What is Diabetic Neuropathy?

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Diabetic neuropathy is damage that affects the peripheral nerves of the body.
The damage is specifically to the nerves of the ganglia, outside of the skull, the spinal cord, and some other nerves that aid the body in assisting fundamental organs, such as the heart, bladder, intestines, and stomach.
Diabetic neuropathy refers only to individuals who have diabetes. Different nerves are affected in varying ways. Relatively familiar conditions which may be associated with diabetic neuropathy include:
    • Third Nerve Palsy: When the individual cannot move his eye normally due to damage of a cranial nerve.

 

    • Mononeuropathy: When only a single nerve is affected – the nerve is physically compressed, resulting in a lack of blood supply.

 

    • Amythrophy: Muscle pain due to progressive waste and weakening of muscle tissues.

 

    • Mononeuropathy multiplex: Profound aching soreness regularly felt in the lower back, hips or legs, resulting in sharp loss of sensory function of the nerves. This can slowly develop over a number of years.

 

    • Polyneuropathy: Most commonly, this disorder results in weaker hands and feet, as well as some loss of sensation in the affected areas. Some patients complain of a burning needles-like pain. This disorder occurs when many nerves throughout the body simultaneously malfunction. The patient might step on something that should hurt, but feel nothing. It can appear either without warning or steadily over a long period.

 

    • Autonomic neuropathy: The visceral nerve is affected, which may impact on the heart rate, digestion, respiration, salivation, perspiration, blood vessels, and sexual arousal. This occurs when there is a failure from the heart arteries to adjust heart rate and vascular tone to keep blood flowing continually to the brain. Dizziness or fainting when standing up rapidly is common.

 

  • Sensory motor neuropathy: When sensory nerve loss affects the face; in some cases it may spread to the upper arms.

According to recent studies, approximately half of all diabetes patients develop diabetic neuropathy. However, the signs and symptoms may nor start to show for one or two decades have diagnosis of diabetes. The majority of individuals with diabetic neuropathy symptoms do not realize they are affected until the complications are severe or permanent.

WHAT ARE THE SIGNS AND SYMPTOMS OF DIABETIC NEUROPATHY?

What is the difference between a sign and a symptom? – A sign is something everyone, including the doctor or nurse, can detect, such as a rash or swelling, while a symptoms is something the patients can feel and has to describe for others to know, such as a headache, tingling or dizziness. There are several signs and symptoms associated with diabetic neuropathy – they depend on which nerves are affected, and usually take several years to become noticeable. Below are some of the signs and symptoms associated with diabetic neuropathy:

    • Numbness, electric pain, tingling and (or) burning sensations starting in the extremities and continuing up the legs or arms

 

    • Heartburn and bloating

 

    • Nausea, constipation or diarrhea

 

    • Problems swallowing

 

    • Feeling full when eating small amounts of food

 

    • Throwing up after a few hours of having eaten

 

    • Orthostatic Hypotension (feeling light-headed and dizzy when standing up)

 

    • Faster heart rate than normal

 

    • Chest pains, which sometimes can be a warning of an impending heart attack

 

    • Sweating excessively even when temperature is cool or the individual is at rest

 

    • Bladder problems – difficulty in emptying the bladder completely when going to the toilet, leading to incontinence

 

    • Sexual dysfunction in men

 

    • Sexual problems in women with vaginal dryness and lack of orgasms

 

    • Dysesthesia – the patient’s sense of touch is distorted

 

    • Significant facial and eyelid drooping

 

    • Eyesight may be affected

 

    • Muscle weakness

 

    • Speech impairment

 

  • Muscle contractions.

DIAGNOSING DIABETIC NEUROPATHY

If some of the above-mentioned signs and symptoms are present, the doctor may recommend some diagnostic tests before making a diagnosis. The doctor may order an electromyogram (EMG), which records the electrical activity in the muscles. He/she may also request a Nerve Conduction Velocity test (NCV), which records the speed on which induced signals pass through the nerves. During the physical exam, the doctor will check for:

  • Ankle reflexes
  • Any loss of sensation in the patient’s feet
  • Changes in skin texture
  • Changes in skin color
  • A sudden drop in blood pressure when the patient stands up from lying down.

What are the treatment options for diabetic neuropathy?Although the metabolic causes of diabetic neuropathy are perfectly well understood and documented, treatments for this disorder are still limited. Most of the treatments described below only help in reducing pain and controlling some of the symptoms. Unfortunately, diabetic neuropathy, typically, is progressive – the symptoms get progressively worse over time. Doctors say the best treatment for diabetic neuropathy is to have the diabetes well controlled, this means maintaining blood glucose levels within a healthy range throughout the day. Diabetic neuropathy can be avoided by learning the simple steps on how to manage diabetes. There are a few drug-related options as well as physical therapy for controlling pain caused by diabetic neuropathy.