Funny feel­ing in your feet

The Star Malaysia - Star2 - - World Diabetes Day -

DO th­ese state­ments ap­ply to you?

You some­times feel like you have socks or gloves on when you do not.

Your feet hurt at night. You feel burn­ing or shoot­ing pains in your feet.

Your feet are numb and you can­not feel your feet when walk­ing.

Peo­ple who ex­pe­ri­ence tin­gling sen­sa­tions, “pins and nee­dles” or numb­ness in the feet may not think too much of th­ese symp­toms. How­ever, if they per­sist, it may sig­nal a con­di­tion known as neu­ropa­thy that can lead to big­ger prob­lems.

Neu­ropa­thy refers to a med­i­cal con­di­tion where nerves be­come dam­aged. It is caused by a va­ri­ety of rea­sons, in­clud­ing di­a­betes, ex­ces­sive al­co­hol con­sump­tion, ge­netic pre­dis­po­si­tion, in­fec­tion, can­cer, nu­tri­tional de­fi­cien­cies, ex­po­sure to tox­ins, dis­eases that cause chronic in­flam­ma­tion in­volv­ing the nerves and other un­clear fac­tors.

Among all, di­a­betes is the most preva­lent cause of nerve dam­age. This con­di­tion is med­i­cally known as di­a­betic neu­ropa­thy. It oc­curs when a nerve or group of nerves is dam­aged as a re­sult of high blood glu­cose level.

Be­low are some statis­tics re­gard­ing di­a­betic neu­ropa­thy.

Up to 50% of di­a­bet­ics will suf­fer from di­a­betic neu­ropa­thy over the course of their dis­ease, ac­cord­ing to a 2004 re­view ti­tled Di­a­betic So­matic Neu­ropathies pub­lished in Di­a­betes Care. Ac­cord­ing to a 2011 study ti­tled Metabolic cor­rec­tion in the man­age­ment of di­a­betic pe­riph­eral neu­ropa­thy: im­prov­ing clin­i­cal re­sults be­yond symp­tom con­trol pub­lished in Cur­rent Clin­i­cal Phar­ma­col­ogy, up to 50% of di­a­bet­ics with di­a­betic neu­ropa­thy do not ex­pe­ri­ence any symp­toms. The preva­lence of di­a­betic neu­ropa­thy in­creases with age and di­a­betic years. It starts in the pre­di­a­betic stage, and 8% of di­a­bet­ics al­ready have di­a­betic neu­ropa­thy when di­ag­nosed with di­a­betes, ac­cord­ing to a 1993 study ti­tled The preva­lence by staged sever­ity of var­i­ous types of di­a­betic neu­ropa­thy, retinopa­thy, and nephropa­thy in a pop­u­la­tion-based co­hort: the Rochester Di­a­betic Neu­ropa­thy Study pub­lished in Neu­rol­ogy. Fifty per cent of di­a­bet­ics over 60 years old have di­a­betic neu­ropa­thy, ac­cord­ing to a 1993 study ti­tled A mul­ti­cen­tre study of the preva­lence of di­a­betic pe­riph­eral neu­ropa­thy in the United King­dom hos­pi­tal clinic pop­u­la­tion pub­lished in Di­a­betolo­gia. Fifty per cent of di­a­bet­ics are un­able to name di­a­betic neu­ropa­thy as a com­pli­ca­tion from di­a­betes be­cause of low aware­ness, ac­cord­ing to a 2009 ar­ti­cle ti­tled Di­a­betes Mel­li­tus: Aware­ness of dis­ease and life style changes in fe­male pa­tients pub­lished in Jour­nal of Post­grad­u­ate Med­i­cal In­sti­tute. Only 28% of di­a­bet­ics are aware that peo­ple with type 2 di­a­betes are more likely to un­dergo an am­pu­ta­tion than those with­out di­a­betes, ac­cord­ing to ICM Re­search sur­vey.

Di­a­betic foot care

Most peo­ple take foot care for granted. For di­a­bet­ics, how­ever, foot care is a se­ri­ous mat­ter that can bring about un­for­tu­nate con­se­quences if ne­glected.

