Diabetic Peripheral Neuropathy

Diabetic peripheral neuropathy (DPN) refers to symptoms and/or signs associated with peripheral nerve dysfunction in patients with diabetes mellitus (DM), after other causes have been excluded. Diabetic sensorimotor peripheral neuropathy (DSPN), for example, is a representative form of diabetic neuropathy. Asymptomatic diabetic neuropathy can be diagnosed only through screening for signs or neurophysiological testing. Diabetic peripheral neuropathy is the most common type of diabetes-related neuropathy and falls within the categories of “blood impediment,” “numbness,” and “flaccidity syndrome” in Traditional Chinese Medicine (TCM).

TCM Pattern Identification and Medication Reference

|Common Symptoms

Clinical description:

Numbness in the hands and feet, tingling pain in the limbs; a pale, dusky tongue, sometimes with petechiae, a thin white coating, and a fine, choppy pulse.

In plain language:

  • The hands and feet may feel numb, with reduced sensation or a crawling, tingling feeling.
  • The limbs may feel as if they have tiny, needle-like pricks.
  • The tongue may look pale and dusky, sometimes with bluish-purple spots.
  • The tongue coating is thin and white rather than thick or greasy.
  • The pulse is fine and choppy, with an uneven, obstructed sensation beneath the fingers.

|Treatment Approach

Clinical description:

Invigorate blood and dispel stasis; move qi and unblock the collaterals.

In plain language:

  • Promote blood flow and gradually disperse stagnation.
  • Help qi flow smoothly throughout the body and unblock the meridians and collaterals.

|Related Products

The products below are provided for informational reference only and do not constitute medical advice or a prescription. Follow the product packaging and instructions, and use under the guidance of a doctor or pharmacist.

|Common Symptoms

Clinical description:

Numbness in the hands and feet, with a crawling sensation; intermittent pain in the extremities, often stabbing and mainly affecting the lower limbs, worsening at night; shortness of breath and fatigue, low energy and tiredness, spontaneous sweating and aversion to drafts, susceptibility to colds; a pale, dusky tongue, sometimes with petechiae, a thin white coating, and a fine, choppy pulse.

In plain language:

  • The hands and feet may feel numb, as if tiny ants were crawling under the skin.
  • The extremities may hurt at times, often with a prickling pain. Symptoms are more noticeable in the legs and worsen at night.
  • You may feel short of breath and weak, with little energy even when talking or walking a short distance, as well as generally tired and low in energy.
  • You may sweat easily and feel sensitive to drafts, and may become unwell with a cold after slight exposure to chill.
  • The tongue may look pale and dusky, with small bluish-purple spots.
  • The tongue coating is thin and whitish, rather than thick or greasy.
  • The pulse is fine and not smooth, with an uneven, sluggish sensation beneath the fingers.

|Treatment Approach

Clinical description:

Tonify qi and invigorate blood.

In plain language:

  • Support the body’s qi and stamina to help restore energy.
  • Promote blood circulation and help address blood stasis.

|Related Products

The products below are provided for informational reference only and do not constitute medical advice or a prescription. Follow the product packaging and instructions, and use under the guidance of a doctor or pharmacist.

|Common Symptoms

Clinical description:

Numbness and reduced sensation in the limbs; cold, painful extremities, with pain eased by warmth and worsened by cold, more pronounced in the legs and worse at night; fatigue and reluctance to speak, low energy and tiredness, aversion to cold; a dusky, pale tongue or one with petechiae, a white, slippery coating, and a deep, tight pulse.

In plain language:

  • The limbs may feel numb, with reduced sensation and less responsiveness.
  • The hands and feet may feel cold and painful, affecting daily activities.
  • Pain may ease with warmth, such as after applying a warm compress.
  • Pain may worsen in cold conditions or after exposure to wind and cold.
  • Symptoms are often more pronounced in the lower limbs, especially the calves and feet.
  • Symptoms may be worse at night, with increased pain and discomfort after dark.
  • You may often feel weak, lacking energy and not wanting to talk much.
  • You may feel tired and easily fatigued, even after a little activity.
  • You may be especially sensitive to cold and feel chilly even when the surroundings are only slightly cool.
  • The tongue may look dusky and pale, with small bluish-purple spots.
  • The tongue coating may be white and slippery, with a moist rather than dry appearance.
  • The pulse may be easier to feel with deeper pressure and feel tight beneath the fingers.

|Treatment Approach

Clinical description:

Strengthen the Spleen and warm Yang; invigorate blood and unblock the collaterals.

In plain language:

  • Support the Spleen’s digestive and transport functions and warm the body’s Yang to help restore energy.
  • Promote blood flow and help unblock the meridians and collaterals.

|Related Products

The products below are provided for informational reference only and do not constitute medical advice or a prescription. Follow the product packaging and instructions, and use under the guidance of a doctor or pharmacist.

|Common Symptoms

Clinical description:

Tightness or cramping in the legs and feet, numbness in the limbs, soreness, distention and pain, or a burning sensation in the limbs; restlessness and heat in the palms, soles, and chest, insomnia with vivid dreams, dry skin, soreness and weakness of the lower back and knees, dizziness and tinnitus; dry mouth with little desire to drink, often with constipation; a tender-red or dark-red tongue, patchy or scant coating with little moisture, and a fine, rapid or fine, choppy pulse.

