What is Diabetic Neuropathy?
What is diabetic neuropathy?
Diabetic neuropathy is a nerve disease caused by diabetes. Over time diabetics can get nerve damage in different parts of their body. Some people with nerve damage do not have any symptoms. Others feel pain, tingling or lose feeling in their hands, arms, legs, and feet. Diabetic neuropathy can also affect other parts of the body like digestive organs, the heart, and sex organs.
Almost three quarters of people with diabetes have some form of neuropathy. Diabetics can have problems with neuropathy at any time, but the longer they have diabetes the higher the risk for nerve damage. People with uncontrolled blood sugar, high blood pressure, high levels of fat in their blood, and those who are overweight also have a higher risk of neuropathy.
What are the types of diabetic neuropathy?
There are four types of diabetic neuropathy:
Peripheral: This is the most common type of diabetic neuropathy and causes pain or loss of feeling in the toes, feet, legs, hands, and arms. It usually starts in the toes and moves upwards to the feet and legs with time. It affects the hands and arms in very severe cases.
Autonomic: Affects digestion, bowel and bladder function, sexual response, and sweating. Autonomic neuropathy can also cause problems with your heart, blood pressure and the nerves in your lungs and eyes. Problems with the stomach and bowel are common.
Proximal: Causes pain in the thighs, hips, or buttocks and leads to weakness in the legs.
Focal: Causes sudden nerve problems that lead to muscle weakness or pain. Focal neuropathy can affect any nerve in the body.
What causes diabetic neuropathies?
The most important factor is uncontrolled high glucose, which damages the nerves, and the vessels that supply blood and nutrients to the nerves.
What are the symptoms of diabetic neuropathies?
The symptoms of diabetic neuropathy depend on the type of neuropathy and the nerves that are damaged. Although some people do not feel any symptoms at all for other symptoms start small at first and become severe over time.
Symptoms of nerve damage may include:
- • numbness, tingling, or pain in the toes, feet, legs, hands, arms, and fingers. The first parts to be usually affected are the toes and feet.
- • wasting of the muscles of the feet or hands
- • indigestion, nausea, or vomiting
- • diarrhea or constipation
- • dizziness or faintness because of low blood pressure after standing or sitting up
- • problems urinating
- • erectile dysfunction in men or vaginal dryness in women
- • weakness
Aside from these symptoms of neuropathy, other related symptoms are weight loss and depression.
How are diabetic neuropathies diagnosed?
Your doctor will diagnose diabetic neuropathies by looking at your symptoms and doing a physical exam. Your doctor may check your blood pressure, heart rate, and the strength of your muscles. They may also check for nerve damage by looking at your reflexes and how sensitive you are to changes in positions, touch, vibration, and temperature. Your doctor should also do a comprehensive foot check each year to check for peripheral neuropathy. If you are diagnosed with peripheral neuropathy you may need a foot check more frequently.
How are diabetic neuropathies treated?
The most important step is to keep your blood sugar levels normal to prevent any more nerve damage. You will need to have a diabetes management plan that includes checking your blood sugar, planning healthy meals, including physical activity and taking any medication you may need to keep your blood sugar under control. The symptoms of neuropathy may get worse when you are first trying to control your blood sugar, but with time the symptoms will get better.
Other treatments depend on the symptoms:
- • Pain: Oral medicines to relieve pain
- • Digestive problems: Eating small, frequent meals with less fat and fiber to help mild symptoms of indigestion, belching, nausea, or vomiting. If symptoms are severe then some medication may be needed.
- • Dizziness and weakness: Sitting or standing up slowly may help with blood pressure problems that cause dizziness and weakness. You may also need to make changes to your diet to include more salt, take medicines to help retain salt or to lower blood pressure, and maybe even have physical therapy to help with the weakness.
- • Urinary problems: For urinary tract infections, because of problems urinating, your doctor will likely need to give you an antibiotic. Making sure to drink enough liquids that can help prevent future infections. If you are having problems with accidental urination, making sure to urinate frequently may help if you cannot feel when your bladder is full.
- • Erectile dysfunction in men: After your doctor checks that the cause of the erectile dysfunction is not due to hormones, they may suggest medication or certain devices to help increase the blood flow to the penis and maintain an erection.
- • Vaginal dryness: Lubricants may help women who suffer from neuropathy that causes vaginal dryness. A gynecologist may be able to help with issues of arousal and orgasm.
- • Foot care: It is very important for diabetics with neuropathy to take care of their feet. If you have lost feeling in your feet you can often miss injuries or wounds. These wounds can become infected and lead to ulcers or gangrene, which is when the area around an infected wound dies. Because diabetes can also cause problems with circulation, the risk for an ulcer or gangrene that could lead to amputation is higher. Smoking can also increase the risk of problems with your feet so quitting smoking is an important step to preventing future problems for diabetics with neuropathy.
Nerve Damage (Diabetic Neuropathies). (2013). National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases.