More than ten million people in Bangladesh live with diabetes. When blood sugar stays high for years, nerves are gradually damaged — this is diabetic neuropathy. Around half of all people with diabetes develop it at some point.
What are the symptoms?
- Tingling, pins-and-needles or burning in the soles and toes — usually worse at night
- Numb feet; not feeling whether socks or sandals are on
- Unsteady walking
- Not feeling pain from a wound on the foot
- Later, similar symptoms in the hands
- Some people get dizziness on standing, digestive or bladder problems
Warning: on a numb foot, even a small cut or blister can go unnoticed and turn into a serious ulcer, infection or even amputation. Check your feet every day.
Diagnosis
A clinical examination (sensation, reflexes, vibration sense) and, when needed, a nerve conduction study (NCS) confirm neuropathy. Other causes — vitamin B12 deficiency, thyroid or kidney disease — must be excluded; long-term metformin use can lower B12.
Treatment
- Sugar control is the key to slowing progression. HbA1c is usually targeted below 7%.
- Nerve-pain medicines: ordinary painkillers work poorly; your doctor will choose specific medicines for neuropathic pain.
- Risk reduction: stop smoking, control blood pressure and cholesterol.
Seven foot-care rules
- Inspect your soles every night, using a mirror
- Never walk barefoot, even at home
- Wear soft, comfortable, well-fitting shoes
- Wash feet in lukewarm water and dry between the toes
- Never warm feet with hot-water bags or fire
- Cut nails straight across
- Show any wound to a doctor without delay
Dr. Al-Mahamudul Alam Mimo is trained in both neuromedicine and diabetology (CCD), so blood-sugar control and nerve treatment are planned together.