This is be­cause nerve dam­age can bring about re­duced or loss of sen­sa­tion in the feet, caus­ing sores and small in­juries to go un­no­ticed and be­come badly ul­cer­ated, in­fected or dif­fi­cult to heal.

The heal­ing process for di­a­bet­ics is also com­pro­mised by poor cir­cu­la­tion. Even­tu­ally, am­pu­ta­tion of the toe, foot or even lower leg may be nec­es­sary if treat­ment is no longer pos­si­ble.

While you may know that di­a­betes can lead to am­pu­ta­tion, you may not know that the rea­son for am­pu­ta­tion is nerve dam­age. Am­pu­ta­tion can be avoided with proper nerve care.

Other com­pli­ca­tions of di­a­betic neu­ropa­thy to watch out for in­clude joint de­for­mi­ties, sharp pain and ex­treme sen­si­tiv­ity in limbs, uri­nary tract in­fec­tions, in­con­ti­nence, low blood pres­sure, di­ges­tive prob­lems, sex­ual dys­func­tion and eye com­pli­ca­tions.

Am­pu­ta­tion and foot ul­cer­a­tion are com­mon, se­ri­ous prob­lems among di­a­bet­ics that can be pre­vented or de­layed if iden­ti­fied and dealt with early on.

The Amer­i­can Di­a­betes As­so­ci­a­tion rec­om­mends that di­a­betic adults go for an­nual health screen­ings to de­tect di­a­betic neu­ropa­thy. Such screen­ings in­volve record­ing your dis­ease his­tory, a phys­i­cal foot in­spec­tion and neu­ro­log­i­cal and di­a­betic pe­riph­eral neu­ropa­thy tests.

There are five sim­ple clin­i­cal tests to di­ag­nose pe­riph­eral neu­ropa­thy in the legs and arms, in­clud­ing pin­prick sen­sa­tion and an­kle re­flex test­ing, vi­bra­tion test­ing us­ing a tun­ing fork and bio­th­e­siom­e­try.

Tight blood sugar con­trol, ap­pro­pri­ate di­etary con­trol, proper foot care, reg­u­lar ex­er­cise and smok­ing ces­sa­tion are im­por­tant to prevent or de­lay neu­ropa­thy and as­so­ci­ated com­pli­ca­tions.

Vi­ta­mins B1, B6 and B12

B vi­ta­mins, specif­i­cally thi­amine (vi­ta­min B1), pyri­dox­ine (vi­ta­min B6) and cobal­amin (vi­ta­min B12), are used by the body in the pro­cesses of nour­ish­ing and re­gen­er­at­ing nerves.

Vi­ta­min B1 is in­volved in en­ergy me­tab­o­lism, helps main­tain the myelin sheaths that cover the ax­ons of nerves, and is used in the syn­the­sis of key sig­nal­ing mol­e­cules in the ner­vous sys­tem, which are known as neu­ro­trans­mit­ters.

Vi­ta­min B6 is in­volved in the syn­the­sis of neu­ro­trans­mit­ters while vi­ta­min B12 is in­volved in nerve cell mat­u­ra­tion and re­gen­er­a­tion, nerve cell me­tab­o­lism and for­ma­tion of nerve myelin sheaths.

In pop­u­la­tions at risk of neu­ropa­thy, es­pe­cially di­a­bet­ics, early de­tec­tion and treat­ment of neu­ropa­thy is cru­cial to avoid ir­re­versible dam­age to nerves.

The in­for­ma­tion in this ar­ti­cle is not in­tended or de­signed to di­ag­nose, prevent, treat or pro­vide a cure for any con­di­tion or dis­ease, as­cer­tain the state of your health or act as a sub­sti­tute for med­i­cal care.

Seek ad­vice from a doc­tor or health­care pro­fes­sional if you have any ques­tions or con­cerns about the in­for­ma­tion in this ar­ti­cle.

This ar­ti­cle is brought to you by Merck Sdn Bhd. For more in­for­ma­tion, e-mail ch.my@mer­ck­group.com

Proper foot care is es­sen­tial for di­a­bet­ics, who, be­cause of di­a­betic neu­ropa­thy, may not have much sen­sa­tion in their feet and thus can­not tell when they have an in­jury.

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