UNDERSTANDING DIABETIC NEUROPATHY

This article was written by Rachael Lee McCowen, a Care Advisor for Caregiver Homes and a Certified Health Education Specialist.

Diabetes often has no recognizable symptoms. I have frequently heard people say, "I think my blood sugar is a little high," or, "I think my doctor said I might be pre-diabetic," without fully understanding the impact elevated blood sugar has on their bodies. They continue to consume chips, soft drinks, and sugary cereals on a daily basis. Although they may not be feeling the impact directly, high (or even moderately high) blood sugar can cause long-term problems. Prolonged exposure to high blood sugar can damage many cells in the body, including delicate nerve fibers. This nerve damage is known as diabetic neuropathy, and care teams and live-in caregivers can help consumers reduce the risk of this diabetic complication.

About 50 percent of people who have diabetes will develop some type of neuropathy. Other risk factors for developing diabetic neuropathy include: high blood pressure, history of smoking, and obesity. Symptoms typically develop slowly over many years. The types of symptoms depend on the nerves that are affected. The prominent symptom of peripheral neuropathy is numbness, tingling, and pain that begins in the toes and feet and gradually progresses to the hands and arms. It may cause problems with a variety of everyday tasks, such as walking, dressing, and eating. Chronic nerve pain from diabetic neuropathy can cause emotional ups and downs. Many caregivers are assisting consumers who struggle with the loss of independence caused by diabetic neuropathy.

Other common concerns for those with diabetic neuropathy are foot injuries. Individuals with diabetic neuropathy often have diminished sensation in their feet, leaving them unable to notice foot wounds. When combined with the poor circulation that commonly affects those with neuropathy, minor foot injuries (such as a cut, blister or ulcer) may heal poorly and become infected, leading to serious complications that require foot amputation. It has always been very sad for me to see people who have suffered through an amputation that is so largely preventable.

Here are a few tips to prevent or slow the progression of diabetic neuropathy:

  1. Control blood sugar levels. Research has shown that good glycemic control can reduce neuropathy by up to 60 percent. Testing glucose levels at home can help caregivers and consumers make daily nutrition decisions as well as identify any problem areas that need some work.
  2. Take medications as prescribed. Since diabetes often does not have noticeable symptoms, many consumers may not see the importance of taking their medication daily. However, it is very important to take diabetes and blood pressure medications as prescribed to consistently manage these risk factors.
  3. Use proper foot care to prevent future problems. Feet should be checked once a day for blisters, cuts, cracks, sores, redness, tenderness or swelling. Consumers may need help from caregivers to assist with this task. Foot exams should be scheduled at least once a year. A doctor or podiatrist can inspect feet for early signs of nerve damage, poor circulation or other foot problems.

Although both consumers and live-in caregivers can be affected by diabetes complications, consumers may need additional assistance from caregivers to prevent or slow neuropathy progression. After all, caregivers are often responsible for nutrition choices, assuring adherence to medications, assisting with foot care and hygiene, and making sure consumers get to regularly scheduled doctor's appointments. With dedication and patience, caregivers and consumers can avoid and limit multiple diabetes complications, such as diabetic neuropathy.