Diabetic neuropathy is a condition where nerve damage occurs in people with diabetes, leading to various symptoms. These can range from pain and numbness in the feet to issues with internal organs like the heart and bladder. The damage is typically associated with prolonged high blood sugar levels. To prevent diabetic neuropathy, it is essential to manage your blood sugar levels effectively with your doctor’s guidance.
What is Diabetic Neuropathy? Diabetic Neuropathy is a nerve damage that occurs by diabetes. Diabetes aka high blood sugar can injure your nerves throughout your body. Diabetic Neuropathy mostly affects the nerves in your legs and feet which can implicate in ways that include numbness and pain in your feet and issues with your digestive system, urinary tract, blood vessels and heart.
Types of Diabetic Neuropathy There are four types of diabetes-related neuropathy: peripheral, autonomic, proximal, and focal.
Neuropathy can sometimes be the first indication of diabetes, with significant nerve damage often developing within the first decade of diagnosis. The risk of neuropathy increases with the duration of diabetes, affecting about half of those with the condition.
Peripheral neuropathy, a common form, primarily impacts the feet and legs but can also affect the hands and arms. Between one-third and one-half of people with diabetes experience this type.
Diabetic polyneuropathy (DPN) involves damage to multiple peripheral sensory and motor nerves, particularly those extending from the spine to the feet. The longest nerves are typically the most affected.
Autonomic neuropathy damages nerves controlling internal organs, leading to issues with heart rate, blood pressure, digestion, bladder function, sexual organs, sweat glands, and eyes. It can also result in hypoglycemia unawareness.
Focal neuropathies affect single nerves, usually in the hand, head, torso, or leg. Common types include entrapment syndromes like carpal tunnel syndrome. Symptoms vary based on the affected nerve, such as chest pain mimicking angina or appendicitis.
Proximal neuropathy is a rare type affecting the hip, buttock, or thigh, usually on one side of the body. It can occasionally spread and typically improves over months or years. This form affects about 1% of type 2 diabetes patients and is more common in older adults, including those with recent or well-controlled diabetes.
Symptoms of Diabetic Neuropathy
There are four types of neuropathies and the most common one is diabetic neuropathy, which may also be called distal symmetric peripheral neuropathy. It affects the legs first and then your arms. The symptoms are often worse at night, and these may include numbness or reduced ability to feel pain or temperature changes. You would also experience
tingling and burning feeling, sharp pains, or cramps, followed up with muscle weakness. You may also experience sensitivity to touch so much so that even a bedsheet weight can be painful. Serious foot issues such as ulcers, infections, bone and joint damage are also possible.
For Autonomic Neuropathy, diabetes can affect the nervous system that controls the blood pressure, heart rate, sweating, eyes, bladder, digestive system, and sex organs. Some symptoms may include a lack of awareness that blood sugar levels are low, blood pressure dropping when you rise from sitting to lying down, bladder and bowel problems, slow stomach emptying, difficulty swallowing, issues with sweating and your eyes having trouble adjusting from light to dark far or near.
When you have Proximal neuropathy (diabetic polyradiculopathy) your symptoms may appear on one side of the body and spread from there, severe pain in the buttock, hip, or thigh, weak and shrinking thigh muscles, difficulty rising from a sitting position chest or abdominal wall pain. Mononeuropathy (focal neuropathy) refers to the damage in a single specific nerve that could cause difficulty focusing or double vision, paralysis on one side of the face, tingling or numbness on your fingers and hands, shaking hands, pain in the shin or foot and thigh.
Causes of Diabetic Neuropathy
The exact cause of diabetic neuropathy is unknown. While researchers have figured out that uncontrolled blood sugar damages nerves and interferes with their abilities to send signals, this leads to diabetic neuropathy. It is said that high blood sugar also weakens the walls of the small blood vessels that supply the nerve with oxygen and nutrients. There are a lot of risk factors that one should be aware of like poor blood sugar control increases the risk of every diabetic complication including nerve damage, diabetes increases the longer the person has it and does not take care of it.
People who have had kidney diseases should also be aware that blood sugar can damage the kidneys as well and damaged kidneys send toxins into the blood vessels which can lead to nerve damage. If you are overweight, you should also be aware as that is a major risk factor along with smoking. There are multiple complications to this condition Hypoglycaemia unawareness, loss of a toe, for or leg, UTIs (Urinary Tract Infections), digestive issues and sexual dysfunction.
Tests and Treatments for Diabetic Neuropathy
Your healthcare worker will check your overall muscle strength and tone, your tendon reflexes, and your sensitivity to touch, pain temperature and vibration. These are what you should expect in a physical examination. Along with this, you should also be ready for Filament testing, which will check your sensitivity, and sensory testing which will see how you are responding to the vibration and temperature. Nerve conducting test that will show how fast your arms and legs respond through electric signals. Electromyography is also called needle testing done with nerve testing to measure the electrical discharge produced in your muscles. And lastly, Autonomic testing will determine your blood pressure change in different positions.
For treatments, consistency is key, you must manage your blood sugar level and maintain a healthy weight with regular exercises. Although there are medications available for nerve pain relief, they may not work for you, so you must speak to your healthcare provider and show side effects. You may also experience urinary issues so you must consult a urologist who will help you treat or prevent those complications along with your digestive problems. You must keep your blood pressure low, make healthy food choices, be active every day and stop smoking. Remember to exercise regularly even if they are not intense workouts, start with whatever you can and progress from there.
Prevention for Diabetic Neuropathy
While it may be incurable, you can most definitely prevent it and manage it by monitoring your blood sugar and taking good care of your feet. Blood sugar management should be your top priority as it can have major consequences. This will give you a chance to live a healthy life as you can adjust your diet and do more physical activity.
According to the American Diabetes Association (ADA) people who have diabetes should get glycated haemoglobin (A1C) tested at least twice a year as it reflects their blood sugar level for the past 2-3 months. Secondly, you must do foot care as things like foot ulcers, soreness and even amputation are common complications of this disease. As it starts from your foot, you should check your feet daily, keep them cleaned and dry, moisturize them, trim your toenails, wear clean, dry socks, and wear appropriate shoes. Often while you are caring for yourself your feet go unnoticed; people do not wear appropriate shoes and that can cause you a lot of issues as well.