Complications of Diabetes - Diffuse Neuropathy

Diffuse neuropathy is a kind of nerve problem that affects many parts of the body. There are two types of diffuse neuropathy. Peripheral neuropathy affects the feet and hands and autonomic neuropathy affects the internal organs. Autonomic neuropathy can affect a lot of body processes and systems, everything from sexual response in both women and men, digestive problems that cause weight loss, even regulation of body temperature and sweat.

Focal Neuropathy

    This kind of diabetic neuropathy appears suddenly and affects specific nerves, most often in the torso, leg or head. Symptoms can include severe pain in an area of the body, eye and hearing problems or even paralysis on one side of the face called Bell's palsy. Carpel tunnel syndrome is a common symptom of focal neuropathy. This type of neuropathy is unpredictable and most often occurs in older people who have mild diabetes. Although it's painful, it tends to improve by itself without causing long-term damage

How is it diagnosed?
    Your doctor should use a simple screening test to check sensation in the feet. This should be done once a year. You may also have an ultrasound if your urinary tract is affected. Nerve studies or biopsies in which a sample of your tissue is removed and studied are also possible. Your doctor may refer you to a specialist who may conduct other kinds of tests depending on your symptoms and the kind of neuropathy you have.

What is the treatment?    The first step is to bring blood sugar under control. Good control of blood sugar can also help prevent future problems. Your doctor may change, add or adjust medications.
Tips to help

• Ask your doctor to suggest an exercise routine that is right for you. Many people who exercise regularly find the pain of neuropathy less severe. Aside from helping you reach and maintain a healthy weight, exercise also improves the body's use of insulin, helps improve circulation and strengthens muscles. Check with your doctor before starting exercise that can be hard on your feet, such as running or aerobics.

• A variety of drugs are being tested for their effect on improving neuropathy including ace inhibitors and aldose reductase inhibitors.

• If you smoke try to stop because smoking makes circulatory problems worse and increases the risk of neuropathy and heart disease.

• Reduce the amount of alcohol you drink. Recent research has indicated that as few as four drinks per week can make neuropathy worse.

• Take good care of your feet.

Why check your feet?
    If you have peripheral neuropathy, your feet are especially vulnerable. That's because one of the symptoms of this kind of neuropathy is a loss of feeling. You should check your feet carefully every day for cuts, bruises and sores because you might not feel a pebble in your sock that's causing a sore or even feel a blister.

    If you notice anything unusual, see a doctor as soon as possible because foot infections and sores can be difficult to treat in people with diabetes. Your doctor should check your feet at every visit and at least once a year. Your doctor should check to see how much sensation you have in your feet.

Foot care tips

1. Work with your health care team to keep your blood sugar within good range. Click on Benefits of tight control.
2. Wash your feet every day in warm, not hot, water. Dry your feet well, even between the toes.
3. Smooth corns and calluses gently with a pumice stone.
4. Check your feet every day. Look for cuts, blisters, red spots and swelling. Use a mirror to check the bottoms of your feet if you can't see or ask a family member for help.
5. Keep skin soft and smooth. Rub a thin coat of skin lotion over the tops and bottoms of your feet, but not between the toes.
6. Trim toenails each week or when needed. Trim the nail to the shape of the toe and file the edges with an emery board or file.
7. Wear shoes and socks all the time. If you have diabetes, you should never walk barefoot. Wear comfy shoes and always check inside your shoes before wearing to be sure there are no objects inside.
8. Keep the blood flowing to your feet. Keep your feet up when sitting. Wiggle your toes and move your ankles up and down for five minutes, two or three times each day. Don't smoke. Limit alcohol.
9. Protect your feet from hot and cold by wearing shoes at the beach or on hot pavement. Wear socks at night if your feet get cold.
10. Be more active. Plan your physical activity program with your doctor. Click on Exercise tip of the week.
11. Check with your doctor. Have your doctor check your bare feet and find out whether you're likely to have serious foot problems. Remember that you may not feel the pain of an injury.