Diabetic neuropathy occurs as a result of Diabetes Type 1 and 2. It develops due to increased blood sugar levels for a long time. High blood sugar, in turn, affects the nervous system, damaging the nerves in the body. This condition slowly shows its effect and can develop over the years. The nerve damage can be observed in the legs and feet.
The condition is common in most diabetic people, affecting over 50% of the patients. It is a serious condition in which symptoms include numbness, tingling, pain, and weakness in the legs and feet. Diabetic neuropathy starts with the legs and hands but can affect other body parts too, like the urinary tract, digestive system, and heart of patients. It is necessary to consult a doctor if the patient observes the symptoms.
Types of Diabetic Neuropathy
Diabetic neuropathy can be of different types and identifiable through the patient’s symptoms and the damaging nerves. However, the patient may not notice having this condition until most of the nerves are damaged. The four types we have are Peripheral Neuropathy, Autonomic Neuropathy, Proximal Neuropathy, and Mononeuropathy.
Peripheral neuropathy is the nerve damage occurring to the peripheral nervous system. The peripheral nervous system is the part that sends nerve signals to the brain, spinal cord, and other parts of the body. The damage to peripheral nerves causes weakness and numbness. As the peripheral system connects to the sensory, motor, and autonomic nerves, it affects them. Symptoms include numbness in legs and hands, sensitivity to touch, extreme pain in feet, lack of coordination, and even paralysis of nerves. Moreover, peripheral neuropathy also causes foot infections and ulcers.
Autonomic Neuropathy is the nerve damage occurring to the autonomic nervous system. Autonomic nerves control body functions that occur outside of your direct control, such as breathing, digestion, heart rate, blood pressure, sweating, bladder control, and sexual arousal. The autonomic nerves monitor and respond to external stresses and bodily needs. Diabetes affects these nerves causing symptoms such as bowel and bladder problems, including diarrhea, constipation. The nerves that control your heart rate and blood pressure are damaged in autonomic neuropathy and can make them respond more slowly. The patient may experience a drop in their blood pressure, feel lightheaded or dizzy when standing up after sitting or lying down, or during exertion. Autonomic Neuropathy can also cause an abnormally fast heart rate. The nerve damage also affects sexual organs in patients causing erectile dysfunction and decreased sexual response.
Proximal neuropathy is a rare condition, which is also known as Diabetic Amyotrophy. The condition is identified in adults over 50 years old with fairly well-controlled type 2 diabetes, and more often in men. It mainly affects the nerves of the hips, thigh, legs, and buttocks. The nerve damage may also impact the abdominal area and chest. In this condition, the symptoms are noticed at one side only and rarely spread to the other side. Symptoms include severe pain in a hip and thigh or buttock, eventual weak and shrinking thigh muscles, difficulty rising from a sitting position, and severe stomach pain.
Mononeuropathy is also known as focal neuropathy, is the nerve damage occurring to specific nerves or clusters of nerves. The condition has two types – cranial and peripheral depending on the nerves, the condition damages. It causes difficulty in focusing or double vision, aching behind one eye, paralysis on one side of your face known as Bell’s palsy, numbness or tingling in your hand or fingers, and weakness in your hand that may cause you to drop things.
Diabetic neuropathy is a serious condition that develops slowly over the years, while others may progress rapidly, causing extreme nerve damage. The progress of this condition depends on the type of nerve damage and underlying cause of the condition. Neuropathy treatment is easily determined if the cause is known to the doctor. Multiple conditions cause diabetic neuropathy; however, the leading cause is diabetes. A diabetes patient is at potential risk of neuropathy as high blood sugar over time damages nerves and prevents them from sending signals. Likewise, the high level of blood glucose weakens small blood vessels’ walls, which supply the nerves with oxygen and nutrients they rely on to function.
Apart from diabetes, neuropathy can also be caused due to Trauma. Like injuries from falls, car accidents, and fractures result in neuropathy. Compression of the nerves due to repetitive stress can cause the condition too. Autoimmune disorders and infections such as Guillain-Barre syndrome, lupus, and rheumatoid arthritis can cause neuropathy. Infections including chickenpox, shingles, human immunodeficiency virus (HIV), herpes, syphilis, Lyme disease, leprosy, West Nile virus, Epstein-Barr virus, and hepatitis C can also cause neuropathy.
Furthermore, neuropathy can be caused by kidney disorders, liver disorders, hypothyroidism, and tumors. Some antibiotics, some anti-seizure medications, and some HIV medications among others, can cause neuropathy. Treatments, including cancer chemotherapy and radiation, can also damage peripheral nerves. Likewise, exposure to toxic substances such as heavy metals and industrial chemicals, especially solvents, can also affect nerve function. All of these can be the leading cause of neuropathy, however, sometimes there is no cause, and the condition can occur without any prominent cause in patients.
It is important to consult a doctor with the onset of symptoms, where the doctor can diagnose the condition and recommend best diabetic neuropathy treatment. The doctor may check your vitals and do a physical examination, including a filament test and sensitivity test. Apart from checking the patient’s reflexes, coordination and balance, the doctor may also run blood tests. The blood test can reveal vitamin and mineral imbalances, electrolyte imbalances, thyroid problems, toxic substances, antibodies to certain viruses, or autoimmune diseases. Furthermore, test such as Electrodiagnostic assessment (EDX), Nerve conduction study (NCS), and Needle electromyography (EMG) can determine the specific location of nerve damage and its intensity.
Neuropathy has no cure in the medical field. However, the treatment with great care can slow its progress and manage its complication over some time. Treatment for neuropathy includes regulating blood sugar levels to prevent the condition from worsening. Maintaining sugar level, weight control, and physical activity can help improve the symptoms of this condition. Medicines are prescribed for pain management as several different medications contain chemicals that help control pain by adjusting pain signaling pathways within the central and peripheral nervous system. Physical therapy using a combination of focused exercise, massage, and other treatments helps increase strength, balance, and range of motion. Occupational therapy can help cope with the pain and loss of function. Further, surgery is available for patients with compression-related neuropathy caused by such things as a herniated disc in the back or neck, tumors, infections, or nerve entrapment disorders, such as carpal tunnel syndrome. Mechanical aids, such as braces and specially designed shoes, and casts, can help reduce pain by providing support or keeping the affected nerves in alignment.
Neuropathy is a condition that can get severe over time, causing extreme nerve damage. To prevent this condition from growing, diabetic patients need to maintain blood sugar levels, lead a healthy lifestyle, and exercise. With the first few noticeable symptoms, the patient should consult a doctor immediately to avoid any further complications and treat the condition.