Have you been told “You have Neuropathy” or “You have Diabetic Peripheral Neuropathy”?
If you have, you may have also been told “there is nothing you can do about it,” but what if I told you that there is not only a lot you CAN do about Diabetic Neuropathy, but there is also a lot that you MUST do to prevent a progressive decline in your ability to function?
You see, in the traditional medical world, Diabetes and Diabetic Neuropathy are almost exclusively treated with medications and in many cases there is an unfortunate absence of a more comprehensive approach that can have life changing and even life saving benefits.
In addition, millions of people think that their Diabetes or Diabetic Neuropathy is under control because of the medications. Patients may be told to “cut down on the sugars.”
When it comes to treatment for Diabetic Peripheral Neuropathy it helps to first understand what caused it. The underlying culprits are Insulin Resistance and Hyperglycemia and it is so important to understand one critical fact about Diabetic Peripheral Neuropathy, it is nerve condition caused, in large part, by a cellular metabolic condition. That means that before you experience any Neuropathy symptoms there is a disruption in the way your cells metabolize or process glucose at the deep cellular level. You can’t see it, you can’t feel it, but it is happening and, more often than not, Neuropathy is developing for years before it rears its ugly head in the form of symptoms.
What’s fascinating is many people, including medical professionals, think that Insulin Resistance is the primary underlying problem and while it is part of the problem, it doesn’t really explain Diabetic Peripheral Neuropathy. You see, while muscle cells and fat cells in our body need insulin to get sugar out of the blood and into our cells, Nerve cells do not. Nerve cells are what we call Insulin-independent. There in lies the problem. Nerve cells are like dogs, they will always keep eating more and more and there is no off switch. When your blood sugar levels are abnormally high for extended periods of time, your nerve cells are basically at an all you can eat sugar buffet. Your nerve cells then become overloaded and the normal cellular processing of glucose becomes dangerously disrupted. Without getting into the deep science of it, your nerve cells begin to utilize an alternate route to accommodate the persistent influx of too much glucose! That alternate route, known as the Polyol pathway, leads to ongoing nerve damage and dysfunction. At the end of the day, Diabetic Peripheral Neuropathy develops from chronically high blood sugar levels.
When this pathological environment happens long enough you begin to feel the symptoms of Neuropathy. Burning, tingling, aching, numbness, and tingling are the most prevalent Neuropathy symptoms and the feet and hands are typically the first to be affected.
While most people are primarily focused on symptom relief when it comes to their Diabetic Peripheral Neuropathy, they are missing some key elements in combatting some of the more serious consequences of the underlying disease process. While the nerves are progressively deteriorating, so are the Heart, blood vessels, kidneys, and the eyes to name a few. Diabetes may be the 7th leading cause of death in the US, but one of the major complications of Diabetes, heart disease, is the number one cause of death in the US.
So, what then, is the best treatment for Diabetic Peripheral Neuropathy?
You MUST stop the bleeding!!! It’s not the symptoms as much as it is the cause of the symptoms that should be at the top of your priority list! Simply put, you have to get your Insulin and blood glucose levels under control IMMEIDATELY. Do you realize, by the time people are diagnosed with Type II Diabetes, they have likely been Insulin resistant for potentially a decade or more? If you have Diabetic Neuropathy you have ZERO time to waste. Symptom reduction is great, but if you don’t significantly reduce the Hyperglycemia (High Blood Sugar) and Insulin Resistance your condition and your symptoms will continue to progressively worsen.
Remember something very critical; The ability of your feet to interact with and detect the ground you walk on and send information to your spinal cord and brain can be a matter of life and death. Falls due to poor balance can be quite lethal, especially as we age.
I have patients with Diabetes and Diabetic Peripheral Neuropathy come to me and their HbA1c is hovering between 7 and 9 despite taking several “Diabetes medications.” This is not effective management and the underlying disease continues to manifest.
Here are the top 5 things that are critical for successful Diabetic Neuropathy treatment that can lead to a reduction in Neuropathy symptoms in your legs and feet while addressing the root cause and slowing down the progression of this metabolic disease:
- Nutritional Strategies
There is no doubt that all of the foods you put in your mouth on a daily basis invoke a unique insulin and/or blood glucose response. The type, quantity, and combination of different food types as well as speed of digestion all impact your body’s response.
In general, eliminating all added sugars, sugary drinks (including “natural fruit juice”), processed/packaged foods, baked goods, gluten, flour, alcohol, as well as vegetable and other hydrogenated oils is paramount in curbing hyperglycemia and erratic insulin spikes in your blood stream. This is paramount in Diabetes and Diabetic Peripheral Neuropathy treatment. However, nutritional guidance by a metabolic health expert or functional medicine provider should be a non-negotiable especially for those already taking “Diabetes medications” or blood glucose lowering agents. When you eliminate the food types mentioned above your blood glucose levels and insulin response will drop quickly and if you are already taking medications that also lower your glucose levels the two efforts together can plunge you into hypoglycemia if medication dosages are not adjusted. Hypoglycemia can be dangerous so it is important to have a strategy guided by a professional!
