Monday, April 13, 2009

Diabetic Neuropathy

Let’s start with a good solid definition of Diabetic NeuropathyDiabetic Neuropathy is a group of nerve disorders that occur in diabetics and people suffering from diabetes.  The symptoms of diabetic neuropathy can be numbness in a person’s hands, arms, legs, and feet.  The longer a person has diabetes, the greater the risk that nerve problems will occur.

About 50% of all people that have diabetes also have some form of neuropathy.  People who have neuropathy do not always experience symptoms.  Symptoms are much more likely to be experienced with people who have had diabetes for at least 25 years.  Diabetic Neuropathy is more prevalent in diabetics that have had a history of not being able to control their blood glucose levels, have had high levels of blood fat and high blood pressure, have been overweight or obese, and are over the age of 4o.

There are 4 classes of Diabetic Neuropathy:

  1. Peripheral Diabetic Neuropathy
  2. Autonomic Diabetic Neuropathy
  3. Proximal Diabetic Neuropathy
  4. Focal Diabetic Neuropathy

Diabetic Neuropathies are defined below.

Peripheral Neuropathy will cause pain and/or a loss of feeling in the one or both arms, hand, feet, leg, and toes. 

Autonomic Neuropathy will cause a change in a person’s digestion, the function of the bowel and bladder, sexual response, and perspiration.   It also may affect the nerves that serve the heart and control blood pressure.

Proximal Neuropathy will cause a pain in a person’s  thigh, hip, or buttock and will lead to weakness in the legs.

Focal Neuropathy will result in the sudden weakness of a nerve, or a small group of nerves, that will cause muscle weakness or pain.  It is possible that every nerve in the body may be affected. 

Blood glucose

levels need to be brought within the normal range to prevent further nerve damage. Symptoms can get worse when blood glucose is initially brought under control, maintaining lower blood glucose levels over time will  help decrease neuropathic symptoms and prevent further problems. Good foot care is necessary and should not be ignored.  Patients will  find that regular walks, warm baths, and using elastic stockings will help relieve leg pain.

Painful Diabetic Neuropathy can manifest itself with a severe burning pain.  There are treatment regiments that a qualified doctor can recommend.  The first thing you will have to do is to get your diabetes under control the best you can.  A doctor may have you take insulin several times a day to accomplish this.  This would just be the first step in a treatment program for painful diabetic neuropathy.

Diabetic Numbness:  It is recommended that diabetics have an annual foot exam to check for peripheral neuropathy. 

A complete examination will include focusing on the feet, skin, muscles, bones, circulation, and sensation.  Focusing on sensation or numbness is important and will be paid attention to during the exam.

Diabetic Food---Diabetic Recipes---Diabetic Nutrition---Carbohydrate Counting

You might as well face it, the days of eating whatever you want, whenever you want are over.

Carbohydrate counting is planning technique for managing your blood glucose levels. You should always remember that food that contains carbohydrates will raise your blood glucose levels.  Keep track of how many carbohydrates you eat and set a limit for your maximum amount to eat.  This will help to keep your blood glucose level within your target range. The right amount of carbohydrates will depend on many factors including how active you are and what, if any, medications you take.

How much carbohydrates?
A good place to start is 45-60 grams of carbohydrates at a meal. Your doctor  will adjust your carbohydrates intake for more or less carbohydrates at meals depending on how you agree to manage your diabetes.  Once you have settled on how many carbohydrates to eat at a meal, you will then choose your food and the portion sizes to match.

Which foods have carbohydrate?
Food that contain carbohydrates are:

starchy foods like bread, cereal, rice, and crackers
fruit and juice
milk and yogurt
dried beans like pinto beans and soy products like veggie burgers
starchy vegetables like potatoes and corn
sweets and snack foods like sodas, juice drinks, cake, cookies, candy, and chips
Non-starchy vegetables have a little bit of carbohydrate but in general are very low.

How much carbohydrate is in these foods?
Reading food labels is a great way to know how much carbohydrate is in a food. For foods that do not have a label, you have to estimate how much carbohydrate is in it. Keeping general serving sizes in mind will help you estimate how much carbohydrate you are eating.

For example there is about 15 grams of carbohydrate in:

1 small piece of fresh fruit (4 oz)
1/2 cup of canned or frozen fruit
1 slice of bread (1 oz) or 1 (6 inch) tortilla
1/2 cup of oatmeal
1/3 cup of pasta or rice
4-6 crackers
1/2 English muffin or hamburger bun
1/2 cup of black beans or starchy vegetable
1/4 of a large baked potato (3 oz)
2/3 cup of plain fat-free yogurt or sweetened with sugar substitutes
2 small cookies
2 inch square brownie or cake without frosting
1/2 cup ice cream or sherbet
1 Tbsp syrup, jam, jelly, sugar or honey
2 Tbsp light syrup
6 chicken nuggets
1/2 cup of casserole
1 cup of soup
1/4 serving of a medium french fry

Protein and Fat
With carbohydrate counting, it is easy to forget about the protein and fat in meals. Always include a source of protein and fat to balance out your meal.

Using Food Labels
Carbohydrate counting is easier when food labels are available. You can look at how much carbohydrate is in the foods you want to eat and decide how much of the food you can eat. The two most important lines with carbohydrate counting are the serving size and the total carbohydrate amount.

1. Look at the serving size. All the information on the label is about this serving of food. If you will be eating a larger serving, then you will need to double or triple the information on the label.

2. Look at the grams of total carbohydrate.
Total carbohydrate on the label includes sugar, starch, and fiber.
Know the amount of carbohydrates  you can eat, figure out the portion size to match.

Other important label information:
3. If you are trying to lose weight, look at the calories. Comparing products can be helpful to find those lower in calories per serving.

4.To cut risk of heart disease and stroke, look at saturated and trans fats. Look for products with the lowest amount of saturated and trans fats per serving.

5. For people with high blood pressure, look at the sodium. Look for foods with less sodium.

Control of your diabetes is key.  Proper diet and nutrition is a good first step to controlling both type 1 and type 2 diabetes.

Diabetic Neuropathy is serious and should be taken seriously.  Always consult with your doctor before making any changes to your diet, lifestyle, or daily activities.

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