Dr. Ahmed Diabetic neuropathy and vitamin D deficiency may coexist since both conditions are very prevalent. However, whether vitamin D deficiency can lead to diabetic neuropathy or not is not clearly known.
A study conducted on about 257 diabetic patients evaluated the possible link between vitamin D deficiency and diabetic neuropathy.
Key points of the Study:
- A recent research investigated the effects of low serum vitamin D levels on certain nerve issues in older people with type 2 diabetes.
- The study included 257 diabetics who were similar in age, sex, and other health issues.
- They found out that diabetics with peripheral neuropathy had lower levels of vitamin D as compared to diabetics without neuropathy.
- They concluded that lower levels of vitamin D were associated with longer delays in nerve signals. So, the nutrient has effects on nerves, especially larger ones.
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Diabetic Neuropathy and Vitamin D Deficiency:
According to research diabetic peripheral neuropathy affects almost 50% of diabetics [ref]. This is termed as the most common complication of type 2 DM. It appears as pain or numb sensations in the limbs.
More studies are looking at vitamin D for its therapeutic properties. A study from 2009 has shown that lack of this vitamin is associated with pain conditions like chronic widespread pain which has the same symptoms and pathophysiology as neuropathic pain. [ref]
On this subject, a recent study concluded the following.
A deficiency of vitamin D in the blood is independently associated with higher chances of peripheral diabetic neuropathy by damaging large nerve fibers. [ref]
Methodology and Results:
There were 257 older adults with type 2 diabetes involved. Factors like age, sex, and diabetes duration were balanced among all participants through the use of propensity score matching.
Researchers measured vitamin D levels and nerve damage using an electromyogram and skin conductance.
They concluded that patients with diabetic neuropathy had lower levels of vitamin D and this deficiency was related to a higher risk of neuropathy and nerve damage.
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Symptoms of Diabetic Neuropathy
Diabetic neuropathy is one of the most common complications of diabetes. Unlike all other complications of diabetes, peripheral diabetic neuropathy is not caused by uncontrolled diabetes.
The signs and symptoms of diabetic neuropathy may develop as early as in the prediabetic stage.
In addition, fluctuation in blood glucose is more strongly associated with diabetic neuropathy than uncontrolled diabetes.
Some of the common manifestations of diabetic neuropathy include:
Tingling or Burning Hands and Feet:
In research, 43% of people reported tingling, aching, and burning sensations in their feet. [ref].
This happens due to extremely raised sugar levels and glycated end products which can damage the nerves in your extremities.
Ultimately, it harms the normal functioning of the nerves in said regions which makes you feel a prickling sensation.
Changes in Nails and Feet:
Due to the mentioned nerve damage, the nails and hair growth patterns are also affected.
Your hair might appear thinner and your nails brittle because the nerves responsible do not function properly.
The nails become dystrophic, thickened, and brittle. Toes become hammer-like (hammer toes).
Patients may develop calluses at pressure points which may ulcerate.
Ulcers and diabetic wounds are common and may heal with ugly scars.
Problems with balance and coordination:
Proprioception is the sense of joint position. It is like understanding where your hands or feet are when your eyes are closed or in a dark environment.
Proprioception and vibration sensations are the first to get affected in diabetic patients with neuropathy.
Loss of proprioception and position sense can impair your ability to walk steadily without falling.
You won’t be able to coordinate where you are in space and your feet will be unsteady, increasing the risk of falls.
Dizziness or fainting when standing up:
A 2013 review has shown that orthostatic hypotension is the most bothersome and most complained symptom of diabetic neuropathy [ref].
It occurs when nerves controlling the blood pressure become impaired. When you stand up, your blood pressure adjusts so to keep it flowing towards the brain.
However, damaged nerves can not let the pressure adjust, leading to a sudden drop. This leaves you feeling dizzy and you might faint.
Difficulty Swallowing
Dysphagia is also seen in diabetic neuropathy because the muscular components involved in swallowing can become damaged [ref].
This may cause feelings like food being stuck in the throat, heartburn, chest pain, or coughing while eating.
High blood glucose levels are all behind this miscommunication between the muscles and the nerves.
Stomach Problems:
Bloating, early satiety and fullness after eating, alternating constipation and diarrhea, and gustatory sweating are all symptoms of diabetic autonomic neuropathy.
Double Vision:
Blurred vision can be caused by cataracts, glaucoma, or diabetic retinopathy but diplopia or double vision develops as a result of diabetic autonomic cranial neuropathy.
Sixth nerve palsy can lead to diplopia or double vision.
Erectile Dysfunction:
Erectile dysfunction, loss of libido, and early or retrograde ejaculations are common in diabetics with autonomic neuropathy.
Muscle Weakness:
Muscle weakness is a rare manifestation of a unique type of diabetic neuropathy called “diabetic amyotrophy“.
Patients with diabetic amyotrophy commonly have pain and weakness in the thigh muscles.
It is usually unilateral and sudden in onset. Patients may later develop wasting of the muscle involved.
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Can Diabetic Neuropathy be Reversed?
Diabetic neuropathy can be reversed if picked up earlier during the course of illness.
In addition, good glycemic control, a healthy anti-inflammatory diet, and regular exercise can stop or reverse nerve damage.
Painful neuropathy can be treated with medications like pregabalin, gabapentin, and duloxetine.
In addition, supplements like vitamin B12, alpha-lipoic acid, vitamin B1, and Vitamin B6 can heal neuronal damage (in addition to good glycemic control).
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Vitamin D Supplementation And Its Effects
Research has shown that vitamin D deficiency can cause neuropathy so it only makes sense for its supplementation to improve nerve functioning or slow down the damage.
Potential Benefits:
Studies have explored the use of vitamin D as a pain relief for neuropathy in diabetes. As it turns out, supplementation has shown improvements in pain and nerve functioning.
Vitamin D might be able to do this by regulating inflammation. It can also lower the overall neuropathic severity. [ref]
Important aspects:
If you have diabetic neuropathy then consult your doctor rather than jumping towards supplements.
Your physician will assess your situation and see if supplements will work for you.
Do not treat yourself at home or follow online tutorials that are based on illogical concepts.
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