Dr. Alan Pressman, DC, CNS, DAC, BN
Patients with long standing diabetes may experience a certain kind of nerve pain in the arms and legs, known as diabetic neuropathy. Damage to the nerves from too much sugar in circulation affects the microvasculature. Small vessels called the vasa vasorum and vasa nervorum are particularly susceptible to physical changes such as mechanical pressure or plaque formation that decreases blood flow through these tiny nerves.
Symptoms of Diabetic Neuropathy may include any of the following and they usually progress slowly over time:
- Difficulty with balance
- Numbness and tingling of extremities
- Abnormal sensation to a body part (Dysthesia)
- Erectile dysfunction
- Urinary incontinence (loss of bladder control)
- Facial, mouth, and eyelid dropping
- Vision changes
- Muscle weakness
- Difficulty swallowing
- Speech impairment
- Fasciculation (muscle contractions)
- Anorgasmia (lack of an orgasm)
- Retrograde ejaculation (in males)
- Burning or electric pain
For an older individual, balance is a real problem because very often all it takes it one bad fall resulting in a broken hip to lose their independence. For this reason, balance training on a Bosu Ball is highly recommended.
Not all nerves are affected the same by diabetic neuropathy. There are a wide variety of nerves in the body, but the long nerves tend to be harmed more by uncontrolled blood sugar resulting in sensorimotor polyneuropathy, autonomic neuropathy, and cranial neuopathy.
Sensory nerves are the ones that give us information about feeling. With this problem, decreased sensation and loss of reflexes occurs first in the toes on each foot, then extends upward. Sensations in extremities are usually described as glove-stocking distribution of numbness, sensory loss, dysesthesia, and night-time pain. The pain can feel like burning, a pricking sensations, or dull. A pins and needles sensation is common. Loss of proprioception, the sense of where a limb is in space, is affected early.
Autonomic nerves control parts of the body that we do not have conscious control over, like nerves serving the heart, lungs, blood vessels, bone, adipose tissue, sweat glands, gastrointestinal system and genitourinary system. The types of problems that can develop from autonomic neuropathy are changes in heart rate, sluggish movement of the intestines, and incomplete emptying of the bladder. Common symptoms associated with autonomic neuropathy are: fainting and falling from rapid changes in blood pressure, constipation or diarrhea from changes in normal gastric movement known as gastroparesis, urinary tract infections or sexual problems like the inability to maintain or achieve an erection or ejaculate.
"There are a wide variety of nerves in the body, but the long nerves tend to be harmed more by uncontrolled blood sugar resulting in sensorimotor polyneuropathy, autonomic neuropathy, and cranial neuopathy."
In the head, the cranial nerves control things like facial muscles, eye movements, and even some gut and heart functions via the vagus nerve. Quite often, the manifestation of cranial neuropathy are changes in eye function because the oculomotor nerve is affection. Diplopia, double vision, is the most common symptom.
Of all of the changes an individual might face with diabetes, neuropathy is probably the most bothersome and troubling, in terms of the effect on your daily quality of life. Due to many neurological implications of diabetic neuropathy, many nutrients are suggested to help balance and support the body.
A nutritionist may suggest these nutritional components in addition to a healthy diet and lifestyle:
- Glucose maintaining nutrients like, chromium, alpha-lipoic acid, and bitter melon
- A high energy multivitamin
- Neurological support containing Phosphatidylserine, Acetyl-l-carnitine, Myoinosital
- Omega-3 Fish Oils
- Nitric oxide precursors - Organic Greens
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