Diabetic Neuropathy

Diabetic neuropathy is a nerve disorder caused by diabetes which is characterized by tingling, pain, or numbness. Although it can occur in nerves anywhere in the body, diabetic neuropathy is more common in the nerves in the legs

High blood sugar levels can cause long-term damage to nerves throughout the body. Not only in the legs, nerve damage can also occur in the digestive system, urinary tract, blood vessels, and heart.

Diabetic Neuropathy Causes

Diabetic neuropathy occurs in people with diabetes when high blood sugar levels weaken the walls of blood vessels that supply oxygen and nutrients to nerve cells. As a result, there is damage and disruption of nerve function.

The nerve damage can be accelerated or exacerbated by a combination of the following factors:

• Autoimmune disease that attacks the nerves causing inflammation of the nerves
• Smoking habit
• Consumption of alcoholic beverages

Risk factors for diabetic neuropathy

All diabetics are at risk for diabetic neuropathy, but the risk is greater if the following factors are present:

• Unable to maintain blood sugar levels properly
• Suffered from diabetes for a long time
• Being overweight
• Suffering from kidney disease

Diabetic Neuropathy Symptoms

Diabetic neuropathy symptoms vary, depending on the location of the affected nerves. In many cases, symptoms develop slowly and gradually so that the sufferer only realizes it when nerve damage has occurred.

At first, diabetic neuropathy will cause tingling, cramping, or pain in the legs and feet. Over time, the area will become numb, both to pain and temperature.

This numbness often causes diabetics to be unaware of the wound. If not treated properly, the wound on the foot will expand, causing infection and tissue death.

In addition to problems in the feet and legs, diabetic neuropathy sufferers can also experience symptoms such as:

• Balance disturbance
• Difficulty swallowing
• Excessive or even reduced sweating
• Erectile dysfunction or impotence
• dry vagina
• Loss of libido
• Constipation or diarrhea, or both alternating
• Urinary disturbances, such as bedwetting or difficulty urinating
• Blurred vision or double vision
• Paralysis on one side of the face (Bell's palsy)
• Heart pounding

When to see a doctor

If you have diabetes, check with your doctor regularly to keep your blood sugar levels under control. The doctor will also examine the condition of your feet, because often diabetics are not aware of the sores on the feet.

Immediately go to the doctor if you experience the following complaints:

• Wounds on legs that don't heal or get infected
• Changes in sexual arousal
• Disorders urinating (BAK) and defecating (BAB)
• Pain or burning feeling in the hands or feet

Please note, the above conditions do not always indicate nerve damage, but can be symptoms of other conditions that require immediate medical attention.

Diabetic Neuropathy Diagnosis

To see if someone has diabetes or not, the doctor will check blood sugar and HbA1c levels. HbA1c is a blood test to see the stability of blood sugar in the last 2-3 months.

Blood sugar levels and HbA1c are also used by doctors to monitor the effectiveness of treatment in diabetics.

In diabetics or people who are not aware that they have diabetes, the doctor will carry out the following examinations:

• Blood pressure measurement in various positions
• Test the body's ability to sweat
• The filament test, using a thin fiber to check sensitivity to touch

After that, the doctor will perform an electromyography (EMG) examination to see the electrical activity of the nerves in the muscles. In this examination, the doctor will also assess the speed at which the nerve impulses conduct, as well as the response of the nerves to changes in temperature and vibration.

Diabetic Neuropathy Treatment

Diabetic neuropathy treatment aims to relieve pain, and restore normal nerve function in the body. For more clarity, see the explanation below:

Relieve pain

To relieve pain caused by diabetic neuropathy, doctors can prescribe:

• Antidepressants, such as amitriptyline and duloxetine
• Anticonvulsants, such as gabapentin, carbamazepine, and pregabalin
• Cream containing capsaicin

Restore normal body function

Doctors will also provide treatment to restore body functions, depending on the affected body part, including:

• Medication to treat digestive problems

  The doctor may suggest changing your diet, for example by reducing fibrous or fatty foods, eating soft and easy-to-digest foods, and eat more often with smaller portions. This change in diet can also be accompanied by the administration of drugs by the doctor.

• Treatment to treat urinary disorders

  If diabetic neuropathy sufferers find it difficult to urinate, the doctor can give urinary tract muscle relaxants to increase urination. If the BAK disorder is caused by the use of certain drugs, the doctor will advise you to stop using the drug.

• Treatment to treat sexual problems

  Doctors may prescribe sildenafil or tadalafil to treat erectile dysfunction in men. Meanwhile, in the case of vaginal dryness in women, the doctor will provide a special vaginal lubricant.

Please note, diabetic neuropathy cannot be completely cured. However, the development of diabetic neuropathy can be slowed by keeping blood sugar levels within normal limits. The recommended blood sugar level is 80-130 mg/dL before eating and less than 180 mg/dL 2 hours after eating.

In addition to medication, diabetics also need to adopt a he althy lifestyle by maintaining an ideal body weight, maintaining normal blood pressure, not smoking, and reducing consumption of alcoholic beverages.

Diabetic Neuropathy Complications

Diabetic neuropathy can cause a number of serious complications, namely:

• Infection and death of tissue in the leg, so the leg needs to be amputated
• Damage and deformity of joints
• urinary tract infection
• Gastroparesis

Diabetic Neuropathy Prevention

The main way to prevent diabetic neuropathy is to prevent diabetes, namely by:

• Eat foods low in calories and fat, and high in fiber, such as fruits and vegetables
• Exercise regularly with a light intensity of at least 30 minutes every day, such as jogging, swimming, or cycling
• Lose weight if you are overweight

For diabetics, prevention of diabetic neuropathy and its complications can be done by:

• Routinely control blood sugar levels
• Keep feet clean and not dry
• Do not walk barefoot even in the house
• Wear well-fitting and comfortable shoes
• Check your feet every day, and immediately go to the doctor if there are sores on your feet