Not so sweet after all

Alan was 76 when he noticed a weakness in his legs whenever he squatted. “I initially attributed it to my age. But the weakness soon worsened, so I avoided squatting unless it was really necessary,” he recalls. Convinced that his problem was ‘muscle weakness’ which could be treated with ‘something called gamma globulin injections’, he asked his doctor if he could have the shot.
His doctor proceeded to run some tests – and Alan couldn’t be more surprised when he was diagnosed with diabetic peripheral neuropathy instead.

‘Diabetic peripheral what?’

Excess sugar is never a good thing – and that applies to our nerves too. Abnormally high blood sugar levels can cause diabetes and if ineffectively managed, our nerves may be eventually damaged – a condition known as diabetic neuropathy. If the damaged nerves happen to be in our legs, arms, hands or feet, this type of neuropathy is called diabetic peripheral neuropathy.

While studies show that 60-70% of diabetics will develop peripheral neuropathy in the long run, uncontrolled blood sugar isn’t the only cause of this condition. Other factors include smoking, excessive alcohol intake and genetic predisposition.

‘Do I have it?’

Peripheral neuropathy typically attacks the feet and legs first, before moving to the arms and hands. Its symptoms are normally more severe at night, and include:

• Tingling
• Numbness
• Stabbing or burning pain
• Loss of co-ordination, balance or reflexes
• Muscle weakness
• Heightened sensitivity to touch
• Infections (e.g. ulcers) in the feet.

How bad is bad?

Those with peripheral neuropathy are unlikely to be aware of cuts, blisters or sores in their feet due to the numbness. If untreated, these wounds can evolve into ulcers, which may turn gangrenous as time progresses. When that occurs, surgery may be required to extract the damaged tissue. But if the gangrene is too severe, amputation of the affected limb (e.g. toe, foot or leg) may be necessary.

It can be treated

If you’ve been experiencing similar symptoms, get yourself checked by a doctor. Your life may not be exactly the same with peripheral neuropathy but take heart, there are ways to manage its complications, relieve pain and delay its progression such as:

Manage blood sugar levels

A well-balanced diet comprising lots of fruits and vegetables, and a low amount of red meat, a healthy BMI, regular exercise and smoking cessation can keep your blood sugar in check.

Foot care

It’s crucial to inspect your feet daily for any blisters, cuts or swelling. If there are any injuries, inform your doctor immediately. Even if there are no injuries, have your foot and ankle surgeon regularly examine your feet for preventive purposes. Wearing soft, seamless socks and comfortable footwear can also help prevent foot injuries. Always wash your feet with lukewarm water and mild soap; remember to dry them (and between the toes) after.

Medication

To relieve pain or other symptoms, drugs may be prescribed. Several types of drugs are used in peripheral neuropathy treatment e.g. anticonvulsants which act by controlling nerve cells in the brain, legs and arms amongst other body parts which transmit pain signals.

References:

Foot Health Facts. Available at www.foothealthfacts.org

Mayo Clinic. Available at www.mayoclinic.org

National Institute of Diabetes and Digestive and Kidney Diseases. Available at www.niddk.nih.gov

Nerve and Muscle Center of Texas. Available at www.nerveandmuscle.org

NHS Choices. Available at www.nhs.uk

WebMD. Available at www.webmd.com

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