Diabetic Neuropathy

What is diabetic neuropathy

Diabetic neuropathy is a cluster term for several nerve disorders that are a result of diabetes. Studies show that people with diabetes tend to develop nerve damage with the passage of time. Some people show no symptoms at all, while others show symptoms like numbness, tingling, loss of feeling in the extremities of the body like hands and feet. In addition to this, nerve problems start to occur in every organ of the body that includes the heart, sexual organs, as well as the digestive tract. Per the National Institute of Diabetes and Digestive and Kidney Diseases, around 60 to 70% of the people that have diabetes also have some form of neuropathy. Such people can develop neuropathy any time but the risk gets higher with age or if the person had diabetes from a very young age. It is also found in people who have problems with blood pressure or blood sugar.

Causes of Diabetic Neuropathies

  • Autoimmune issues that can cause inflammation in the nerves
  • Hereditary issues
  • Injury to the nerves like the carpal tunnel syndrome
  • Metabolic factors that can include high blood fat levels, high blood glucose, low levels of insulin, extended duration of diabetes
  • Neurovascular issues that can lead to damage to the blood vessels that are responsible for leading nutrients as well as oxygen to the nerves
  • Use of alcohol

Symptpoms of Diabetic Neuropathies

  • In the beginning, the symptoms are always very minor, but if the situation goes unnoticed, then severe damage may occur.
  • Feeling numbness and a tingling sensation in their hands and feet.
  • Symptoms may involve motor, sensory, autonomic, as well as nervous systems.
  • In some people the symptoms may be severe and sudden in nature.

Types of Diabetic Neuropathy

  1. Peripheral Neuropathy
    • Distal polyneuropathy and diabetic nerve pain
    • The nerves that go to the feet are severely damaged. The reason is that these nerves have to travel a long distance as they are branched off in the spinal cord and then make their way to the lower back (the lumbar region) and then to the feet. This often leads to foot related problems, amputations, infections, and even ulcers.
      • Cramps
      • Insensitivity to temperature
      • Loss of balance
      • Loss of coordination
      • Numbness
      • Sharp pains
      • Tingling and burning sensation
    • People often report that these symptoms worsen at night and they feel pain in the feet, arms, legs, and toes. Since the muscles in the limbs are affected, there are chances that it might affect the way these people walk.
    • A lot of times, patients develop foot deformities or their mid foot collapses. They also report that sores and blisters appear on their body and sometimes they suffer from infections. It is important to treat the issues on time or else it can lead to amputation.
  2. Proximal Neuropathy
    • Proximal Neuropathy is also referred to as diabetic amyotrophy.
    • This is the second most common type of neuropathy and generally affects elderly people that have diabetes.
    • Since the word ‘myo’ refers to muscle, this is a form of neuropathy that deals with muscle weakness and muscles in hips, legs, as well as the buttocks.
    • Sometimes, people with proximal neuropathy also experience nerve pain, especially the kind that shoots down from spine towards the leg. This is the kind of pain that is commonly referred to as sciatica, described as a shooting pain, and is also known as polyradiculopathy-diabetic amyotrophy.

How Is Diabetic Neuropathy Diagnosed?

  • Most of the times doctors diagnose it through a physical exam, based on the symptoms and checks the following things during the exam:
    • Blood pressure
    • Heart rate
    • Muscle strength
    • Reflexes
    • Sensitivity to position changes, temperature, and touch
    • Foot exams
      • A lot of experts resort to foot exams and encourage the people to go for a yearly examination so that they can get their peripheral neuropathy checked.
      • The doctor does a comprehensive foot exam and looks at the sensation of the foot, muscles, bones, condition of the skin, and the circulation of blood.
      • People that can’t feel any pressure when the nylon monofilament is applied are at a risk of developing foot sores.
      • The doctors also assess the temperature sensitivity of the feet by applying a tuning fork.
    • Other tests
      • Using electromyography

How is Diabetic Neuropathy to be treated?

  • The first step is to make sure that the blood glucose levels come to the normal range. This can be done by monitoring the levels, taking medicines, getting insulin, planning meals, and with the help of light exercise12. By controlling the blood glucose level, you would be stopping the onset of other symptoms as well.
  • Anticonvulsants
  • Opioids and opioidlike drugs
  • Other types of antidepressants
  • Tricyclic antidepressant
  • Duloxetine
  • Pregabalin

Things you did not know about diabetic neuropathy

  • There are more than 20 million people that suffer from peripheral neuropathy but not all of them have diabetes.
  • Burning sensations in the feet can be treated with topical creams or by soaking feet in ice cold water for 15 minutes before going to bed.
  • Diabetic nerve pain can be controlled if you pair up with your doctor to find out the treatment plan that works for you.
  • Diabetic neuropathy can affect the sensory motor nervous system as well as autonomic nervous system. It can also affect organs including kidney, lungs, stomach, and the heart.
  • Good nutrition is extremely important especially vitamin supplements as they help in overcoming the symptoms.
  • To maintain the flexibility and the strength of the muscle exercise is important. However, intense exercises are not recommended as they may increase the pain in the muscles.
  • It is seen that serotonin helps in reducing main so some of the things that can be tried include biofeedback and massages.
  • Neuropathic pain is a result of affected nerves that send faulty signals to the brain. This type of pain is generally controlled in the patients with the help of anticonvulsants and anti-depressants. In some of the severe cases, a combination of both may also be used.
  • There are special shoes and socks that are made for diabetic patients, which help in alleviating the symptoms as it allows the blood to flow freely.
  • Neuropathy is basically a nerve disorder that is caused by abnormalities that are similar to diabetes like high blood glucose.
  • Foot care is important to people who have diabetic neuropathy need to examine their foot on a daily basis.
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