Diabetic Neuropathy in Seniors

Diabetes is a disease that can affect every part of your body in some way. While keeping your blood sugar levels in check and following all your doctor’s recommendations can help you live well with diabetes, as you get older and deal with diabetes for many years, you might start to suffer from complications. One of those is diabetic neuropathy, a condition that affects the nerves in your body.

What is Diabetic Neuropathy?

Diabetic neuropathy is a type of nerve damage that can occur in those who have diabetes. While diabetic neuropathy is most common in the legs and feet, it can affect other parts of the body, including the hands, digestive system, heart, blood vessels, and urinary tract. According to the American Diabetes Association, about half of those who have diabetes also have some form of diabetic neuropathy.

Though the four types of neuropathy are associated with diabetes, scientists don’t know for sure what causes the problem. But it is believed that over time, high blood sugars can make it difficult for nerves to send signals to other parts of the body. High blood sugar can also damage the small blood vessels that bring oxygenated blood to the nerves. Both of these issues make it hard for the nerves to communicate.

In addition, there might be a genetic component, and metabolic factors such as high cholesterol can also affect the nerves.

Some might have mild diabetic neuropathy. This might take the form of tingling, numbness, or pain. For some, it can come and go. For others, diabetic neuropathy can be painful and even debilitating. How bad it gets might be influenced by the type of neuropathy you have. There are four main types, and you might have just one, or may have more than one at the same time.

Peripheral Neuropathy

This is the most common type of diabetic neuropathy. It usually affects the feet and legs first and later, the hands and arms. It tends to be worse at night. Symptoms can include a tingling or burning feeling, sensitivity to touch, numbness or an inability to feel sensation, muscle weakness, and sharp pains or cramps in the affected area. It can also lead to very serious foot problems, including infections, ulcers, and bone or joint damage[1].

Any sort of nerve issues with your feet or legs can lead to other problems, including issues with how you walk or balance. If you are feeling any of the signs of diabetic neuropathy in your feet, talk to your doctor right away. Take care when you walk, as you are at a higher risk of falls, which means it’s a very good idea to consider an emergency response system.

Autonomic Neuropathy

This is a rarer but potentially more dangerous form of neuropathy that affects 30% of those with diabetes[2]. The autonomic nervous system controls many bodily functions, including your bladder, digestive system, sex organs, blood pressure, heart rate, eyes, and the ability to sweat. That means that this type of neuropathy has many places where it can affect you.

According to the Mayo Clinic, problems might include:

·         Trouble with the bladder or bowel

·         Difficulty swallowing

·         Drops in blood pressure when rising from a sitting position (which can lead to dizziness and fainting)

·         Nausea and vomiting due to slow stomach emptying

·         Changes in vision and how your eyes adjust

·         Issues with sweating – either increased or decreased

·         Problems with sexual response

One of the most frightening of the symptoms is hypoglycemia unawareness. This means that the usual signs of low blood sugar simply don’t occur. Without the signs of low blood sugar, your glucose levels can drop dangerously low before you have the opportunity to do anything to bring them back up[3]. Severe hypoglycemia can lead to coma and death[4].

With hypoglycemia unawareness, sometimes the only sign you will have of very low blood sugar is the feeling of knowing you are going to faint. It’s vitally important to check your blood sugar on a regular basis – much more often than someone else might. Wearing a continuous glucose monitor can help. It’s also a good idea to have a medical alert handy, as you can press the button the moment you begin to feel “off” in any way. This can ensure that you get assistance immediately.

Proximal Neuropathy

This type of neuropathy affects the nerves in the abdomen, chest, thighs, hips, buttocks, or legs. It often occurs on just one side of the body but may eventually spread to the other side. This can include severe pain in the affected area, weak thigh muscles, shrinking muscles, difficulty rising from a sitting position, and pain in your chest or abdominal wall[5].

This type of neuropathy can lead to problems with the muscles and pain, both of which can easily lead to falls. If you are diagnosed with any type of neuropathy, a medical alert pendant or wristband is a great idea. Consider one that has fall detection for added protection.

Focal Neuropathy

This is a unique form of neuropathy that damages a single nerve. That nerve might be located anywhere in the body. The result of the damage can vary widely depending upon the nerve that is affected. It might include difficulty with eyesight, paralysis on one side of the face, numbness and tingling in the extremities, weakness in the hands or feet, and pain in the foot, shin, or thigh.

