What Is Diabetic Neuropathy?
Diabetic neuropathy is a common problem that affects as many as 50% of people with diabetes. It can cause a range of symptoms and has some potentially serious complications. So, what is diabetic neuropathy and how does it affect patients? Let’s take a look.
What Is Diabetic Neuropathy?
Neuropathy is a medical term meaning nerve damage. It is especially common in people with type 1 and type 2 diabetes. Diabetic neuropathy can affect any of the nerves, including the sensory nerves, motor nerves, or autonomic nerves. There are four common types of diabetic neuropathy.
Peripheral
This is the most common type of neuropathy, affecting as many as 50% of people with diabetes. It usually affects the nerves of the feet and legs first, but can also impact the hands and arms.
Autonomic
This type of neuropathy affects up to 30% of people with diabetes. It affects the nerves that supply the internal organs such as the bladder, heart and digestive organs. Therefore, it can cause a wide variety of symptoms depending on where it occurs.
Focal
Also known as mononeuropathy, this condition causes damage to a single nerve. One of the most commonly affected nerves is the median nerve in the wrist. Damage to this nerve causes the disorder known as carpal tunnel syndrome. It occurs in up to 25% of diabetics.
Proximal
This type is more unusual. It affects the nerves of the hips, buttocks and thighs.
What Are the Symptoms?
The symptoms depend on the type of nerve damage and where in the body it occurs. Some typical symptoms:
- Stabbing, shooting, or burning pain
- Numbness or tingling
- Insensitivity to touch, heat and cold
- Muscle weakness or wasting
- Loss of coordination
- Difficulty swallowing
- Digestive problems (nausea, vomiting, bloating, etc.)
- Bowel and bladder problems (diarrhea, constipation, urinary incontinence, etc.)
- Sexual dysfunction (vaginal dryness in women or erectile dysfunction in men)
- Increased or decreased sweating
- Rapid or irregular heart rate
- Dizziness when standing up
- Blurred or double vision
This health condition can also make it more difficult to notice when a person has low blood sugar (hypoglycemia). This is potentially dangerous situation as untreated hypoglycemia can lead to unconsciousness and even death. Other serious complications of diabetic neuropathy include foot ulcers, which can lead to gangrene and amputation.
What Causes Diabetic Neuropathy?
When a person’s blood sugar remains too high over a long period, it damages the nerves and blood vessels that supply them. Therefore, the risk of increases with age and the longer someone has diabetes.
Other factors that can contribute to the development:
- Being overweight
- High cholesterol
- High blood pressure
- Kidney or liver disease
- High alcohol consumption
- Smoking
- Vitamin B deficiency
There may also be genetic factors that mean some people are more likely to suffer from diabetic neuropathy than others.
Diabetic Neuropathy Treatment Options
Unfortunately, diabetic neuropathy can be difficult to treat. Neuropathic pain does not respond well to traditional painkillers such as acetaminophen.
Doctors may prescribe stronger painkillers like opioids for diabetic neuropathy. However, these drugs have a long list of side effects and can also be highly addictive. Therefore, they are unsuitable for long term use. There are some other treatments that may be useful for diabetic neuropathy.
Antiseizure Drugs
These medications are designed to treat seizures in patients with epilepsy. However, they may also be beneficial for people with diabetic neuropathy. They slow down signals in the nervous system to relieve symptoms such as pain. Some common examples include pregabalin and gabapentin.
Antidepressants
Tricyclic antidepressants such as amitriptyline may also be helpful for managing neuropathic pain. They work in a similar way to antiseizure drugs, by altering signals in the nervous system.
Capsaicin
Capsaicin is the chemical that makes chili peppers hot. When it is applied to the skin in the form of a cream, it can help to relieve painful neuropathy symptoms.
Other Medications
Doctors may prescribe other medications to manage specific symptoms such as digestive issues, bladder problems, or sexual dysfunction. In some cases, patients will need to take a combination of medicines to get all of their symptoms under control.
Physical Therapy
Physical therapy can help maintain muscle strength and coordination. Certain exercises may also help with some types of neuropathic pain.
Acupuncture and Massage
Some people with diabetic neuropathy find therapies like acupuncture or massage helpful for managing pain and other symptoms.
Diabetic Neuropathy Prevention Methods
The best way to prevent diabetic neuropathy is to keep your blood sugar, blood pressure and cholesterol under control. This is why it is essential that diabetics follow their physician’s instructions carefully with regard to diet, exercise and medication. It is also crucial to conduct regular glucose testing to ensure that the blood sugar stays within a healthy range.
There are critical factors in preventing diabetic neuropathy:
- Eating a healthy, balanced diet
- Eating regular meals and not consuming too much food at once
- Taking diabetic medications on time
- Undertaking regular physical activity
- Keeping alcohol consumption to a minimum
- Not smoking
People who are already affected by diabetic neuropathy should also follow these guidelines to slow the progression of their symptoms. It is possible to reduce the risk of serious complications by performing daily foot checks and regularly testing blood pressure and cholesterol, as well as glucose.