If you have diabetes, it is important to be aware of diabetic neuropathy and the ways it can affect your feet, ankles, and legs.
Diabetic neuropathy is a complication of diabetes that occurs when there is damage to the nerves and can cause a variety of different symptoms.
In some cases, diabetic neuropathy can lead to serious complications too.
It is important to know the symptoms of diabetic neuropathy and see your doctor if you are experiencing any problems with your feet, ankles, or legs.
Although there is no cure for it, there are treatments available for diabetic neuropathy and ways to prevent it which we will detail below.
What is diabetes?
Insulin is a hormone that plays a large role in the metabolizing of glucose because your cells use it to take in glucose and convert it into energy.
When you have diabetes, your body either does not make enough insulin (type 1 diabetes) or can not use its own insulin because your cells have developed insulin resistance (type 2 diabetes).
When left untreated, this causes your blood sugar levels to rise and can lead to serious complications such as cardiovascular disease (heart disease), stroke, kidney damage, and eye damage.
How does diabetes cause numb feet, ankles, or legs?
Diabetic neuropathy is a type of nerve damage that can occur due to elevated blood glucose levels if you do not manage your diabetes over a long period.
It most commonly affects the feet and legs, but can also affect the hands, arms, and torso.
There are four different kinds of diabetic neuropathy including diabetic peripheral neuropathy, autonomic neuropathy, proximal neuropathy (diabetic polyradiculopathy), and mononeuropathy (focal neuropathy).
In this article, we will focus on diabetic peripheral neuropathy as it is the most common type to affect your ankles, legs, and feet.
What are the symptoms of diabetic neuropathy?
There are several common symptoms associated with diabetic neuropathy and they include the following:
- A tingling sensation
- Loss of feeling in your hands, arms, legs, or feet
- Loss of balance that can lead to more falls
- Burning feeling in the affected area
- Sharp pains or shooting nerve pains
- Muscle weakness
- Becoming more sensitive to touch in the affected area
- Foot deformity due to bone damage
- Joint damage
- Diabetic foot ulcers
- Increased risk of infection
The symptoms may be mild at first and you may not even notice them.
However, as the damage to your nerves progresses, the symptoms will become more severe and can interfere with your daily activities.
Please talk to your doctor if you are experiencing any of these symptoms.
What causes diabetic neuropathy?
The exact cause of diabetic neuropathy is unknown, but it is believed to be the result of a combination of factors.
High blood sugar levels are thought to interfere with your nerves and their ability to send signals to your brain.
Blood vessel damage to the blood vessels that supply your nerves with oxygen and nutrients is also thought to be due to uncontrolled diabetes and elevated blood sugar levels too.
Are there any risk factors for diabetic neuropathy?
Several risk factors may increase your chances of developing diabetic neuropathy.
The most important risk factor is uncontrolled diabetes as it can lead to nerve damage over time. Being obese or overweight with a body mass index (BMI) over 25 is thought to play a role.
The longer you have diabetes you are at a higher risk of developing diabetic neuropathy too.
Smoking also can be a risk factor as it contributes to poor circulation. Finally, if you have kidney disease you are at a greater risk for diabetic neuropathy as it may allow toxins in your blood that can also damage your nerves.
What are the treatment options for diabetic neuropathy?
Over-the-counter pain relievers such as ibuprofen (Advil) or acetaminophen (Tylenol) can help ease the pain if you have mild to moderate symptoms.
Your doctor may also prescribe medications such as antidepressants, antiseizure drugs, or opioids as they are known to help with nerve damage.
Opioids will only be prescribed for a short time though as they can be addictive.
There are also two medications approved by the United States Food and Drug Administration (FDA) for diabetic peripheral neuropathy and they are Lyrica (pregabalin) and Cymbalta (duloxetine).
Antibiotics or other medications may also be used if you have any signs of infection with your diabetes-related foot ulcers.
Please discuss any new medications with your doctor before you start taking them.
Capsaicin cream is a topical treatment that can be applied to the affected area. It contains an ingredient that helps block pain signals from your nerves to your brain.
