What is Autonomic Neuropathy?

Autonomic Neuropathy
One of the hallmark conditions that can occur with diabetes is neuropathy, a misfire in the nerves that impacts feeling and function. There are several types that can affect your body in different ways, but one version — autonomic neuropathy — affects the background functions of your body. That makes getting an accurate diagnosis critical.

What is autonomic neuropathy?

Autonomic neuropathy, also called dysautonomia, affects the nerves that control your involuntary bodily functions. When these nerves are damaged it impacts your blood pressure, temperature control, digestion, and bladder function.

The problems occur because the nerve damage makes it harder for your brain to send messages to your organs and parts of the autonomic nervous system, including your blood vessels, heart, and sweat glands.

What symptoms are common?

The symptoms you experience are directly tied to the part of your autonomic nervous system affected by the neuropathy. Pay attention to these symptoms, and talk with your doctor if they appear.

  • Dizziness and fainting when standing
  • Urinary problems, including incontinence, difficulty starting or sensing a full bladder, and an inability to empty your bladder.
  • Digestive problems, including feeling full after only a few bites, loss of appetite, diarrhea, constipation, bloating, nausea, vomiting, and heartburn.
  • Lack of signs of low blood sugar, such as shaking.
  • Sweating too much or too little, making it harder to regulate your body temperature.
  • Difficulty adjusting your eyes from light to dark.

How is autonomic neuropathy treated?

There are several things you can do to treat your symptoms and minimize the impact. Consider these steps:

  • If you experience nausea or feel full after eating small amounts, work with a dietician to plan your meals.
  • Take medications to accelerate your digestion and reduce diarrhea.

Preventive steps

Slowing the progression of autonomic neuropathy is possible, and it can greatly minimize your symptoms. To limit the impact of the condition as much as you can, follow these tips:

  • Control your blood sugar. Keep it between 80-130 mg/dL before eating and under 180 mg/dL after.
  • Avoid alcohol and smoking.
  • Get appropriate treatment for any autoimmune disease.
  • Control your blood pressure, keeping it below 130/80.
  • Maintain a healthy weight.
  • Exercise regularly, shooting for at least 30 minutes of exercise five times weekly. Biking, running, walking, or swimming are good options.

Making a few lifestyle changes can also lead to improvements:

  • Posture changes: Stand up slowly to decrease dizziness. Tense your leg muscles when standing to increase your blood pressure.
  • Elevate the bed: If you have low blood pressure, raise the head of your bed by approximately 4 inches.
  • Digestion: Eat smaller, more frequent meals. Increase fluids. Choose low-fat, high-fiber options, and restrict lactose and gluten.

If you suspect you have autonomic neuropathy, consult your doctor immediately, particularly if your diabetes isn’t well controlled. Even more, you’ll likely be screened for autonomic neuropathy every year after you receive your diagnosis if you have Type 2 Diabetes.

Contact the Amputation Prevention Centers of America if you have any questions.

What is Peripheral Neuropathy?

Peripheral Neuropathy

Do you have numbness, tingling, or constant pain in your feet and legs? It is worse overnight? Is it hard to feel temperature with your feet, but they’re still hyper-sensitive to touch? If you answered yes, you could have peripheral neuropathy.

And, if you have diabetes, it’s critically important to understand this condition.

What Is It Peripheral Neuropathy?

Peripheral neuropathy is loss of feeling mainly in your legs and feet, but it can spread to your arms and hands.

It affects between 60 percent to 70 percent of people with diabetes, according to the National Institutes of Health, and it worsens at night. It impacts people differently, however. Some feel tingling. Others feel pain or numbness. But, overall, changes appear slowly as people age.

Caused by chronically high blood sugar levels (130 mg/dL before eating; >180 mg/dL after eating), peripheral neuropathy damages nerves, making it harder for messages to travel between your brain and your extremities. It can be particularly dangerous because you might not know you’ve developed an ulcer. Left untreated, ulcers can get infected, potentially leading to amputation or death.

Symptoms

Initially, you can develop numbness; tingling; a prickly pins-and-needles feeling; a burning or cold sensation; pinching; buzzing; or sharp, deep stabbing pains. However, as peripheral neuropathy progresses, these signs are also possible:

  • Touch sensitivity: Your toes, feet, legs, and hands can become overly responsive.
  • Muscle weakness: Nerve damage weakens your muscles, making it harder for you to walk or grab things.
  • Balance problems: Numbness in your feet can make you unsteady and uncoordinated.

