Diabetic Neuropathy: Where Emvit-Win Fits In

Diabetic peripheral neuropathy is damage to the small nerves that serve the feet, legs and later the hands. It develops over years, most often in people whose blood glucose has stayed above target for long periods, and it is one of the more common long term complications of diabetes in India.

Several processes are involved. Persistently high glucose alters the chemistry inside nerve cells, oxidative stress builds up, and the tiny blood vessels that feed the nerves become less efficient at delivering oxygen. Other factors add to the load, including smoking, high blood pressure, high triglycerides, regular alcohol use, kidney disease and low vitamin B12, which is why a doctor investigates rather than assuming diabetes is the only cause.

Symptoms usually begin in both feet and spread slowly upward. Numbness worries doctors more than pain does, because a person who cannot feel a stone in the chappal or a hot floor can develop a wound without knowing. Any new numbness, weakness or wound needs a prompt appointment.

Foot care is the habit that protects the most. Look at both feet every day, including between the toes and the soles, using a mirror if bending is difficult. Wash and dry them well, especially between the toes during the monsoon when fungal infection is common. Use a plain moisturiser on dry skin but not between the toes.

Do not walk barefoot, even at home or in a temple courtyard; use covered footwear that fits with no hard seams. Check inside footwear with your hand before wearing. Test bath water with the elbow rather than the foot. Have toenails cut straight across, and let a professional handle corns and calluses instead of using blades or chemical corn caps.

Alongside this sit the wider measures: reaching your glucose targets, keeping blood pressure and lipids in range, stopping smoking, limiting alcohol, regular walking as advised, and steady weight management.

Once the main measures are in place, doctors often look at nutrition. Low vitamin B12 can cause nerve symptoms of its own and can go unnoticed in vegetarians and in people on certain long term medicines. Thiamine status affects how cells handle glucose. Oxidative stress is part of the underlying process.

This is the space in which a prescription formulation such as Emvit-Win is used. It supplies Mecobalamin, Alpha Lipoic Acid and Benfotiamine along with other B vitamins, Zinc, Chromium, Inositol and Lutein in one softgel, so a patient does not need several separate products. Emvit-Win is nutritional support and does not replace glucose lowering treatment, nerve pain medicines, physiotherapy or wound care. Where pain is significant, a doctor may prescribe a specific nerve pain medicine in addition.

Neuropathy is a moving picture, so it needs review. A typical follow up includes a foot examination with a monofilament or tuning fork, a check of pulses in the feet, HbA1c, kidney function, lipids, blood pressure, and a retinal examination, since eye and nerve complications often travel together.

Bring your glucose diary or meter, your full list of medicines and supplements, and any new symptom you have noticed. Go back sooner, without waiting for the scheduled date, if you find a blister, crack, ulcer or colour change on a foot, if a foot becomes swollen, red or warm, if weakness appears in a leg or hand, or if your vision changes. Early attention to a small foot problem is what keeps it small. This article is for general information only and is not a substitute for advice from a registered medical practitioner.