What is Diabetic Neuropathy?
Diabetic Neuropathy is a very serious complication of Type One or Type Two Diabetes due to lack the of good blood sugar control. Diabetic neuropathy is nerve damage in various parts. It occurs mostly in the feet or legs in Diabetics. While it happens over a long period of time, it does produce noticeable symptoms and other kinds of serious complications.
Types of Diabetic Neuropathy
There are several types of Neuropathy. These include Peripheral, Autonomic, Proximal and Focal. In Diabetics, Peripheral Neuropathy is most common. However, Diabetics are still susceptible to the other types of Neuropathy.
- Peripheral (Feet or legs – Most common for Diabetics)
- Autonomic (Nervous System)
- Proximal (Mostly found in men 50+ years of age)
What is Peripheral Neuropathy?
As mentioned above, this type of Neuropathy is the most common in Diabetics. It normally occurs in a person’s feet or legs, but also can show up in their hands or arms. With Peripheral Neuropathy, Diabetics can experience the following symptoms in those extremities:
- A tingling or burning sensation
- Extreme sensitivity to touch
- Unable to sense hot or cold temperatures
- Sharp pains or cramps
- Weakened muscles
- Lack of coordination
- Trouble balancing
- Poor circulation
If not treated, this type of diabetic neuropathy can cause serious infections, which unfortunately, can lead to a foot or other limb being amputated.
What is Autonomic Neuropathy?
Autonomic Neuropathy is also fairly common. It includes a person’s nervous system and controls a lot of the body’s organs or muscles. It can create problems with a person’s:
It can cause things like constipation, diarrhea, gastroparesis, problems swallowing, delayed digestion (which causes problems with blood sugar control), or hypoglycemia or low blood sugar problems.
Sex organs: It can cause erectile dysfunction, vaginal dryness, or inability to have an orgasm.
Bladder: Incontinence or inability to empty bladder
Heart: Causes palpitations, drops in blood pressure, dizziness, fast heartrate
What is Proximal Neuropathy?
This is the rarest type of neuropathy and is also called Diabetic Amyotrophy. It usually happens in people over 50 years old, and more so in men than women.
Symptoms can include:
- Severe pain in hips, buttocks or thighs
- Weak leg muscles
- Only affects one side of the body
What is Focal Neuropathy?
Focal Neuropathy, which is also called Mononeuropathy, is when a specific group of nerves are targeted. Usually this happens to the hands, head, legs or torso. It is quite painful.
Symptoms can include:
- Feeling pain, numbness, and tingling in the fingers
- Troubles focusing
- Double vision
- Pain behind the eyes
- Bell’s Palsy
- Pain in thigsh, pelvic area, abdomen, chest, back, inside of the feet, outside of lower legs, or big toe weakness
Causes of Diabetic Neuropathy
What causes Diabetic Neuropathy?
Diabetic Neuropathy has several possible causes, with the main reason being: poor blood sugar control. There are other causes that may be associated with Diabetic Neuropathy or Neuropahty in general. The following is a list of other causes that may be associated with Neuroapthy:
- High cholesterol
- Damaged blood vessels
- Mechanical injuries (i.e. Carpal Tunnel Syndrome)
- Lifestyle (i.e. smoking, alcohol)
- Low B-12
Other Common Diabetic Neuropathy Symptoms
What are other Diabetic Neuropathy Symptoms?
Besides those mentioned, there are a few other common symptoms to look out for if you are a Diabetic.
- Getting cold easily
- Pins and needle feelings
- Sharp and/or deep stabbing feeling
- Worse symptoms at night for any of the above or previously listed symptoms
Other Diagnoses that can lead to Neuropathy
Besides having some type of diabetes, other reasons someone could develop diabetic neuropathy include:
- Obesity (Being overweight)
- High blood pressure
- High cholesterol
- Kidney disease
Diagnosing Diabetic Neuropathy
How is a Diabetic diagnosed with Diabetic Neuroapthy?
Doctors test for diabetic neuropathy in several different ways. This includes checking sensitivity to cold, heat, and touch, as well as checking a person’s heart rate. But doctors don’t stop there. They also check blood pressure and their muscle tone. Let’s not forget the most affected parts of the body. Which would be the feet, ankles and legs. The doctor will check to see if they have lost any sensation. This includes, but not limited to, poking the patient’s feet while having them close their eyes and saying when they feel a poke or not.
Doctors will also check a person’s reflexes in their tendons. There are special tests, such as the filament test, which is when they run a nylon fiber over the skin to see if the patient can feel it or not. Or they may see how your nerves react to vibration and temperature change, or a nerve conduction study, which is where they see how fast the nerves in the arms or legs react and conduct electrical signals. Another kind of test is an EMG (Electromyogram), which measures electrical discharges of the muscles. Another is, Autonomic testing, which determines if a person sweats in a normal fashion or if their blood pressure reacts poorly when standing or lying down.
Treatment for Diabetic Neuropathy
How to treat Diabetic Neuropathy?
Sadly, there is no cure for diabetic neuropathy, however there are many ways to help treat and manage it. Endocronologists can help with the best treatment and management options. Such as prescription medicines or CGM’s (Continual Gluecose Monitor) to help control blood sugar levels. All these can help with the pain and slow down the progression of future complications.
Foremost, you must have proper blood sugar control. Blood sugar levels should be 80 to 150 mg/dl prior to eating a meal, and lower than 180 two hours later. You should also try to control your blood pressure and if needed, take blood pressure medication. Plus, if you are overweight you should try to lose weight.
Pain relief for diabetic neuropathy
There are several pain medications used for neuropathy pain. These include:
Anti-seizure medications like Lyrica, gabapentin, and carbamazepine
Antidepressants (they disrupt a chemical reaction that causes pain) like amitriptyline, desipramine, or imipramine, which are all tricyclics. Or another class of antidepressants is sometimes taken, to include serotonin and norepinephrine reuptake inhibitors (SSNRs) like Cymbalta or Effexor XR.
Lifestyle changes and home therapies
There are also things you can do at home or via lifestyle changes such as:
Control your blood pressure (sometimes via medication and periodic testing)
Eat healthy foods like fruits, veggies and whole grains
Maintain a normal weight
Be active and exercise regularly
Don’t smoke or stop smoking
Plus some alternative medical therapies include:
Alpha lipoic acid
TENS machine treatment
The bottom line is that diabetic neuropathy occurs in people with either type 1 or type 2 diabetes and it can cause major complications if not treated and monitored, and if you don’t take care of your blood sugar levels, along with other issues such as being overweight and having high blood pressure or high cholesterol levels. See you doctor if you suspect you have diabetic neuropathy.