By Annette R. Karnash, R.N., M.N.
Neuropathy, a common complication of diabetes, affecting more than one half of all those with diabetes, is caused by long term hyperglycemia.
Peripheral Neuropathy that affects the toes, feet, ankles and hands with sharp, intermittent pain, burning pain, pins and needle sensations or an icy like feeling, having been described by many diabetes patients. They often feel pain when clothing, bed sheets or gentle fabrics come in contact with the skin. As this condition progresses, sensations of heat, cold and vibrations may be absent and limbs feel weak and eventually numb. This raises the risk of injury and infection which can ultimately lead to amputation.
Autonomic Neuropathy can affect the nerves that regulate the heart, blood pressure, bowel, bladder, sweat glands and erections in men. If nausea, anorexia, bloating and diarrhea are experienced the neuropathy has affected the G.I. tract with can ultimately cause variations in the blood sugar, because the digestive tract is functioning improperly. If nausea, dizziness (esp. postural hypotension) fainting, and palpitations occur, it may indicate neuropathy involving the heart muscle and the physician should be notified to rule out other conditions such as hypothyroid disease, alcoholism, low folic acid or B-12 readings.
Acute Mononeuropathy, a rare type of nerve damage causing diplopia, lazy eye, droopy eyelid with pain, results from a sudden loss of circulation to the eyes and face. Symptoms may last from several weeks to months, but patients respond to minor treatment by a physician.
Often, over the counter medications such as Advil, Acetaminophen, Motrin, Ibuprophen, Tylenol and gels and creams containing “capsaicin” may relieve the pain of neuropathy. A topical cream containing the amino acid L-arginine shows promise for increasing peripheral blood flow in those with diabetes by 35%. Or perhaps a prescribed medication may be indicated. Those with kidney disease should not take Advil, Ibuprofen or Motrin.
Several anticonvulsants are currently being prescribed such as Tegretol, Neurontin and Depitol. Antidepressants, another group of medications – Elavil, Tofranil, Aventyl, and Pamelor – may help to eliminate pain in addition to Mexitil, a heart regulator.
Despite being used to treat neuropathy, anticonvulsants, antidepressants and Mexitil have not yet been approved by the FDA. Physicians should examine for nerve damage and perform a foot examination annually or more frequently if there is nerve damage, ulcers or deformities.
