Managing Diabetic Neuropathy: Solutions for Numbness in Hands and Feet

Diabetes-related peripheral neuropathy issues?

Hello Dr.
Shih, thank you very much for your detailed response last time.
I have another question I would like to ask you again.
My mother (63 years old) has been suffering from diabetes for thirty years.
She has previously controlled her blood sugar with medication, but as her medication dosage increased, she switched to insulin injections at the beginning of this year.
While her blood sugar has been controlled, she has started experiencing numbness in her hands and feet, particularly in her legs, which is very uncomfortable for her.
She is currently trying to improve this through increased exercise.
Besides exercise, are there any other methods to alleviate this issue? Could this numbness be caused by the insulin injections? Is it likely to become more severe? I found a medication at the pharmacy that claims to improve peripheral neuropathy; is it effective? Please take some time to answer my questions, thank you.

Ms. Huang, 30~39 year old female. Ask Date: 2005/05/12

Dr. Shi Guangzhong reply Internal Medicine

The most concerning aspect of diabetes is its chronic complications.
Your mother's numbness in her hands and feet is a symptom of neuropathy and is not caused by insulin injections.
Insulin is a hormone used to lower blood sugar levels and is not harmful to the body.
Therefore, you do not need to worry.
Currently, there is no specific medication for the numbness in her hands and feet.
As for the medication you purchased at the pharmacy, I cannot comment on its effectiveness without knowing the name of the drug.
Moreover, purchasing medication without a prescription is illegal and may not benefit the patient.
There are some medications available that can improve peripheral blood circulation, which you can inquire about with a specialist in metabolic disorders.
It is also recommended that your mother engage in exercise to improve her condition and maintain good blood sugar control to reduce the worsening of her symptoms.

Reply Date: 2005/05/12

More Info

Managing diabetic neuropathy, particularly the numbness and discomfort in the hands and feet, is a multifaceted approach that requires careful consideration of various factors, including medication, lifestyle changes, and monitoring of blood sugar levels. Your mother’s situation, having been diagnosed with diabetes for over thirty years and recently transitioning to insulin therapy, is not uncommon. It’s important to clarify that while insulin is crucial for managing blood sugar levels, it is not directly responsible for causing neuropathy. Instead, the underlying condition of diabetes itself, particularly when poorly managed over time, can lead to nerve damage.

Understanding Diabetic Neuropathy
Diabetic neuropathy is a common complication of diabetes, characterized by damage to the peripheral nerves due to prolonged high blood sugar levels. Symptoms often include numbness, tingling, pain, and weakness, particularly in the extremities. The fact that your mother has experienced these symptoms after starting insulin therapy may be coincidental; it’s possible that the neuropathy was already developing due to years of fluctuating blood glucose levels.

Management Strategies
1. Blood Sugar Control: The most critical aspect of managing diabetic neuropathy is maintaining stable blood sugar levels. Since your mother’s blood sugar has improved with insulin, this is a positive step. However, continuous monitoring is essential to prevent further nerve damage.

2. Medication: There are several medications specifically designed to alleviate neuropathic pain. Gabapentin and pregabalin are commonly prescribed for nerve pain and may be beneficial for your mother. If she has found a medication at the pharmacy that claims to improve peripheral nerve function, it’s essential to consult with her healthcare provider before starting any new treatment. Some supplements, like alpha-lipoic acid and acetyl-L-carnitine, have shown promise in some studies, but their effectiveness can vary.

3. Physical Activity: Regular exercise can significantly improve symptoms of neuropathy. It enhances blood circulation, which is vital for nerve health. Activities like walking, swimming, or even gentle stretching can be beneficial. Since your mother is already engaging in exercise, encourage her to maintain a consistent routine.

4. Dietary Considerations: A balanced diet rich in antioxidants, vitamins, and minerals can support nerve health. Foods high in omega-3 fatty acids, such as fish, and those rich in vitamins B1, B6, and B12 can be particularly helpful. Consulting with a nutritionist who specializes in diabetes management can provide tailored dietary advice.

5. Foot Care: Given that diabetic neuropathy can lead to loss of sensation in the feet, regular foot care is crucial. This includes daily inspections for cuts or sores, proper hygiene, and wearing well-fitted shoes to prevent injuries.

6. Alternative Therapies: Some patients find relief through alternative therapies such as acupuncture, massage, or physical therapy. These can help manage pain and improve mobility.

7. Regular Check-ups: Continuous follow-up with healthcare providers, including endocrinologists and neurologists, is essential for monitoring the progression of neuropathy and adjusting treatment plans as necessary.

Prognosis and Future Considerations
As for whether the numbness will worsen, it largely depends on how well blood sugar levels are managed moving forward. If blood glucose levels remain stable, the progression of neuropathy can often be slowed or even halted. However, if blood sugar control is inconsistent, symptoms may worsen over time.

In summary, while your mother’s transition to insulin therapy is a significant step in managing her diabetes, the numbness in her hands and feet is likely a result of long-standing diabetes rather than the insulin itself. A comprehensive approach that includes medication, lifestyle changes, and regular monitoring will be key to managing her symptoms effectively. Always consult with her healthcare provider before making any changes to her treatment plan or introducing new medications.

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