What is diabetic neuropathy?

Neuropathy No More By JODI KNAPP Neuropathy No More is an eBook which is a compilation of all the essential information and details about the nervous system and how to keep it active and healthy. With the help of this program, one can get a relief from the symptoms of neuropathy. This eBook not only tells you about the nervous system, but also helps to provide essential information to get relief from the condition of neuropathy. It also provides information about how you can prevent this condition from coming back in the near future.

What is diabetic neuropathy?

Diabetic neuropathy is a type of nerve damage that occurs as a complication of diabetes. It is one of the most common complications of both type 1 and type 2 diabetes, affecting the peripheral nerves, which transmit signals between the brain and spinal cord to the rest of the body. Over time, high blood sugar (glucose) levels associated with poorly controlled diabetes can damage these nerves, leading to a variety of symptoms, primarily affecting the legs and feet but sometimes impacting other areas as well.

Types of Diabetic Neuropathy:

Diabetic neuropathy can affect different types of nerves, leading to different forms of the condition. The main types include:

Peripheral Neuropathy (most common):
- Symptoms: Numbness, tingling, burning, or stabbing pain, typically in the feet and legs, and less commonly in the hands and arms. The symptoms often worsen at night.
- Progression: Peripheral neuropathy often starts in the toes or feet and may gradually spread upward. If left untreated, it can lead to loss of sensation and increase the risk of foot injuries, ulcers, and infections, potentially resulting in amputations.
Autonomic Neuropathy:
- Symptoms: This affects the autonomic nerves that control involuntary bodily functions, such as digestion, bladder control, heart rate, and blood pressure. Symptoms may include:
  - Gastrointestinal issues such as constipation, diarrhea, or gastroparesis (delayed stomach emptying).
  - Urinary incontinence or difficulty emptying the bladder.
  - Sexual dysfunction, including erectile dysfunction in men and vaginal dryness in women.
  - Abnormal heart rate or blood pressure regulation, leading to dizziness or fainting when standing up (orthostatic hypotension).
Proximal Neuropathy (Diabetic Amyotrophy):
- Symptoms: This type of neuropathy affects the thighs, hips, buttocks, or legs. It often causes sudden, severe pain in one side of the body, followed by muscle weakness and potential muscle wasting. Unlike peripheral neuropathy, it primarily affects larger nerves and tends to affect older adults with type 2 diabetes.
Focal Neuropathy (Mononeuropathy):
- Symptoms: Focal neuropathy affects a single nerve or group of nerves, often in the head, torso, or legs. It can lead to sudden weakness or pain, such as in the hand, thigh, or foot, or cause vision problems or Bell’s palsy (paralysis on one side of the face).
- Example: Carpal tunnel syndrome is a common form of mononeuropathy in people with diabetes, causing pain or weakness in the hand due to nerve compression in the wrist.

Causes of Diabetic Neuropathy:

Diabetic neuropathy is caused primarily by prolonged high blood sugar levels, which lead to nerve damage in several ways:

Hyperglycemia and Nerve Damage:
- High blood sugar can damage the tiny blood vessels (capillaries) that supply oxygen and nutrients to the nerves, particularly in the extremities. This leads to poor nerve function and, over time, nerve damage.
Inflammation:
- Chronic high blood sugar levels can also trigger inflammation in the nerves and blood vessels, further contributing to nerve damage.
Metabolic Factors:
- Poor control of blood sugar, blood pressure, and cholesterol levels increases the risk of developing diabetic neuropathy by affecting the nerves and blood supply.
Oxidative Stress:
- High glucose levels can lead to the production of free radicals, which cause oxidative stress and damage nerve cells.
Other Risk Factors:
- Long duration of diabetes (the longer someone has diabetes, the higher their risk of developing neuropathy).
- Poorly controlled blood sugar levels over time.
- High cholesterol levels, obesity, and smoking can all increase the risk of nerve damage.

