Introduction.
Have your hands been tingling lately, or have you been dropping things more easily?
In diabetes, the nerves can be gradually damaged by persistently high blood sugar levels. This is called "diabetic neuropathy" and often manifests itself as numbness or dull sensation in the limbs.
This article describes the causes and mechanisms of diabetic numbness in the hands, the risks of leaving it untreated, and how to deal with it as soon as possible.
1. what is diabetic neuropathy?
Prolonged high blood sugar due to diabetes damages the blood vessels that feed the nerves, causing nerve cells to gradually lose function. This is diabetic neuropathy.
It is one of the three major complications of diabetes and the “shimeji” (neuropathy, eye, and kidney), which is another sign.
There are several types of diabetic neuropathy, the most common being peripheral neuropathy. It is characterized by starting at the ends of the limbs and gradually expanding in scope.
Characteristics of numbness in the hands
(1) Tingling or zinging sensation
It will cause mild pain like an electric shock or discomfort like wearing a glove.
(2) Sensory perception becomes dull.
The senses of hot, cold, and pain may be dulled, making it difficult to notice burns and injuries.
(3) Worse at night or at rest
Numbness may be more intense when sleeping at night or when not using the hands.
(4) Symptoms also occur in the feet.
A "glove-sock type" distribution is typical, appearing first on the toes and gradually spreading to the fingers.
3. difference from non-diabetic numbness
Numbness in the hands can also have other causes, such as cervical spondylosis and carpal tunnel syndrome.
Diabetic cases are characterized by a slow, bilaterally symmetrical progression.
- Cervical spondylosis: unilateral predominance, worse with neck movement
- Carpal tunnel syndrome: Numbness mainly in the thumb, index and middle fingers
- Diabetic: symmetrical, with sensory insensitivity
4. what happens if left unattended
If left untreated, diabetic neuropathy can cause the following problems
- Injuries, burns, and infections due to decreased sensation
- Impairment of dexterity movements due to muscle weakness in limbs
- Autonomic neuropathy (dizziness, constipation, abnormal sweating, etc.)
Loss of sensation in the limb can worsen without the wound or ulcer being noticed, and in severe cases there is a risk of gangrene or amputation.
5. how to improve numbness in the hands
(1) Regulate blood sugar control
The most important way to stop the progression of neuropathy is to bring blood glucose levels closer to normal.
- Diet: Avoid too much carbohydrates and focus on vegetables and protein
- Exercise: Walking and stretching are habit-forming
- Medication: appropriate use of insulin and oral medications
(2) B vitamins that aid in nerve repair
Vitamins B1, B6, and B12 help nerve metabolism and are effective in improving numbness. Dietary or pharmaceutical supplementation (e.g., Methycobal) is recommended over supplements.
(3) Treatment for severe pain
If numbness or pain is severe,
- Pregabalin (Lyrica)
- Duloxetine (Cymbalta)
Neuropathic pain medications such as
(4) Review of overall lifestyle
- Smoking cessation (improves blood flow)
- Sobriety (to prevent neurotoxicity)
- Ensure quality of sleep
6. response at Ikejiri-Ohashi Sera Clinic
For numbness and neuropathy associated with diabetes mellitus in our clinic,
- Blood glucose control + neurological evaluation (vibratory, reflex, and sensory testing)
- Comprehensive evaluation of complications with fundus examination, ABI, and carotid echocardiography
- Supporting fundamental improvement through exercise therapy and medical dieting
and other "treatments that regulate the whole body while protecting the nerves".
summary
- Numbness in the hands may be an early sign of diabetic neuropathy.
- It often appears symmetrically on the left and right sides, and if left untreated, it will progress and lead to sensory insensitivity.
- Blood sugar control + vitamin supplementation + lifestyle modification are essential for improvement.
- The Ikejiri-Ohashi Sera Clinic manages diabetes and other lifestyle-related diseases across the board and provides support for early prevention of neurological disorders.
References
- The Japan Diabetes Society. Diabetes Care Guide 2024-2025.
- Pop-Busui R, et al. Diabetic Neuropathy: A Position Statement by the American Diabetes Association. Diabetes Care. 2017.
- Tesfaye S, et al. Diabetic neuropathies: update on definitions, diagnostic criteria, estimation of severity, and treatments. Diabetes Care. 2010.