The National Institute of Diabetes and Digestive and Kidney Diseases reports that carpal tunnel syndrome is one of the most common types of focal neuropathy. About 25% of those with diabetes have some nerve damage at the wrist.

If you are suffering from numbness, tingling, weakness, or pain in your feet or legs, you are more likely to suffer a fall. That’s why a medical alert system with fall detection is a great idea. If you do fall down, the device itself can sense it and send an alert for help, without your having to press the button yourself. That peace of mind can make it easier to live with diabetic neuropathy.

How to Reduce Your Risk of Neuropathy

In any of these types, the onset happens gradually, even over a period of many years. So by the time you do notice the symptoms, the neuropathy might be advanced.

If you are diagnosed with type 2 diabetes, it’s important to get screened immediately. By the time your diagnosis comes, you might have been diabetic for a while and that could have given time for neuropathy to set in. In most cases, those with type 1 diabetes are diagnosed in childhood or as young adults; they should be screened five years after diagnosis. After the first screening, it should be repeated at least once a year[6].

You are at greater risk of diabetic neuropathy if you have the following risk factors[7]. Doing what you can to reverse or improve these situations can help you avoid developing nerve damage:

·         A history of diabetes. The longer you have diabetes, the greater your risk of nerve damage.

·         Poor blood glucose control. If your blood sugars consistently run high, you are at risk for many complications, including nerve problems.

·         Smoking. Smoking affects every part of the body in a negative way. It can lead to hardening and narrowing of the arteries, which compromises blood flow to the nerves.

·         Kidney disease. The toxins that can build up in the blood can lead to nerve damage.

·         Carrying too much weight. You’re at increased risk if your body mass index (BMI) is greater than 25.

·         Chronic conditions. High blood pressure and high cholesterol puts you at greater risk[8].

·         Alcohol consumption. If you drink alcohol, you might be more prone to diabetic complications, including neuropathy.

How to Reduce Complications

You can fight some of the consequences of diabetic neuropathy by being proactive about your care. Good blood sugar management is a key component of staying healthy. The American Diabetes Association recommends an A1C test twice a year for those who have diabetes. The A1C is best below 7%, though your situation might be different – speak to your doctor about the proper range for you[9].

You should also get your feet checked out by a doctor or podiatrist at every office visit. A foot exam can spot discoloration, ulcers, wounds, and other problems that could lead to more serious complications. In between visits, inspect your feet every day for signs of trouble, keep them clean and dry, moisturize them well to prevent cracked skin, and wear proper shoes.

Depending upon the type of neuropathy you have, you might need other specialists to help you with specific problems. An urologist can assist you with bladder problems and might be able to help with issues with sexual health. A cardiologist can help you with nerve issues that cause pain in your chest, hypotension, or problems with your blood vessels. An internal medicine specialist can help with digestive problems. It might even be helpful to engage an orthopedic surgeon in your care, especially if you have nerve damage in the hands and arms, which often leads to carpal tunnel syndrome. If neuropathy is severe, a personal emergency response system, or button alarm, is highly recommended.

Easing the Pain of Diabetic Neuropathy

For every person who feels numbness in their feet or hands, another person will feel sharp pain and cramps. Sometimes the symptoms might vary from one day to the next. If you are suffering from pain, there are some medications you could try that might relieve it. Your doctor will look at your medical history to help choose the right one for you.

Anti-seizure drugs have shown promise, even if you don’t have a history of seizures; antidepressants show promise too, as they can improve nerve function. Pain-relieving medications might work for some, including ibuprofen, acetaminophen, and topical lidocaine to numb a painful area. Talk to your doctor about treatment options.

Staying Safe with Nerve Damage

When you have diabetic neuropathy, many parts of your body can be affected. But the most common problems appear in your feet and legs in the form of numbness or pain. As a result, senior fall risk goes up.

The next best thing to preventing a fall is having help right at your fingertips if it does happen. An in-home or on-the-go medical alert device is an excellent way to make sure that if you do suffer an accident or injury, you can reach out for help immediately. The panic alarm isn’t just for falls, however – it can also come in very handy for any emergency or concern. Alert-1 wishes you health and safety!