- Exercise
While aerobic exercise and resistance training are better and safer when prescribed by an exercise science expert, there is no doubt that these measures can significantly reduce insulin resistance and blood glucose levels while helping to prevent some of the major complications of metabolic disease. In addition, on a deeper level, these efforts can improve something that is critical to curbing damage to the nerves affected by Diabetic Neuropathy which is improved cellular function.
- Nerve Receptor Activation and Input to Your Central Nervous System
Your feet are loaded with neuro – receptors which provide critical information to the spinal cord and brain in terms of maintaining your sense of balance with good reflexive responses to changes in grade and make-up of the surfaces you walk on. While it is important to protect your feet from cuts and injury due to numbness and diminished feeling it is beneficial to let your bare feet experience the textures of different surfaces and allow your feet and ankles to be able to respond without the excessive support and cushion of footwear. When done safely, the input to your central nervous system is highly beneficial.
- Softwave – Extracorporeal Shockwave Therapy
Providing damaged nerves with an optimal healing environment is a hallmark of Softwave – Regenerative Tissue technology. With shockwave therapy, your nerves are given a greater capacity to recover due to the reduction in inflammation, improvement in blood flow, recruitment of regenerative cells, and the stimulation of nerve remodeling. Softwave -ESWT signals the body to release growth factors in the blood that are beneficial for nerve support and improved circulation. Angiogenesis, or the production of new blood vessels alone is tremendously beneficial for Diabetes and Diabetic Neuropathy treatment because of the microvascular complications associated with these conditions. This Neuropathy treatment aims to recruit your body’s own stem cells to assist in the repair and regenerative process.
- Stress Management and Sleep Improvement
Getting a good night’s sleep and reducing chronic stress can lower cortisol levels, improve insulin sensitivity, decrease inflammation, and optimize glucose control which can curb the progressive metabolic damage to your nerves and other tissues. Eliminating or minimizing sleep deprivation can improve tissue repair mechanisms and optimize your immune function leading to a better healing environment for affected peripheral nerves associated with Diabetic Neuropathy.
In summary, please understand that Diabetic Peripheral Neuropathy is much more than just some burning, numbness, aching, and tingling. These Neuropathy symptoms tell a deeper story about the damage that is happening to your nerves. The damage is ongoing and progressive and the only way to slow down the progression and get some relief is to get involved with a Neuropathy treatment program that is much more comprehensive than taking medications. Do you want potential temporary relief with medication or do you want to address all the things that are causing the symptoms in the first place?
Hopefully now you have a renewed perspective on what Diabetic Peripheral Neuropathy is and what should be included in your Neuropathy treatment program. Please don’t take the advice, “there’s nothing that can be done,” and have a new sense of hope and inspiration on your new path to metabolic health and improved neurological function.
*Dr Joe Martin, PT, DPT, OCS is a Metabolic Health expert and a Diabetes and Insulin Resistance Reversal coach in Southeast Florida and has a passion for saving people’s lives.
Frequently Asked Questions
What causes diabetic peripheral neuropathy in the feet?
Chronic Insulin Resistance and Hyperglycemia. Over time, persistent high blood sugar levels leads to nerve cell overload, abnormal glucose processing by the nerve cells, and progressive degeneration and deterioration of the peripheral nerves. Diabetic Neuropathy typically affects the longest nerves which is why patients experience symptoms in their feet and toes first and also their hands and fingers.
What are the early symptoms of neuropathy in the feet?
Intermittent burning, aching, and tingling are some of the earliest symptoms in the feet whereas later stage symptoms can involve constant numbness, burning, aching, tingling, and weakness in muscles and tendons of the lower leg and feet. These symptom behaviors are generalized, but symptom presentations can vary and be very individualized depending on multiple factors.
Can diabetic neuropathy be reversed with treatment?
When it comes to Diabetic Neuropathy “reversed” is a strong word and there is no evidence to indicate that it can be reversed 100%, however, the underlying disease process and progression can be significantly reduced when a very comprehensive Neuropathy treatment program is implemented.
What is the best treatment for neuropathy in the feet?
Nutrition is one of the most critical components as it can significantly and quickly reduce high blood sugar levels which in essence can reduce the hazardous influx of glucose into your nerve cells. Other components that need to be part of the overall strategy include sleep and stress management improvement, Softwave-Extracorporeal Shockwave Therapy, aerobic and resistance exercise, and nerve receptor re-engagement and optimization strategies.
How is nerve pain in the feet different from other foot pain?
Many foot conditions can cause mild and even severe foot pain, however, when nerves are involved there is typically burning, numbness, tingling, aching and shooting pain vaguely throughout an area. Nerve pain can also feel like there is a vice or a tight band around the foot and sometimes people describe a pebble, stone, or bunched up sock feeling under their toes and balls of the feet. Lastly, Neuropathy type pain tends to present itself at night after getting into bed and sometimes with compression neuropathies people can feel the need to get out of tight shoes to feel relief.