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What is it about ?
The nerves in our body carry messages between the brain and the muscles or skin so that we can move and feel. These messages also regulate the functioning of organs.
One of the complications of diabetes is damage to the nerves. Too high levels of sugar in the blood (glycemia) damage the blood vessels that bring blood to the nerves, which disrupts the functioning of the nerves. It is therefore essential to have good diabetes control.
Sometimes symptoms of nerve damage are the first sign of diabetes.
Doctors classify nerve damage according to the damaged parts of the nervous system.
Damage to the nerves of the foot
This nerve damage is very common in diabetics. It is characterized by tingling or drowsiness in the feet and is often accompanied by pain (neuralgia). Muscle cramps and a feeling of restlessness in the legs can also occur. The longer the damage to the nerves, the more the muscles weaken. In an advanced stage, the hands can also be affected. Symmetry of symptoms is typical for this form of nerve damage.
You feel much less pressure or pain in your feet. For example, if you have healthy nerves in your feet and wear shoes that are too tight or have blisters after walking for a long time, you will take your shoes off and let your feet rest from the pain. But if you have damaged nerves in your feet, you will continue to walk longer with your shoes on and risk more serious injury. In addition, diabetes often causes damage to the blood vessels, making it difficult for wounds to heal.
Small nerve fibers damage
This form of attack can already appear when blood sugar is slightly increased, that is to say even before having diabetes. Characteristic complaints are a feeling of burning, tingling and sleepiness in the feet. You feel less cold and heat. But there are no symptoms in the muscles.
Damage to the nerves with pain (neuralgia) in the back and thigh
This form of neuropathy most commonly affects older men or middle-aged people with poorly controlled diabetes. It is accompanied by a decrease in muscle mass and weakness in the muscles of the hip and thigh. Complaints decrease markedly within 6 to 18 months after better rebalancing of diabetes.
Damage to the nerves of the dorsal spine (thoracic)
This form of nerve damage is difficult to recognize. And yet, it is not uncommon. This condition begins between the ages of 50 and 70 in patients with type 2 diabetes. Its main symptom is severe pain (neuralgia) on one side of the chest, which reaches its peak within a few days. The pain is sometimes accompanied by disturbances in feeling and weakness in the muscles of the chest or stomach. Often you lose weight. This condition usually goes away on its own.
Single nerve damage (mononeuropathy)
A mononeuropathy refers to the involvement of a single nerve. In diabetes, it is most often the thigh nerve (crural nerve) and its involvement causes pain (neuralgia) and weakness of the muscles in the thigh. This condition usually goes away on its own.
Carpal tunnel syndrome is common in people with diabetes. In this case, the damage affects the nerve of the wrist and causes pain and disturbances of sensitivity in the fingers.
Optic nerves damage
This form of neuropathy can cause double vision, a drooping eyelid, inability to turn the eye, abnormal eye position (the eye is turned outward, for example) and dilation of the pupil. , which complicates the reading. This condition often heals on its own.
Damage to the nerves of the organs
When nerves in organs are damaged, neuropathy can lead to the following symptoms:
- Disturbed or irregular heartbeat;
- Dizziness when you stand up;
- Diarrhea or constipation;
- Nausea after eating;
- Problems urinating;
- Erection problems;
- Sweat problems and skin changes;
- Reduction or disappearance of the symptoms that appear when the level of sugar is too low in the blood (hypoglycemia);
- Fluid retention (edema).
What is its frequency?
All people with diabetes can develop some form of nerve damage. Up to 1 in 2 diabetics will have symptoms and 16 in 100 people with diabetes suffer from persistent neuralgia.
How is the diagnosis made?
The doctor can already gather a lot of useful information by asking you various questions and by performing a physical examination.
Larger nerve damage can be diagnosed by an electromyogram (EMG). To detect damage to the nerves of a smaller caliber, we test the sensitivity of certain parts of the body.
A skin biopsy can also reveal loss of small nerve fibers.
What can you do ?
Observe good foot hygiene. Wash your feet thoroughly every day and dry them well, to avoid maceration between the toes. Avoid crevices, especially in the heels, and use a moisturizing ointment. Take care of your nails, cut them straight to avoid ingrown toenails and preferably file the sharp edges with a cardboard file. If you have diabetes, have calluses and corns (partridge eyes) removed, preferably by a pedicurist or podiatrist. Wear quality socks and shoes, inside and out. Be careful not to hurt yourself. Therefore, do not walk barefoot and avoid contact with heat sources. Make sure there are no irregularities or objects in your shoes before putting them on. Check your feet regularly … If necessary, ask a member of your household or a home nurse for help.
Tell a doctor if you have a blister or sore on your foot. Ensure optimal control of your diabetes. Try to quit smoking, as smoking makes nerve damage worse.
What can your doctor do?
Certain medications for depression and epilepsy may have a beneficial effect on neuralgia associated with diabetes. If they don’t work or are not right for you, your doctor may prescribe other painkillers.
Transcutaneous Electrical Nerve Stimulation (TENS) may be considered to relieve pain. The procedure consists of generating an electric current by means of electrodes placed on the skin. This current stimulates the nerves, which relieves pain.
If you have nerve damage to certain organs, your doctor may prescribe medicines that will reduce the symptoms of dizziness when you stand up, nausea, or diarrhea.
Find out more
- Eat better – Christian mutuality
- Nutri-Score – SPF Public health, food chain safety and the environment
- Stop smoking. It’s possible – Tabacstop – Foundation against cancer
- Alcohol, the point on your consumption – Stop or else?
Are you looking for more specialized help?
- Smoking Assistance Center (CAF®) – FARES – Respiratory Affections Fund
- Tobacco specialists – FARES – Respiratory Affections Fund
- Find a registered dietitian – Professional Union of French-speaking dieticians
- Find a nutritionist doctor – Belgian Society of Nutritionist Doctors
- Alcohol aid – Le Pélican & Le center ALFA
Sources
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