Diabetic focal neuropathy is sudden unpredictable pain. It strikes like lightning in older type 2 diabetics, and it can be frightening. But if you know what it is and what you can do for it, you will not add fear and stress to this painful complication.
Diabetic focal neuropathy is different from all the other neuropathic pains that type 2 diabetics experience.
It appears suddenly in a specific part of your body, like a muscle cramp. It is painful and impossible to predict.
But just like any diabetic complication, its source is thought to be the long-term high blood sugar that causes nerve damage.
Older adults deal with diabetic focal neuropathy after years of type 2 diabetes.
That may be because it takes a long time for blood vessels to fail and nerves to be starved.
Another pathway for nerve damage is the inflammatory condition of having too much insulin in your body, called hyperinsulinemia.
The inflammatory effect is probably responsible for the onset as well as many of the complications of type 2 diabetes that show up after many years with diabetes.
Doctors may not know all the causes of diabetic focal neuropathy, but they know the symptoms quite well.
The pain is focused on one nerve, which is why it is called focal. That is also why when it hits you it is sudden, like lightning.
One common symptom is sudden aching behind one eye or an inability to focus the eye. There may be double vision or sharp pain.
Another symptom may be Bell's palsy, a paralysis on one side of the face that makes the eyelid, cheek and lip droop.
Bell's palsy makes you look like a stroke victim, but it only affects your face, and it gradually fades away over a few weeks.
Non-diabetics get Bell's palsy also, but for us it may be brought on by neuropathy.
Sudden pain may strike one spot in your lower back or pelvis. It may also hit one side of your chest or rib cage, and many people think they are having a heart attack.
But if the pain does not spread and you are able to breathe normally, it is probably diabetic focal neuropathy.
If you are not sure, it is a good idea to get a blood test from an EMT or your doctor to rule out any heart problem.
Sudden abdominal pain in one spot can be diabetic focal neuropathy but sometimes is mistaken for appendicitis.
If it worries you, talk to your doctor about how to tell the difference so you will not stress over this.
By far the most common form of diabetic focal neuropathy is a leg cramp. The cramp will usually hit you on the outside of your shin or the inside of your foot.
It can startle you out of a sound sleep. All you can do is stretch or get up and walk around until it eases. Sometimes a hot bath helps too.
The front of one thigh is another spot where diabetic focal neuropathy can strike. But no matter where it strikes, this kind of neuropathy has its own peculiar character that sets it apart.
It always appears suddenly and is very localized, for instance in one eye, not both, or one foot and not the other. It is painful and cannot be predicted.
It hits older adults or those who have had type 2 diabetes for a very long time.
The other characteristic is that it improves by itself. It may take days, weeks or even months, but the symptoms gradually fade away.
There is no treatment your doctor can offer except to give something for the neuropathic pain and reassure you that the pain will ease with time.
Researchers have proved that treatment with insulin to get tight control of blood sugar reduces diabetic focal neuropathy and even prevents it.
What does that mean to you? It means you can prevent neuropathic pain by controlling your blood glucose.
If you are willing, you can do this with diet and exercise.
Every kind of diabetic neuropathy responds to well controlled blood sugar, so use what you understand about carbohydrates and other foods to help you succeed.
You have the arsenal of superfoods with antioxidants that heal and protect nerves in your eyes and muscles as well as improve your blood sugar.
If you need insulin or oral medications, they are there to help. Many type 2 diabetics are using insulin. There is no longer a stigma of failure if you inject insulin to help control type 2 diabetes.
I hope that understanding how and where the lightning of diabetic focal neuropathy strikes will keep it from frightening you if and when it shows up.
It helps to know this is not a chronic pain, that it will go away, and that you can do something to prevent it in the long term.
If you have the numbness, tingling and pain of peripheral neuropathy there are things you can do about that as well.
Please don't let pain take away the joy you find in the people around you.
Facing a chronic, often painful condition like type 2 diabetes and yet continuing to live without self-pity takes courage. You may find out you have a lot of it.
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