Monitoring and treating your diabetes
It is important to keep your diabetes under control as it can help prevent further nerve damage. You will also need to monitor your blood sugar levels closely to maintain control of your diabetes.
To help you control your diabetes you may need to make some lifestyle changes that include eating a healthy diet, exercising regularly, and taking your medications as prescribed by your doctor.
Exercise can help improve blood flow to your nerves, help you maintain a healthy weight, and lower your blood sugar levels which can help relieve symptoms.
Walking, swimming, or biking are all low-impact exercises to try if you have diabetic neuropathy. Be sure to talk to your doctor before starting any exercise program as they will be able to tailor an exercise plan that is right for you.
Physical therapy or occupational therapy may be recommended to help you with any balance or mobility issues you may have. These therapies can also help relieve pain and teach you how to take care of your feet if you have numbness in them.
Transcutaneous electrical nerve stimulation (TENS)
TENS is a treatment that uses low-voltage electrical currents to help relieve pain. The electrical current is applied to the skin through electrodes that are placed on the affected area.
Some dietary supplements may help relieve symptoms of diabetic neuropathy. Alpha-lipoic acid (ALA) is an antioxidant that can help reduce inflammation and pain.
It is available in capsule form and needs to be taken as directed. Acetyl-L-carnitine is another supplement that may help with nerve damage and pain.
Please note that dietary substances are not regulated by the United States Food and Drug Administration and more research needs to be conducted to come to any firm conclusions about their benefits in treating diabetic neuropathy.
Acupuncture is a traditional Chinese treatment that uses thin needles that are inserted into the skin at specific points.
It is thought to help relieve pain by stimulating the nervous system although more research is needed about its ability to help treat diabetic neuropathy.
What are the complications of diabetic neuropathy?
There are two common complications that can happen due to diabetic neuropathy.
The first is amputation as you may need to have a toe, foot, or part of your leg amputated if you have considerable nerve damage from diabetic neuropathy or a severe infection.
When you lose sensation in your legs, ankles, or feet you may not notice a cut that can become an ulcer and get infected which can lead to amputation. Amputation is usually only done as a last resort though and other treatments will be tried first.
Nerve damage can also lead to Charcot foot which is when the bones in your feet break due to a loss of sensation which can cause your foot bone structure to change shape and become deformed.
Charcot foot is a serious foot condition that needs to be treated as it can also lead to amputation if left untreated.
Can diabetic neuropathy be prevented?
The best way to prevent diabetic neuropathy is by consistent blood sugar management.
Eating a healthy diet, exercising regularly, taking your medications as prescribed, and monitoring your blood sugar levels closely to ensure they are in the target range can all help you manage your blood sugar levels and prevent diabetic neuropathy.
Quitting smoking will also improve your chances of not getting diabetic neuropathy as it causes poor blood flow.
You also need to keep your feet healthy by practicing proper foot care which includes washing them every day with a mild soap, keeping them dry, wearing comfortable closed-toed shoes that fit well, and checking your feet regularly for any cuts, sores, or other problems.
See your doctor right away if you notice anything out of the ordinary.
If you already have diabetes and are starting to experience numbness in your feet, ankles, or legs be sure to talk to your doctor so they can treat the neuropathy before it gets worse and schedule regular appointments for a foot exam to avoid foot complications caused by diabetic neuropathy.
It is important to keep your blood sugar levels under control to prevent diabetic neuropathy from occurring or prevent it from getting worse.
If you already have diabetic neuropathy, there are treatments available that can help relieve symptoms and prevent further complications from occurring.
Please talk to your doctor, podiatrist (foot doctor), or health care provider if you have any more questions regarding diabetic neuropathy or how to treat it.
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Diabetic.org is devoted to producing expert and accurate articles and information for our readers by hiring experts, journalists, medical professionals, and our growing Diabetic.org community. We encourage you to read more about our content, editing, and fact checking methods here. This was fact checked by Jacqueline Hensler and medically reviewed by Dr. Angel Rivera.
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