Diabetes Peripheral neuropathy

Under normal circumstances, our body regulates the blood-sugar level very precisely via hormones, including insulin – the most well known hormone. Diabetic people no longer produce insulin or their bodies no longer react to it or react inadequately.

The number of people suffering from diabetes is increasing. Due to ageing and the number of people who are overweight, by 2025 this number will double. In addition, many people have diabetes without knowing it. Diabetes can cause multiple complications. We will limit ourselves here to describing the neuropathic pain in diabetes.

Signs and symptoms

  • The pain is describes as piercing, burning, nagging or prickling.
  • The symptoms are predominately in the feet.
  • Patients indicate that they feel as if they are walking on glass or feel something itching under the skin.
  • They often experience numbness in the toes, feet and sometimes in the fingers.
  • Sometimes there are nightly painful muscle cramps.

Causes

If diabetes is not treated in the best way possible, the excess blood sugar affects the peripheral nerves and the blood. In case of diabetic neuropathy, it appears that a chronically mild inflammatory response is present in the body.

Pain treatment

A number of studies among diabetic patients that suffer greatly from neuropathic pains indicate that treatment with PEA is worthwhile. These studies have shown that:

  • PEA reduces the pain. Some patients found that they need fewer painkillers of other brands.
  • PEA reinforces the effectiveness of other painkillers.
  • PEA improves the condition of the nerves; this was measured based on the increase of nerve conduction time during and after treatment with PEA in comparison to worsening of nerve conduction in patients that were not treated with PEA.

PEA is a 100% natural remedy. In order to get the most out of PEA, it is recommended to use PEA for at least two months.

If after one month, you have the feeling that PEA is not working optimally, you can double the dosage. The use of PEA over a period of two months is a realistic evaluation period. After these two months, you can determine the follow-up treatment. After all, some patients might respond more slowly because the effects of PEA occur through the natural mechanism of the body.

The two most common PEA products on the market are PeaPure, produced by JP Russel Science Ltd, which is a supplement that can be ordered worldwide and PEA tablets, produced by Epitech Group S.r.l., an Italian preparation available in pharmacies in Italy and Spain, among others places.

Diabetic (painful) poly-neuropathy

The number of diabetes cases is increasing exponentially. If you have unexplained pain or burning sensation in the feet or if you have the feeling that you are walking on cotton wool, always contact your general practitioner to rule out the possibility of diabetes.

Signs and symptoms

Diabetes can lead to many complications. One of the complications is diabetic neopathy, which leads to nerve pains, irritations, an unpleasant feeling in the feet, nettle-like sensations, a feeling of cramped shoes or of walking on cotton wool. Neuropathy causes pain – among other things – and at a certain point there is reduced sensation in the toes, feet, fingers and hands. These disorders have a tendency to increase. It starts at the toes and ultimately moves up to the feet and hands. The pain is describes as tingling or burning, but some people feel it as stabbing. Sometimes it feels like walking on glass or as if something is itching under the skin. This sensation is also referred to as ‘crawling ants’. The loss of sensation is comparable to wearing a sock or glove or too tight shoes.

Causes

There are a number of causes for neuropathy. Diabetes is the most prevalent one. The main reason for this form of neuropathy is most likely poor monitoring of diabetes. Sadly, even diabetes patients with proper care can develop diabetic neuropathy.

In diabetic neuropathy, the body apparently suffers from a chronic mild inflammatory response. The metabolism in the body cells is upset by the increases blood-sugar level and consequently the inflammatory response. Doctors refer to this as a silent inflammation.

Diagnosis

Diabetic neuropathy and neuropathic pain are simple to diagnose. Often, the person was already diagnosed for diabetes and if he/she develops the aforementioned pains and sensation disorders, then in fact per definition, we are talking about neuropathy. By using the simple DN-4 questionnaire (a 4-question questionnaire developed by a French research group in cases of neuropathic pains) one can obtain clarity about the neuropathic nature of the pains. A neurologist will most likely come to the same conclusion. In case of doubt, a nerve conduction test (EMG) can be carried out. The EMG test can show function disorder in many nerves, but abnormalities in the thin layers of the nerve fibre cannot be detected with this method. It is precisely the disorders in these fibres that cause the burning sensations.

The random fibres that support the functioning of internal organs, such as the stomach, intestines and the heart, can be affected. If that is the case, then we refer to this as autonomous neuropathy. Some of the symptoms of autonomous neuropathy are disorders in the gastro-intestinal decomposition, intestinal problems, low blood pressure and cardiac arrhythmia.

These autonomous disorders are very difficult to treat.

Treatment

Since inflammatory response characterises diabetic neuropathy, a treatment with the PEA inflammatory inhibitor and painkiller can be very effective. Various studies about diabetic neuropathy have shown that PEA reduces the pain and reinforces the effectiveness of other painkillers. In addition, in many cases it improves the condition of the nerves. PEA has a double effect against pain: it kills the pain and due to its anti-inflammatory effect, it combats the ‘silent inflammation’, which also affects other parts of the nerves, resulting in the release of more pain signals.

In case of complications due to diabetes, such as diabetic neuropathy, but also for example diabetic retinopathy (damage to the retina due to diabetes), it is of utmost importance to maintain an optimum sugar level.

SOURCES

Instituut neuropathische Pijn | Palmitoylethanolamide (PeaPure, PEA tablets): pijnstillend en ontstekingsremmend, de essentie

Biasiotta A, La Cesa S, Leone C, Di Stefano G, Truini A, Cruccu G. | 34. Efficacy of palmitoylethanolamide in patients with painful neuropathy. A clincial and neurophysiological open study | Preliminary results. Volume 4, Issue 1, May 2010, Page 77. | 2010-5

Schifiliti C, et al. | 36. Efficacy of palmitoylethanolamide in pain and neuropathic symptoms in diabetic patients | IV congress of European Shock society, Taormina, 2011 | 2013-5-8 | 2013-5-8

Adiletta S et al | 37.Pregabalin and Palmitoylethanolamide in diabetic neuropathic pain: a randomized clinical trial. | Presented at the 34th AISD meeting, 2011, Riccione. | 2011

Instituut neuropathische Pijn | Palmitoylethanolamide (PeaPure, PEA tablets): pijnstillend en ontstekingsremmend, de essentie

Deslo. P. Combination of pregabalin and palmitoylethanolamide (PEA) for neuropathic pain treatment. Pathos, 2010, 17,4:9-14

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