Diabetic Peripheral Neuropathy Quiz Diabetic neuropathy, or nerve damage, affects 60 to 70% of people with diabetes. Those who have lived with diabetes for 25 years or longer are more likely to have some degree of neuropathy, although symptoms are not always present. Do you know what to look for? Diabetic peripheral neuropathy is: a) A nerve disorder of the arms, legs, hands, and feet. b) A nerve disorder of the heart and other internal organs. c) A disorder of the eyes. d) All the above The answer is a, a nerve disorder of the arms, legs, hands, and feet. Diabetic Peripheral Neuropathy, or DPN, is a nerve disorder specifically of the arms, hands, legs, and feet, including your toes. Up to 70% of people with diabetes experience some form of DPN. The risks go up with age and the amount of time you have had diabetes. DPN is more common in people with type 2 diabetes than in those with type 1 diabetes. Diabetic peripheral neuropathy equally affects people with type 1 or type 2 diabetes. It is not about diabetes type. It is about diabetes control. If you have diabetic peripheral neuropathy, you will know it by: a) A sensitivity to touch b) Pain or cramping c) Loss of balance d) All of the above The answer is d, all the above. In addition, you may experience the more common tingling or burning sensation. Weight loss and depression are not physical results of the DPN, but sometimes accompany it. Conversely, you may not experience any of these symptoms at all! Your best bet at staying ahead of this particular complication is to visit your doctor regularly and to keep your blood sugar levels in the safe zone as often as possible. 1
That feeling of pins and needles means you have DPN. That tingling/pained sensation really could mean anything. Maybe you slept on a limb the wrong way or sat on your leg too long. You may have been in the cold for a while and you re regaining feeling. Or it could in fact be diabetic peripheral neuropathy. The point is this sensation is often experienced by people with and without diabetes alike. But as a person with diabetes, it is best not to ignore the slightest change in your body, especially if you have had diabetes for a long time. Early diagnosis means a better chance at finding treatment that will help keep the complication at bay or maybe from getting any worse, giving you more years of optimal health. If you have no symptoms, it is not possible to diagnose DPN. Even without symptoms, doctors can diagnose DPN. During a physical exam, your doctor may check blood pressure, heart rate, muscle strength, reflexes, and sensitivity to position changes, vibration, temperature, or light touch. There are other tests too. The primary cause of diabetic peripheral neuropathy is: a) Unnatural positioning of a limb to long, too often b) Unknown c) Uncontrolled blood glucose levels d) None of these The answer is c, uncontrolled blood glucose levels. Uncontrolled blood glucose is the main culprit behind diabetic peripheral neuropathy. Other causes include high blood pressure, high cholesterol, smoking, and alcohol use. The best thing you can do is keep your blood glucose levels in check and get regular check ups. 2
Peripheral neuropathy in the feet can lead to deformities of the feet. The answer is true. Left unchecked, peripheral neuropathy can lead to a terrible game of connect the dots. DPN may cause muscle weakness and loss of reflexes, especially at the ankle, which can affect how a person walks. As a result, foot deformities, such as hammertoes and Charcot foot, may occur. This and other foot conditions affect the sensation or numb the feet and that can hinder a person s abilities to notice blisters and sores as they occur. Blisters and sores may appear on numb areas of the foot because pressure or injury goes unnoticed. Unnoticed and untreated injuries mean infection, which may spread to the bone. This can lead to amputation. Some experts estimate that half of all such amputations are preventable if minor problems are caught and treated in time. What do you do? Stay vigilant. Keep your blood sugars in check and don t just schedule regular doctor visits, go to them too! Share your slightest concerns with your doctor and save your limbs. Antidepressants are used to treat peripheral neuropathy. The answer is true. It is not clear exactly how antidepressants help relieve your pain, but it is thought to be related to their effect on the chemical substances (hormones) that naturally occur in your brain and spinal cord. Oral and topical medications are the only treatment for peripheral neuropathy. There are other treatment options today! However, not all treatments are available to all people. Want to know what else can be done? See the next question! 3
What complementary and alternative therapies are used for diabetic peripheral neuropathy (DPN)? a) Evening primrose oil b) Echinacea c) Alpha lipoic acid d) A and C The answer is A and C. According to the National Diabetes Information Clearinghouse: Treatments that are applied to the skin typically to the feet include capsaicin cream and lidocaine patches (Lidoderm, Lidopain). Studies suggest that nitrate sprays or patches for the feet may relieve pain. Studies of alpha- lipoic acid, an antioxidant, and evening primrose oil have shown that they can help relieve symptoms and may improve nerve function. A device called a bed cradle can keep sheets and blankets from touching sensitive feet and legs. Acupuncture, biofeedback, or physical therapy may help relieve pain in some people, as can surgery. Treatments that involve electrical nerve stimulation, magnetic therapy, and laser or light therapy may be helpful but need further study. Researchers are also studying several new therapies in clinical trials. (1) B vitamins are also commonly used to treat peripheral neuropathy, because they are known to be involved in healthy nerve function. In fact, too much vitamin B6 can cause nerve damage. More research is needed to confirm which dietary supplements are beneficial for DPN and at what doses. (2,3) SOURCES: 1 - NIDDK. NDIC. Diabetic Neuropathies: The Nerve Damage of Diabetes 2 - NIH, Office of Dietary Supplements. Dietary Supplement Fact Sheet: Vitamin B6 3 - Ang CD et al. Vitamin B for treating peripheral neuropathy. Cochrane Database of Systematic Reviews 2008, Issue 3. 8 10: You are a neuropathy know- it- all! Good for you! You have a good chance of heading this thing off at the pass as long as you keep you keep your blood sugars in check and visit your doctor regularly. 5 7: You have normal neuropathy knowledge and that s OK. You probably know the basics, but as you can see, there are some nuances worth learning about too! 0 4: You are a neuropathy newbie! Time to read up and test yourself again. It s good for your health! 4
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