Friday, October 9, 2015

Diabetic Neuropathy: Excercise and Food as Medicine


Diabetic neuropathy is a type of painful nerve damage that can occur in diabetics who have had the disease for a number of years. High blood sugar can injure nerve fibers throughout your body, but diabetic neuropathy most often damages nerves in your legs and feet. About half of the diabetic population has some form of nerve damage. Keeping blood sugar (ALc) within a target range with diet and exercise can help reduce symptoms, and keep them from getting worse.

Disclaimer: This is a subject that is near and dear to me. I do not specialize in diabetic neuropathy. All information was taken from reprebutible and up to date sources such as the United States National Library of Medicine, American Diabetes Association, WebMD, and the  Mayo Clinic. This post serves as a reference and tool for those suffering with the disease. Those with diabetic neuropathy need to take precautions with performing high impact exercises. Always check your blood glucose before and after any exercise routine. Please contact your health care provider before starting any exercise program, and altering or adding supplements to your diet. Start an exercise program slowly and gradually work up your duration. Stop if pain occurs.


Exercise and diabetic neuropathy:

Exercise can help keep the blood sugar in check, therefore reducing symptoms and pain. If walking is too painful, stretching and low impact exercises such as swimming or water aerobics (walking in the pool), stationary bike, and light yoga are good options, especially for those who experience pain, numbness, or tinkling in the feet. While certain types of neuropathy may require slightly different forms of exercise, here are a few low impact exercises.

Chair exercises:

A. Do three sets of 15 toe taps for each foot.
B. While sitting in your chair, lift one leg off the seat. Extend the leg straight out, hold for 2 seconds, then lower your foot, but stop your foot before it touches the floor. Hold for several seconds then switch.
C. If tolerable, place both hands on your chair arms and slowly lift off the chair. Lower back down until almost touching. Hold for several seconds. Repeat as many as you can.
D. While in a seated position, arm exercises with light free weights may be used.

Stretching:

Stretching should never be uncomfortable or painful. Stretching exercises help keep your joints flexible, and prevent stiffness.

Balance exercises:

These balance exercises are great for seniors or anyone who needs the assistance of a chair to help with balance.
  1. Balance exercise video (YouTube)
  2. 10 Exercises for Balance

Charcot Foot:
Charcot foot is a type of peripheral neuropathy where destruction of the nerves on the bottom of the feet occurs. The foot will eventually become deformed and lose sensation. With foot deformity or ulcers, swimming is not allowed as feet need to remain dry.

Exercises: Some good exercises include stationary or arm bike, or chair exercise using free weights in a seated position.

Proliferative retinopathy:

This is an advanced diabetic eye disease. New cells are fragile and are prone to hemorrhaging or leaking into the eyes and can result in loss of vision and increases the risk of retinal detachment. This condition affects balance.

Exercises: Balancing can be improved slowly with balance exercises. Practice getting out of a chair by using your arms to steady yourself. Using a stable object or a chair if needed, try to balance on each leg for 30 seconds without holding onto anything. For more practice, try the previous mentioned exercises also listed below.
1. Balance exercise video (YouTube)
2. 10 Exercises for Balance

Caution: Any exercises that increases blood pressure should be avoided such as lifting heavy objects and vigorous exercise.

Other issues to consider when exercising: Diabetics with Autonomic (central) neuropathy need to check their blood glucose more frequently as they no longer experience the symptoms of low blood sugar. Also, the usual heart rate guidelines do not apply for autonomic neuropathy since the neuropathy may cause significant cardiac changes. A good rule of thumb is the Talk Test. If you can sing or hum, exercise is light intensity. Being able to talk comfortably while exercising indicates moderate intensity. If talking is difficult or uncomfortable, the intensity is too high.

Can food be used as medicine? Food for thought:


While  B vitamins (B-1, B-12, B-6, and folic acid) are essential for nerve health, most people get enough B vitamins from a healthy diet. Consumption of B vitamins higher than 50 milligrams a day   can lead to toxicity, and cause pain and numbness in the hands and legs, and in sever cases, difficulty walking.

Alpha-lipoic acid also known as thioctic acid is a potent antioxidant that may help diabetic peripheral neuropathy. It helps get rid of free radicals from the body, which can potentially reduce nerve damage. Alpha-lipoic acid given orally or intravenously (600-1,200 milligrams per day) seems to be effective at reducing nerve pain according to studies.  While no major diabetes treatment group has yet to endorse this treatment, it is widely used in Germany to treat nerve pain and damage from diabetes.

Green tea and pomegranates are loaded with strong antioxidants that help reduce inflammation and may provide some pain relief.

Turmeric, most commonly used in South Asian dishes, such as curry; has been associated with anti-inflammatory effects thanks to the active ingredient curcumin, which reduces the activity of inflammatory effects.

Tart cherries have natural anti-inflammatory properties which fight free radicals, and repair cell damage. Tart cherry juice is often used by athletes to help reduce exercise induced inflammation and to help with muscle soreness.

Living with diabetic nerve pain can be difficult and challenging. Incorporating exercise, eating healthy, and keeping blood sugars in check, has been shown to help reduce the pain.

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