Type 2 Diabetes - The Effects of Nerve Damage and Excess Foot Pressure

By Beverleigh H Piepers

Foot and leg diseases are among the most common complications associated with Type 2 diabetes. They can lead to severe consequences, including amputation. Nerve damage is one important cause. Type 2 diabetics who cannot feel sensations from their feet can develop damage without realizing it until the problem becomes severe. People with diabetes are also known for putting too much pressure on their feet.
According to the faculty of medicine at Ain Shams University Hospitals in Cairo, Egypt, nerve damage is caused by the excess weight. Their study, reported on in the journal Diabetes and Metabolic Syndrome in September of 2017, compared 50 people with Type 2 diabetes with 30 healthy participants. They compared pressure put onto the volunteer's feet during sitting and standing. Foot pressure in both feet was significantly higher in the diabetics than in the nondiabetic participants. No links to...

• age,
• amount of time with diabetes,
• weight in relationship to height (body mass index or BMI), or
• HbA1c

were seen.

Ways of treating or preventing foot neuropathy include walking and medications. Walk until you feel pins and needles, burning pain, or numbness. Rest and continue after your feet feel better. Other signs and symptoms of diabetic neuropathy include...

• muscle wasting in feet or hands,
• cramping pain,
• unrecognized low blood sugar,
• urinary bladder leaks,
• sensitivity to touch, such as pain from bed linens,
• loss of reflexes, especially those in the ankles,
• loss of balance and coordination,
• ulcers,
• infections,
• deformities, and
• bone and joint pain.

There is a variety of methods to diagnose peripheral neuropathy...

• nerve conduction velocity measures how fast impulses can travel along nerves showing abnormality if impulses travel slower than usual.
• electromyography reveals electrical activity when muscles are working or at rest.
• magnetic resonance imaging shows muscle size and activity.
• nerve biopsy can show nerve damage when bits of nerves are seen under a microscope.
• a skin biopsy will show nerves in the skin.

See your doctor for medication such as Pentoxifylline, (trental), which helps the red blood cells reach the feet with oxygen and nutrients. Other treatments include...

• pain relievers with low risk of abuse or addiction, such as Tylenol and aspirin.
• anti-seizure medications, such as gabapentin (Neurontin) and pregabalin (Lyrica), generally used to treat seizure disorders, can relieve nerve pain too.
• medications applied to the skin, such as capsaicin, a derivative of hot peppers, and lidocaine. Capsaicin can cause burning at first, but users usually develop a tolerance for it.
• antidepressants, such as amitriptyline, doxepin, and nortriptyline (Pamelor), duloxetine (Cymbalta), venlafaxine (Effexor XR).

Although managing your disease can be very challenging, Type 2 diabetes is not a condition you must just live with. You can make simple changes to your daily routine and lower both your weight and your blood sugar levels. Hang in there, the longer you do it, the easier it gets.

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