Symptoms of Diabetic Neuropathy:

Symptoms of diabetic neuropathy vary depending on the type of neuropathy and which nerves are affected. Common symptoms include:

Numbness or Reduced Sensation: Particularly in the feet or hands, leading to difficulty feeling pain, temperature, or touch.
Tingling or “Pins and Needles” Sensation: Often in the toes or fingers, this can progress to other parts of the limbs.
Burning or Sharp Pain: This pain may be persistent or intermittent, often worsening at night.
Muscle Weakness: Weakness in the feet, legs, or hands, which can make walking, standing, or fine motor tasks difficult.
Loss of Reflexes: Reduced reflexes, especially in the ankles.
Balance and Coordination Issues: Due to numbness or weakness, leading to increased risk of falls.
Digestive Problems: Such as bloating, nausea, vomiting, diarrhea, or constipation, especially with autonomic neuropathy.
Bladder or Sexual Dysfunction: Urinary issues or difficulty with sexual function due to autonomic nerve involvement.

Complications of Diabetic Neuropathy:

Diabetic neuropathy can lead to serious complications if left untreated, particularly in people with poorly controlled blood sugar:

Foot Ulcers and Infections:
- Loss of sensation in the feet can result in unnoticed injuries or wounds, which can become infected. Poor blood circulation in people with diabetes further complicates healing, increasing the risk of severe infections that can lead to amputations.
Charcot Foot:
- This is a serious complication where the bones, joints, and soft tissues in the foot become weakened, leading to deformities. It is caused by nerve damage that reduces sensation, allowing unnoticed fractures or joint damage to worsen over time.
Amputations:
- Diabetic neuropathy is a leading cause of foot and leg amputations. Untreated foot ulcers or infections, combined with poor blood flow, can necessitate amputation to prevent the spread of infection.
Digestive and Urinary Complications:
- Autonomic neuropathy can lead to chronic gastrointestinal issues, bladder problems, and sexual dysfunction, further affecting quality of life.

Diagnosis of Diabetic Neuropathy:

Diagnosing diabetic neuropathy typically involves a combination of clinical evaluation, medical history, and diagnostic tests:

Physical Examination: To assess muscle strength, reflexes, sensation (touch, vibration, temperature), and balance.
Nerve Conduction Studies: To measure how fast electrical impulses travel through the nerves, helping detect nerve damage.
Electromyography (EMG): To assess the electrical activity in muscles and detect nerve damage.
Blood Tests: To evaluate blood sugar control, vitamin deficiencies (such as B12), and other conditions that can contribute to nerve damage.

Treatment of Diabetic Neuropathy:

While there is no cure for diabetic neuropathy, early intervention and treatment can help manage symptoms, prevent complications, and improve quality of life. Treatment typically focuses on:

Blood Sugar Control:
- Keeping blood sugar levels within a target range is the most important step in preventing or slowing the progression of diabetic neuropathy. Better blood sugar control can reduce symptoms and prevent further nerve damage.
Pain Management:
- Medications: Neuropathic pain can be managed with medications such as:
  - Anticonvulsants (gabapentin, pregabalin).
  - Antidepressants (duloxetine, amitriptyline).
  - Topical treatments like capsaicin cream or lidocaine patches.
- Over-the-counter pain relievers: Though they are often less effective for nerve pain, nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen may help with mild pain.
Lifestyle Modifications:
- Foot Care: Regular foot exams, wearing protective footwear, and practicing good hygiene are crucial to prevent injuries, infections, and complications.
- Exercise: Physical activity can help improve blood flow, muscle strength, and overall nerve function.
- Diet: A balanced diet that supports good blood sugar control can help manage diabetes and reduce the risk of neuropathy.
Medications for Digestive or Autonomic Symptoms:
- Autonomic neuropathy symptoms such as digestive issues or bladder dysfunction may require specific medications, such as prokinetic agents for gastroparesis or drugs to help with urinary control.
Physical Therapy:
- Physical therapy can help improve muscle strength, balance, and coordination, particularly for patients with muscle weakness or mobility issues.

Prevention:

Preventing diabetic neuropathy involves managing diabetes and associated risk factors. Key strategies include:

Maintaining tight blood sugar control.
Regular foot care and monitoring for any signs of injury or infection.
Managing cholesterol, blood pressure, and weight.
Avoiding smoking and excessive alcohol consumption.
Regular check-ups with healthcare providers to monitor for early signs of neuropathy.

Conclusion:

Diabetic neuropathy is a serious complication of diabetes that affects the nerves, primarily in the feet and hands, but can also impact other parts of the body. Proper management of blood sugar levels, early detection, and effective treatment of symptoms can help prevent complications and improve the quality of life for people with diabetic neuropathy.

Jodi Knapp