In plain language:

  • The legs and feet may feel tight or cramp, with spasms that are difficult to relax.
  • The limbs may feel numb and less responsive, with reduced sensation.
  • The limbs may feel sore and distended, or hot and burning.
  • The palms, soles, and chest may feel hot, with a sense of restlessness.
  • You may have difficulty falling asleep, experience vivid dreams, or wake easily.
  • The skin may feel dry and tight and appear less moisturized.
  • The lower back and knees may feel weak and sore, especially after prolonged standing or walking.
  • You may often feel dizzy or lightheaded, with ringing in the ears.
  • Your mouth may feel dry, but you may not feel like drinking much.
  • Stools may be dry and difficult to pass, with a tendency toward constipation.
  • The tongue may look tender red or dark red, with a dull appearance.
  • The tongue coating may be patchy or peeled, with little saliva and a dry feeling in the mouth.
  • The pulse may be fine and somewhat rapid, or fine and choppy.

|Treatment Approach

Clinical description:

Nourish yin and invigorate blood.

In plain language:

  • Nourish yin fluids to help hydrate and rebalance the body.
  • Promote blood flow and gradually disperse stagnation.

|Related Products

The products below are provided for informational reference only and do not constitute medical advice or a prescription. Follow the product packaging and instructions, and use under the guidance of a doctor or pharmacist.

|Common Symptoms

Clinical description:

Numbness and reduced sensation, often in fixed locations; a feeling as if walking on cotton; heaviness and fatigue in the limbs; a heavy head, as if wrapped, with clouded thinking; often a larger body build; a sticky, bland taste in the mouth; chest oppression, poor appetite, abdominal distention and discomfort, and sticky stools. The tongue is purplish and dusky, enlarged with teeth marks, with a thick, white, greasy coating; the pulse is deep and slippery or deep and choppy.

In plain language:

  • The limbs may feel numb and less responsive, often in the same areas. The soles may feel as if you are stepping on cotton, making it hard to feel steady.
  • You may feel heavy and tired all over and want to rest after a short period of activity.
  • Your head may feel heavy and full, as if wrapped, leaving you feeling unclear or sluggish.
  • You may feel mentally foggy, with poor concentration and slower responses.
  • You may have a larger body build and feel heavy or slow when moving.
  • Your mouth may feel noticeably sticky, with little or no taste.
  • Your chest may feel tight or uncomfortable, and even deep breaths may not feel satisfying.
  • You may have a poor appetite and little interest in food.
  • Your abdomen may feel bloated, full, or uncomfortable.
  • Stools may be sticky and difficult to pass, and may cling to the toilet bowl.
  • The tongue may look dark purplish, with a dull color.
  • The tongue may be enlarged, with tooth marks along its edges.
  • The tongue coating may be thick, white, and greasy, like a layer of sticky white film.
  • The pulse may be easier to feel with deeper pressure and may feel either smooth and rolling beneath the fingers, like beads rolling, or uneven and choppy.

|Treatment Approach

Clinical description:

Transform phlegm and invigorate blood.

In plain language:

  • Help resolve phlegm-dampness and promote smoother breathing and circulation.
  • Promote blood flow and help disperse stagnation and reduce obstruction.

|Related Products

The products below are provided for informational reference only and do not constitute medical advice or a prescription. Follow the product packaging and instructions, and use under the guidance of a doctor or pharmacist.

|Common Symptoms

Clinical description:

Weakness and flaccidity in the limbs, muscle wasting, and, in severe cases, inability to use the affected limbs; soreness and weakness of the lower back and knees, weak bones and loose teeth, dizziness and tinnitus; a pale tongue with a scant or absent coating, and a deep, fine, weak pulse.

In plain language:

  • The limbs may feel weak and limp, with muscles that do not seem to have enough strength for movement.
  • The muscles may gradually become thinner and smaller, losing their fullness.
  • In severe cases, the limbs may be almost unusable, limiting daily activities.
  • The lower back and knees may feel weak and sore, especially after prolonged standing or walking.
  • The bones may feel weak, and the teeth may become loose or wobbly.
  • You may often feel dizzy or lightheaded, with ringing in the ears.
  • The tongue may look pale, with reduced color.
  • The tongue coating may be scant or absent, leaving the tongue surface bare.
  • The pulse may be easier to feel with deeper pressure and feel fine and weak.

|Treatment Approach

Clinical description:

Nourish yin and tonify the kidneys.

In plain language:

  • Nourish yin fluids to help hydrate and rebalance the body.
  • Support kidney function to help replenish essence and stamina.

|Related Products

The products below are provided for informational reference only and do not constitute medical advice or a prescription. Follow the product packaging and instructions, and use under the guidance of a doctor or pharmacist.

Liu Wei Di Huang Wan

References

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