Peripheral Neuropathy in Diabetics
What is Peripheral Neuropathy? Worried aobut your risk? Diabetics with poor blood sugar levels are most at risk.
Peripheral Neuropathy – What is it?
Peripheral neuropathy (PN) is nerve disease or damage that occurs away from the brain and spinal cord. This damage to the peripheral nerves interupts communication between the brain and other areas of the body. As a result, sensation may become compromised. There may also be pain and impaired muscle movment. Peripheral neuropathies are common in people over the age off 55, but even more prevelant in people living with diabetes (6).
In diabetics it is commonly found in the feet and legs, although it can also occur in the hands and arms. Additionally it can occur in the digestive system, the urinary system and affect the sex organs. Diabetic’s with high blood glucose levels are at greater risk, because this can damage their cappillaries. The Damage causes blood flow restriction to nerves that innervate certain parts of the body. Generally this happens gradually. Due to the slow onset, significant symptoms are present before people begin testing with their doctor or podiatrist (3). Diabetics are at risk of all the peripheral neuropathys, but for this purpose we will discuss the most common – the feet and legs.
How is it diagnosed
Diagnosis of peripheral neuropathy is through clinical testing, relying heavily on a patients reporting of symptoms. Common signs are numbness, muscle spasm prickling, deep, sharp and electric shock like sensations through the lower limbs and feet. Exacerbations can occur during sleep or periods of low activity. Patients are asked to report the frequency and level of their pain prior to a diagnosis (2). There are a multitude of clinical tests, but they include sensory tests such as pinprick, pressure sensation, vibration perception and temperature testing. Additional to these is the ankle reflex test, for general nerve reflex. A thorough site inspection of the feet and legs is also conducted, as ulcers are common in people with peripheral neuropathy (5). Doppler testing of the arteries of the feet, may provide early indication for testing peripheral neuropathy due to circulation problems.
Prevention tips for Diabetics
We all know that prevention is better than cure. This sometimes can be challenging for diabetics, as in order to keep things ‘normal’ they need to stick to routines. The best things they can do are:
- Regular GP visits – for their diabetes
- Maintain good control of their BGL
- Make healthy dietary choices
- Complete aerobic exercise on most days to help the cardiovascular system
- Complete some sort of resistance training (weights, yoga, pilates) at least 2 times a week to promote muscle strength and balance
- Visit a Podiatrist at least once a year for a diabetic foot check
- Self checks of feet and legs. Monitor the healing rate of sores
Management techniques for PN have been divided for years, ultimately choosing the best technique for yourself may be as simple as what works or suits you best. At Unison Health we specialise in the treatment of Chronic conditions through exercise application. Research has shown that a 10 weeks structured exercise regime will not only assist with reducing pain levels but have positive effects on nerve function (1). Improvements in nerve function will ultimately result in improvements in strength and proprioception, improving quality of life and lessening your chance of falls in the future. Balance training has shown to be the most effective exercise type in improving motor function and endurance work to have had the high effect on slowing disease progression or development (4).