Peripheral neuropathy can also cause digestive system, urinary tract, blood vessel, and heart problems.

Treatment Options

There’s no cure for peripheral neuropathy, but you can minimize your discomfort. Talk with your doctor about these options.

  • Braces: Hand and foot braces can reduce physical disability and pain. Orthopedic shoes can improve your gait and help prevent foot injuries. Splints can also alleviate carpal tunnel symptoms.
  • Complementary techniques: In some cases, acupuncture, massage, herbal medication, and cognitive or behavioral training can lessen neurological pain.
  • Medication: Some drugs approved for chronic neuropathic pain can provide relief. Discuss effective medications with your doctor.
  • Transcutaneous electrical nerve stimulation: This treatment delivers gentle electrical currents to painful sites via electrodes attached to the skin. Some studies show it improves peripheral neuropathy.

Protecting Your Feet

If you have peripheral neuropathy, take steps to prevent ulcers or sores on your feet. Follow these tips to avoid potentially serious wounds.

  • Check your feet daily for blisters, sores, or ulcers.
  • Keep your feet clean and dry.
  • Trim your toenails carefully. Cut them straight across, filing down sharp edges.
  • Wear clean, dry socks.
  • Wear cushioned shoes with enough space for your toes.

When to See Your Doctor

There will be times you’ll need to consult your doctor. Schedule an appointment if you see any of these changes if:

  • you have any non-healing cut or sore on your foot.
  • burning, itching, tingling, weakness, or the pain in your hands or feet interferes with your daily activities or sleep.
  • you see changes to your digestion, urination, or sexual function.
  • you experience dizziness.

Overall, knowing how to identify and what to expect from peripheral neuropathy can help you manage the condition.

Contact the Amputation Prevention Centers of America for more information.

Why Your Peripheral Neuropathy Feels Worse at Night

Peripheral Neuropathy

The pain, tingling, and burning sensations from diabetic peripheral neuropathy can be debilitating any time of day. But, for some people, these uncomfortable sensations get particularly worse at night, especially when they’re trying to sleep.

If you’re in this category, you might have been told you’re imagining it. But, recent research from the Comprehensive Pain Center at Oregon Health & Sciences University indicates more acute pain at night isn’t in your head. In a study of nearly 650 participants, investigators found patients with diabetic peripheral neuropathy — regardless of age, gender, or other health conditions — reported feeling the most significant pain between 11pm and 8am.

Next time you feel your peripheral neuropathy pain intensifying at night, consider these possible causes. In some cases, you can try to get the discomfort under control.

  1. Fewer distractions: At night, there’s less to take your mind off your pain — no chores, no errands, and no talking as you try to drift off to sleep. That’s when your mind and body become more aware of your surroundings. You notice your pain more, making sleep elusive.

To combat that heightened awareness, try to focus on something you enjoy to take your mind off what you’re feeling.

  1. Cooler temperatures: With peripheral neuropathy, according to Loma Linda University Health, your feet will be far more sensitive to cooler air. As temperatures drop at night, your peripheral nerves can begin to tingle more, and you’ll feel more burning or sharp pains. Your heart rate also slows when you’re colder, slowing your blood and increasing painful sensations.

If you can handle the touch on your feet, wrap up in blankets to warm up.

  1. Stress/Fatigue: Sometimes, physical stress and exertion can increase your nerve pain as your body begins to relax at the end of the day. Vigorous exercise and the soreness that accompanies it can contribute to more night-time nerve pain.

Be sure you alternate your exercise routines so you’re not over-taxing your body, and pay attention to when you need to take a break from exercise and let your body rest.

  1. Medication: Even though your medication might work well during the day, keeping you mostly free from pain, it eventually wears off. This typically happens at night, according to the Innovations Stem Cell Center. When you’ve been comfortable all day, you’ll notice the pain much more when it starts to creep back in.

 

Try these strategies to stay comfortable at night if your have peripheral neuropathy pain:

  • Control your blood sugar. Work to keep your levels between 80-130 mg/dL before eating and under 180 mg/dL after meals.
  • Soak your feet in a warm bath to relax your nerves at night. Be sure to check the water temperature to avoid burning your feet.
  • Exercise regularly. It increases blood flow and oxygen to your feet, reducing pain. Listen to your body, though, and take breaks when needed.

Contact Amputation Prevention Centers of America if you have questions.