Diabetic neuropathy is frequently a complication of diabetes. In diabetic neuropathy, nerves are damaged due to high levels of blood sugar (glucose) which is also known as hyperglycemia.
What causes diabetic neuropathy?
People having diabetes often develop continuous damage to nerve tissues. Nerve injuries result from high levels of glucose and decreased blood flow. Diabetic neuropathy is more likely to spread to different areas of the body if blood glucose levels aren’t well controlled.
Some people having diabetes won’t ever have nerve damage, whereas others may suffer greatly from the effects of diabetic neuropathy. Generally, symptoms start after 10 -20 years of the diabetes diagnosis. Around 50 percent of people having diabetes will sooner or later develop nerve damage. Secondary nerve injuries can affect the cranial and spinal nerves. Diabetic neuropathy is likely to develop in different stages. You might notice your feet hurt more than usual, or that the pain creeps up your legs and hips. Diabetics often have another type of neuropathy, called autonomic neuropathy.
Autonomic neuropathies influence nerves which regulate crucial functions including smooth muscles of the heart, lungs, and blood vessels. An individual with autonomic neuropathy may have problems with sexual response, respiratory function, digestion, and bowel and bladder function.
What are the symptoms of diabetic neuropathy?
The symptoms of diabetic neuropathy include:
Burning or tingling sensation in extremities
Pain in the arms, legs and feet
Difficulty in swallowing
Loss of bowel and bladder control
Loss of sense for cold or warm
Nausea and vomiting
Orthostatic hypotension (low B/P when getting up from lying position)
Numbness in the arms, hands, legs and feet
Rapid heart rate
Vision changes and eye weakness
The symptoms may differ from one person to the next according to the nerves affected in each person. The symptoms may also include symptoms other than the listed ones. These symptoms generally develop slowly over the years.
How is diabetic neuropathy diagnosed?
Physical examinations, eye examinations for vision changes and certain tests to evaluate the nervous system can help the doctor to diagnose neuropathies. An eye doctor is sometimes the first to notice that an individual is diabetic. A common test for diabetic neuropathy is to check one’s reflexes. A lack of ankle reflexes may be a sign of early diabetic neuropathy. Doctors regularly test for sensation loss in feet with brush-like device called a monofilament. Electro-diagnostic testing can also be done to test your neurosensitivity.
What are the possible complications of diabetic neuropathy?
Here are some possible complications for diabetic neuropathy:
Feet injury due to loss of feeling
Soft tissue and skin breakdown
Nausea and vomiting
Lack of controlled blood glucose due to n/v
Angina (heart pain could lead to heart attack) from autonomic neuropathy
What are the treatment options for diabetic neuropathy?
The goals for treating diabetic neuropathy are to prevent the diabetes from getting worse and to decrease the symptoms of diabetes, which also includes decreasing the pain and numbness of diabetic neuropathy. Strict control over blood sugar is very important in trying to avoid these symptoms; however, oftentimes, neuropathies get worse whether the diabetes in under control or not. Medications can be prescribed to help decrease the symptoms of neuropathies of the extremities and the rest of the body. The medications include:
Drugs may also be given to block bladder spasms and for nausea and vomiting. Analgesics may be prescribed temporarily for pain and discomfort as needed. An antibiotic may be given as needed to prevent chronic urinary tract infections. Capsaicin may be used to decrease pain from diabetic neuropathy.
It is important to see your medical doctor or podiatrist for regular foot exams. If you are diabetic, it is important that you don’t try to cut your own toenails – especially if you have neuropathy in your feet. You would not be able to feel if you happen to cut yourself or cause some sort of injury to your feet and toes.
Author’s note: My mother was a type 2 diabetic. She had diabetic neuropathy in her feet and legs. She had painful calluses come up on the soles of her feet. Her doctor instructed her to use a razor blade to work at her calluses. It didn’t take long when my mother kept complaining of pain and she said something smelled really bad. She had no idea that it was her own feet that were stinking. She developed gangrene in her feet. I believe that cutting away at the calluses created an avenue for the infection to start. Had the doctor sent her to a foot doctor, he/she might have suggested leaving them alone. She might have lived longer if she hadn’t taken his advice and worked on her own feet.