Diabetic Nerve Pain

Diabetes is a condition of high blood sugar called as hyperglycemia. Chronic hyperglycemia or high blood sugar is responsible for diabetic-specific complications affecting the eyes (retinopathy), kidneys (nephropathy), hands and feet (neuropathy). Despite all the treatments available, the outcome for patients with diabetes remains disappointing. Long-term complications of diabetes still cause a significant level of morbidity and mortality.

One of the important complication is diabetic neuropathy which mainly affects hands and feet’s.

What is Diabetic Neuropathy:

Diabetic neuropathy is a group of nerve disorder caused mostly by diabetes mellitus. Diabetic neuropathy causes substantial damage to hand and feet. It causes damage to the nerves that sends a signal from feet or hands. It is diagnosed based on signs and symptoms and after exclusion of other causes of neuropathy. It affects between 50 to 90% of patients with diabetes, and of these, 15% to 30% will face a painful diabetic neuropathy condition. Neuropathy is related to the duration of diabetes and degree of metabolic control.

Symptoms of diabetic neuropathy and hand pain:

  • Symptoms can be initially mild and may become worse over time and spread up to legs and arms
  • Tingling or numbness in hands, fingers
  • Burning, aching or sharp pain in hands or fingers, called as diabetic nerve pain
  • Wasting of muscles of hands and weakness
  • Even the soft touch can be painful
  • Hand movements can be painful
  • Pain can disturb sleep and decreases quality of life and causes depression
  • https://academic.oup.com/bjaed/article/14/5/230/286795/Painful-diabetic-neuropathy

Other associated symptoms: Indigestion, nausea, vomiting, dizziness, problems with urination, diarrhea or constipation, erectile dysfunction in men and vaginal dryness in women

Causes of diabetic nerve pain:

https://www.niddk.nih.gov/health-information/diabetes/overview/preventing-problems/nerve-damage-diabetic-neuropathies

Prolonged exposure to high blood glucose can cause damage to delicate nerve fibers, causing diabetic neuropathy. The cause of this is not completely clear but a combination of factors play a role, which includes complex interaction between blood vessels and nerves.

High sugar in blood interferes with the nerve`s ability of signal transmitting. This also causes weakness to the walls of the small blood vessels or capillaries that supply nutrients and oxygen to the nerves. These combinations of factors are:

  • Neurovascular factors cause damage to the blood vessels that carry nutrients and oxygen to nerves
  • Metabolic factors like high glucose in blood, abnormal blood fat levels, long duration of diabetes, and low levels of insulin
  • Autoimmune factors that cause inflammation of nerves
  • Inherited traits that can increase susceptibility to damage to nerves
  • Mechanical injuries to nerves, like carpal tunnel syndrome

Other risk factors and causes of Diabetic nerve pain in hands:

  • Poor control of blood sugar: This is the most important risk factor for all the complications of diabetes including nerve damage.
  • The longer duration or chronic diabetes: With long-standing diabetes complication of diabetic neuropathy increases and especially if blood sugar is not well controlled.
  • Overweight: Having body mass index (BMI) more than 24 can increase the chances of developing diabetic neuropathy in diabetic patients.
  • Kidney disease: Diabetes causes damage to the kidneys ( if not well controlled), and this may be responsible for increasing the toxins level in the blood which further contributes to the nerve damage.
  • Smoking: Smoking in diabetes, hardens and narrows the arteries and thus reducing the flow of blood to the hands and feet. This causes more difficulty in wound healing and damages the peripheral nerve`s integrity

Is diabetic nerve pain reversible?

http://www.diabetesincontrol.com/discovery-shows-the-way-to-reverse-diabetic-nerve-pain/

Pain is a useful information as it alerts about the damaging effect in the body, that something worse is happening to the tissues. Nerves are affected by high glucose level in blood so it starts working on their own and sends signals to the brain. Researchers have demonstrated on mice, the reversal of peripheral diabetic neuropathy. This was done by using a substance that is found naturally in the body of animals as well as in humans. Further research is required in this field.

Management of diabetic nerve pain:

  • The first step for the treatment should be to bring down the blood glucose levels within normal range for preventing further damage to the nerves.
  • Monitoring of meal planning, blood glucose, diabetic medicines or insulin
  • Stable and tight control of blood sugar with the help of diet and medicines
  • Foot and hand care properly
  • Oral antidiabetic drugs or if required insulin should be used judiciously and regularly after consulting to diabetologist

Natural remedies for managing diabetic nerve pain:

  1. Healthy diet plan:

Diet has a direct effect on the blood sugar levels. Diet should be focussed on whole food, unprocessed foods, limit of refined carbohydrates and sugary drinks to stabilize the blood sugar levels.

              Some simple ways are-

  • Drink herbal tea or water over juice or soda or other drinks
  • Use of healthy fats and lean protein
  • Use of less packaged food use of home cooked food by using techniques like baking, roasting, broiling or steaming
  • Use of plenty of high fiber foods like- Vegetables and whole fruits which contain high fibers, antioxidants, vitamins and essential electrolytes like potassium and minerals.
  • Use of wild fish. In fish oil, omega-3 fatty acids are found which is beneficial to diabetics by lowering apoproteins and triglycerides that raise the risk of diabetic complications.
  • Use of lean protein foods like pasture raised poultry, cage free eggs and sprouted beans and legumes

2)    Blood sugar level management:

Most important step to control and prevent permanent damage to nerves and nerve pain or neuropathy is to control blood sugar levels. The best way to control is-

  • Exercise
  • Frequent blood sugar testing
  • Eating healthy and proper diet
  • Taking small meals at frequent intervals
  • If needed proper use of diabetic medications and insulin

3)    Regular exercise and Yoga:

It has been noticed that regular exercise causes a significant reduction in neuropathic symptoms and pain in diabetic patients. Exercise helps in nerve protection by improving circulation, lowering stress and reducing cholesterol levels, which may be responsible for inflammation and raised blood glucose levels.

4)    Stress management:

Stress is responsible for making inflammation more worse and thus raises the risk of complications in diabetics. Reducing stress level by way of meditation, exercise, and acupressure can be helpful in managing diabetic complications.

5)    Reduced exposure to toxins and quit smoking:

Accumulation of toxins in blood worsens the complications and neuropathy of diabetes. By avoiding unnecessary antibiotics, quitting smoking and too much of alcohol can reduce the chances of nerve pain as well as complications.

Conclusion:

Diabetic nerve pain is a result of a complication of diabetes known as diabetic neuropathy and is caused by many factors, but most important is high blood sugar levels. Neuropathy can affect any nerves of the body but most commonly, nerves of hand and feet. The most important remedy is bringing back blood sugar level within the normal range by means of exercise, stress management, meditation, by diet control or if required by antidiabetic medication or insulin. Quitting smoking is important in the prevention of nerve damage and other diabetic complications.

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