I want to address a very common problem that patients with Diabetes face; Diabetic Neuropathy.
Diabetic Neuropathy is damage that occurs to nerves, usually as a result of high levels of glucose (sugar) over a prolonged period of time. It can affect multiple body parts, and is the most common complication of diabetes.
This occurs when the nerves are exposed to high blood sugar levels over a period of time. This seems to impair the ability of the nerves to send messages. It also seems to weaken the walls of the blood vessels which supply nutrients and oxygen to the nerves. But there are other ways that the nerves can be injured; when your body has an immune reaction and the immune system attacks the nerves, thinking they are a foreign material. Genetics may play a role, making some people suffer nerve damage more easily. And smoking, alcohol use and caffeine may also play a role in accelerating nerve damage.
First of all, you should see your family physician for a general medical check-up if you think you have any of this problems. They will want to know about all of your symptoms, how long they have been occurring if there is any worsening, what your diet and lifestyle are like, and any medicines/ supplements you are taking. If it is determined that you are experiencing nerve problems from diabetes, your physician will refer you to a neurologist, a specialist trained to diagnose and treat conditions of the nerves.
After a history and physical exam, including an evaluation of your cognition, cranial nerves (nerves that affect the face, eyes, ears, mouth and tongue) muscle testing, coordination, reflexes, sensation (to touch, temperature, position and vibration) and assessment of your feet, most likely diagnostic testing will be ordered.
Nerve Conduction Tests (NCV): Usually performed by a certified technician supervised by a neurologist. This test determines how fast the nerves conduct electricity in the arms, hands, legs, and feet. This test can diagnose carpal tunnel syndrome.
Electromyography (EMG): Usually performed with the NCV, this explains how the nerves are supplying the muscles and how the muscles are working.
Autonomic testing: This will apply if there are symptoms of autonomic neuropathy; checking blood pressure and pulse sitting and standing, checking the ability to sweat are just some of the assessments that are done.
There is no cure, BUT, you can slow the progression and minimize the symptoms and alleviate the pain. In general, exercise, weight loss, proper diet, limiting alcohol and tobacco are all essential. But there is more that can be done.
Anti-seizure medications: Lyrica (approved for diabetic neuropathy), Neurontin, Tegretol; these medications may provide relief but often have side effects (dizziness, sedation, swelling) as well.
Antidepressants: Cymbalta (approved for diabetic neuropathy), Elavil, Pamelor, Tofranil are often used; side effects can include constipation, dry mouth, weight gain, sweating, dizziness.
Alternative treatments: Topical creams, acupuncture, massage may help.
For more information about diabetic neuropathy and other neurologic conditions, contact the Neurology Office, Joseph Kandel, M.D. and Associates, contact our team of medical professionals to find out what you can do to start on a healthier journey!
Neurology Office, Joseph Kandel M.D. and Associates
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