What is Diabetic Neuropathy?
Diabetic neuropathy refers to a type of nerve damage caused by diabetes. Diabetes is a chronic metabolic disorder characterized by hyperglycemia, the presence of high sugar (glucose) levels in the blood. Diabetic neuropathy most often damages nerves in the legs and feet. Nerves are a group of specialized tissues that convey signals between your brain and other parts of your body. These signals transmit information about sensations, movement of body parts, and control over body functions, such as digestion. Diabetic neuropathy is a serious diabetes complication that may impact as many as 50 percent of diabetics. However, you can often avert diabetic neuropathy or slow its progress through a healthy lifestyle and regular blood sugar management.
Symptoms and Types of Diabetic Neuropathy
Symptoms of diabetic neuropathy depend upon the type of diabetic neuropathy you have and which nerves are affected. Generally, symptoms develop gradually and may not be noticed until significant nerve damage has occurred. The 4 main types of diabetic neuropathy are:
- Peripheral Neuropathy: Peripheral neuropathy is the most common type of diabetic neuropathy, and is also referred to as distal symmetric polyneuropathy (DSP). Peripheral neuropathy is nerve damage that usually affects the feet and legs first, followed by the hands and arms. Some of the common symptoms of peripheral neuropathy include:
- Burning or tingling sensations
- Numbness
- Severe sensitivity to touch
- Sharp pain or cramping
- Loss of balance or coordination
- Muscle weakness
- insensitivity to cold and hot temperatures
- Autonomic Neuropathy: Autonomic neuropathy is the second most common type of neuropathy in individuals with diabetes and is defined by damage to nerves that control your internal organs. Autonomic neuropathy can cause problems with your digestive system, sex organs, blood pressure, heart rate, bladder, eyes, and capacity to sense hypoglycemia. Some of the common symptoms of autonomic neuropathy include:
- Sexual dysfunction
- Bladder or bowel problems
- Difficulty swallowing
- Decreased or increased sweating
- Shortness of breath
- Nausea
- Lightheadedness
- Pain in the neck, jaw, back, arm, or stomach
- Focal Neuropathy: Focal neuropathy, also known as mononeuropathy, is a condition in which you usually have damage to one specific nerve or group of nerves, most often in your hand, head, torso, and leg. Some of the common symptoms of focal neuropathy include:
- Inability to focus
- Pain, tingling, and numbness in fingers
- Pain behind the eyes
- Double vision
- Paralysis on one side of the face
- Pain in the foot or shin
- Hand weakness that may lead to dropping things
- Proximal Neuropathy: Proximal neuropathy, also known as diabetic amyotrophy, is a rare form of neuropathy that often affects nerves in the hips, buttocks, thighs, or legs. Proximal neuropathy is more common in individuals over 50 years old with type 2 diabetes and is diagnosed more often in men. Some of the common symptoms of proximal neuropathy include:
- Severe pain in the hip, buttock, or thigh
- Shrinking and weak thigh muscles
- Chest or abdominal wall pain
- Difficulty rising from a seated position
Causes of Diabetic Neuropathy
Diabetic neuropathy is caused by elevated blood sugar levels sustained over a prolonged period. Other factors that can result in nerve damage include:
- Lifestyle factors such as alcohol or smoking
- Damage to the blood vessels caused by high cholesterol levels
- Reduced levels of vitamin B12 can also result in neuropathy. Metformin, a common medication employed to manage diabetes, can decrease levels of vitamin B12.
Who is Most Likely to Suffer from Diabetic Neuropathy?
You are more likely to develop nerve damage if you have diabetes and:
- Have high cholesterol levels
- Have high blood pressure
- Have advanced kidney disorder
- Are overweight or obese
- Are a smoker
- Consume alcohol
Diagnosis of Diabetic Neuropathy
In order to diagnose diabetic neuropathy, your physician will begin by inquiring about your symptoms and medical history. A physical examination will be conducted to assess your blood pressure, heart rate, muscle tone, and degree of sensitivity to touch and temperature.
Your physician may conduct a filament test to check the sensitivity in your feet. A tuning fork may be used to determine your vibration threshold. Your physician may also conduct tests to check your ankle reflexes. Sometimes, a nerve conduction study may be performed, which can determine nerve damage by estimating the strength and speed of nerve signals.
Treatment for Diabetic Neuropathy
There is no known treatment for diabetic neuropathy, but its progression can be slowed. Keeping blood sugar levels within a healthy range is the optimal way to delay or decrease the chances of developing diabetic neuropathy. This measure can also help relieve some of the related symptoms.
Several medications have been proven to be effective in treating pain caused by diabetic neuropathy. You may also use alternative therapies such as acupuncture that can provide additional pain relief when used in tandem with medication.
Lifestyle changes such as regular exercise, improved diet, and limiting or discontinuing alcohol and smoking, are all part of a comprehensive treatment plan to address symptoms of diabetic neuropathy and prevent any associated complications. You may also consult your physician about supplements or other complementary treatments for neuropathy.
Foot care is crucial for all individuals with diabetes, and is even more important if you have peripheral neuropathy. Improper foot care can result in serious complications, which in turn can lead to amputation. Hence, it is important to take special care of your feet and to promptly get assistance if you have a sore or injury.
Managing your blood glucose level, cholesterol levels, blood pressure, and weight can significantly keep nerve damage from worsening, and thereby ward off diabetic neuropathy.