Diabetes, a metabolism disorder, is mostly attributed to unhealthy eating habits and a generally unhealthy lifestyle. Various complications can arise in the human body due to its overbearing and elongated presence. Diabetic neuropathy is one such complication where diabetes for a long period results in nerve damage, usually affecting the patient’s leg and feet. Patients with type 1 or type 2 diabetes often run the risk of developing diabetic neuropathy.
There may be several causes that lead to diabetic neuropathy. However, all of those causes circle back to diabetes being the core issue. As a direct result of diabetes, high levels of blood sugar in the blood for long periods injure nerves in every portion of the body, and kidneys damaged by diabetes send toxins into the blood that in turn cause nerve damage. Additionally, usage of Metformin drugs to manage diabetes can lead to a Vitamin B12 deficiency and this in turn can cause nerve damage. Apart from this, a diabetic patient may develop diabetic neuropathy if his blood vessels are damaged by high levels of cholesterol, mechanical injuries (such as carpal tunnel syndrome), and unhealthy lifestyle factors including overweight, alcohol consumption and smoking.
Symptoms and Types
The common symptoms for diabetic neuropathy include sensitivity to or loss of feeling of touch, trouble with coordination when walking, numbness or pain in the extremities, muscle weakness, nausea and indigestion, diarrhoea or constipation, unsteadiness upon standing, intemperate sweating, vaginal dryness in women and erectile dysfunction in men, to name a few. These symptoms may, however, vary depending on the type of diabetic neuropathy.
Diabetic neuropathy is of four kinds – peripheral, autonomic, proximal, and focal.
- Peripheral neuropathy is the most common of all that affects the legs, hands and arms, necessarily in that order.
- Autonomic neuropathy occurs when diabetes affects the autonomic nervous system that controls the heart, bladder, stomach, intestines, sex organs and eyes.
- Proximal / radiculoplexus / femoral neuropathy, also known as diabetic amyotrophy, affects the nerves in the thighs, hips, buttocks or legs, commonly observed in type 2 diabetes and older patients.
- Focal neuropathy / mononeuropathy is when a specific nerve in the face or torso or leg is damaged, usually in older patients.
Diagnosis and Treatment: Physiotherapy and Nutrition Therapy
Diabetic neuropathy can be effectively managed through the holistic and therapeutic non-intrusive alternative treatment of physiotherapy. The physiotherapist uses methods such as gross light touch and pinprick sensation to conduct a comprehensive physical test to check the core and muscles strength, sensitivity, reflexes, etc., in order to diagnose and assess the diabetic neuropathy condition. Other tests include filament test, quantitative sensory testing, nerve conduction studies, electromyography (EMG) and autonomic testing.
Techniques such as transcutaneous nerve stimulation (TENS), static magnetic field therapy, low-intensive laser therapy, and monochromatic infrared light therapy, have been shown to have positive effects in the management of diabetic neuropathy, by slowing down the condition, relieving the patient of pain, manage further or associated complications and restore the functionality of the affected regions. There is also an exercise regimen particularly for patients with peripheral and proximal neuropathy, such as aerobic exercise, flexibility exercise, strength training exercise and balance exercise, and generally to manage weight. In addition, nutrition therapy becomes pertinent in order to manage diabetic neuropathy because diabetic conditions call for a massive alteration in food intake. There might be certain nutritional deficiencies that are best managed through food intake. In addition, it also aids in weight loss and maintaining a generally healthy lifestyle.
We at Eva Physiocare have developed an integrated wellness programme comprising of physiotherapy and nutrition therapy in order to effectively manage diabetic neuropathy in our patients.