If you’re a diabetic, you’re probably aware (I hope) that it makes you susceptible to nerve damage, which is called neuropathy.
What you may not know, however, is that diabetes-related neuropathy can sometimes cover up signs of heart disease and even cause you to miss important signs of a heart attack.
The most common form of neuropathy, peripheral nerve damage, causes numbness, tingling or weakness of the hands and feet. Over two-thirds of diabetics will experience some form of neuropathy.
But, diabetes can hide heart disease with an even more serious type — autonomic neuropathy — that can damage the nerves that lead to your heart, bladder, intestines and blood vessels.
When this happens, the body is sometimes not able to regulate functions like urination or feel sensations like pain in these areas.
This can be a serious problem if you have diabetes. Not only are you at higher risk for neuropathy, but you’re also more likely to have heart disease.
If the neuropathy dulls the nerves leading to your heart, you may not be able to notice symptoms of a heart attack, such as chest pain.
Common symptoms of autonomic neuropathy include:
• Postural hypotension (low blood pressure when you stand up), likely accompanied by light-headedness, dizziness, fainting, dimness of vision, unsteady gait, weakness
• Frequent urination or excessive urinating at night, urgency to urinate, stress incontinence (like when you sneeze), urine retention, hesitancy or trouble getting the urine stream going
• Sexual dysfunction: erectile dysfunction, vaginal dryness, decreased libido
• Gastrointestinal problems such as intermittent diarrhea, constipation, nausea, vomiting, abdominal fullness after eating just a little, bloating, heartburn and frequent indigestion
• Excessive or decreased sweating
• Exercise intolerance
• Numbness or tingling in the feet, legs, hands, arms or other body parts, called paresthesia.
If you have diabetes, the single most important thing you can do is to get in tune with your body. Learn to listen closely and act on what it’s telling you.
Make sure to visit your doctor for regular checkups. Annual tests can reveal a problem before symptoms occur, and early interventions can reduce the likelihood that small issues will become larger ones.
If you have any symptoms of a heart attack, go to the nearest emergency room. Don’t wait to see if the pain goes away.
Some signs of a heart attack:
- Indigestion that doesn’t pass quickly can be a sign of a heart attack.
- Chest pain or a feeling of “fullness” in the chest
- Unusual fatigue
- Pain in the jaw (particularly for women) in the neck, or more common to men, pain in the left arm
- Shortness of breath without much exertion
- Sweating or clammy hands without exertion
You can’t always avoid neuropathy, but lifestyle changes can help reduce your risk, even if you have diabetes.
Keeping your blood glucose levels within a healthy range is extremely important.
You can do this by maintaining a healthy weight, eating a healthy diet and getting regular exercise.
- You do NOT need to run a marathon, all you need is 30 minutes a day of concentrated activity such as walking, using a stair-stepper, a stationary bike or riding a bicycle.
- Avoid smoking
- Limit your alcohol intake
If you think you may have autonomic neuropathy, also watch for these symptoms:
- Dizziness or fainting when you stand
- Urinary problems like incontinence or inability to fully empty the bladder
- Sexual difficulties like erectile dysfunction or low libido
- Digestion difficulties like appetite loss, difficulty swallowing and heartburn
- Sweating too much or hardly at all
- Intolerance to exercise
If you have any of these symptoms, see your doctor right away. Getting an early diagnosis and starting treatment can help slow nerve damage and repair problems. Treatment options for neuropathy may include:
- Pain medication
- Physical therapy
- Occupational therapy for coping with pain and loss of function
- Aids like braces to increase mobility and reduce pain
- Nutritional changes
If you have type 2 diabetes have your doctor screen annually for autonomic neuropathy.
If you have type 1 (Juvenile) diabetes, the American Diabetes Association recommends annual screenings starting five years after your diagnosis.
The single most important piece of advice I can offer you is this:
Listen to your body. It knows what it needs.