Diabetic neuropathy

Overview

Diabetic neuropathy is a form of nerve injury that affects people with diabetes which occurs if a patient has uncontrolled blood sugar levels over an extended period of time. As a result of high blood sugar, the nerves in the legs and feet are most frequently damaged by diabetic neuropathy, although it could also cause injury to the nerves throughout the body.

Diabetic neuropathy symptoms might include discomfort, numbness, and weakness in the hands, feet, and legs depending on which nerves are affected. Additionally, it may result in issues with the heart, blood vessels, digestive system, and urinary tract. Mild symptoms are present in some people. However, for some people, diabetic neuropathy can be quite painful and incapacitating.

Mostly half of the population with diabetes could develop diabetic neuropathy if left untreated. With persistent blood sugar control and a healthy lifestyle, patients could avoid diabetic neuropathy or reduce its progression.

Numerous nerves in the body can be damaged from diabetic neuropathy. The following type of diabetic neuropathy includes:

• Peripheral neuropathy: Also know as distal symmetric peripheral neuropathy, is when the nerves that are away from the brain and spinal cord become injured or damaged. Peripheral neuropathy usually affect nerves in periphery such as the legs, feet, hands and the arms.
• Autonomic neuropathy: is the damage to the autonomic nervous system, which is caused by diabetes, autonomic nervous system controls involuntary body function such as blood pressure, heart rate, sweating, eyes, digestion and sex organs.
• Mononeuropathy: Also known as focal neuropathy, is nerve injury that occurs to a single peripheral nerve which can include face, torso, arm or legs.
• Proximal neuropathy: Also known as diabetic polyradiculopathy, is nerve damage that often occurs in thighs, hip, buttocks or legs.

Symptoms

Diabetic neuropathy symptoms may vary depending on the type of diabetes and the nerves affected. Symptoms typically appear over time and may not show any signs until it is significantly damaged.

• Peripheral neuropathy: symptoms and signs, which can include the following:
  • Loss of sensation for temperature changes or numbness
  • Tingling or burning feeling
  • Sharp pains or cramps
  • Muscle weakness
  • Sensitivity to touch
  • Foot issues such bone and joint deterioration, infections, and ulcers
• Autonomic neuropathy symptoms and signs, which can include the following:
  • Orthostatic hypotension (drop in blood pressure after standing from sitting or lying down).
  • Gastroparesis, which is a slow emptying of the stomach and can result in nausea, vomiting, a feeling of fullness, and appetite loss
  • Diarrhea or constipation
  • Difficulty in swallowing
  • Excessive sweating
  • Vaginal dryness or erectile dysfunction.
• Mononeuropathy:
  • Paralysis on one side of the face
  • Double vision
  • Numbness or tingling in the hand or fingers
  • Hand weakness that could lead to dropped objects
  • Foot weakness
  • Leg discomfort in the front of the thigh
• Proximal neuropathy:
  • Severe hip, thigh, or buttock pain
  • Getting smaller and weakening thigh muscles
  • Chest or abdominal wall pain
  • Difficulty to stand up

Seek medical help if the patient is experiencing the signs and symptoms, especially if the patient has a wound or cut at the foot that is infected and does not heal.

It is highly recommended that the patient should undergo screening for diabetic neuropathy if the patient is diagnosed with diabetes, particularly type 2 diabetes, and at least five years of type 1 diabetes.

Causes

The cause of every type of diabetic neuropathy is unknown. Uncontrolled diabetes can result in hyperglycemia (high blood sugar). Elevated blood sugar levels over time can harm the nerves. Additionally, high blood sugar levels might harm the blood arteries that supply the nerves with oxygen and nutrients.

Risk factors

Neuropathy can happen to anyone who has diabetes. But the likelihood of nerve injury is increased by these risk factors:

• History: Long period of diabetes and uncontrolled blood sugar.
• Uncontrolled blood sugar: Uncontrolled blood sugar level increases the risk of nerve damage.
• High BMI: Body mass index (BMI) of 25 or higher are likely to have nerve injury.
• Smoking: Smoking causes the arteries to constrict and harden, which reduces blood flow to the limb. This harms the peripheral nerves and makes it more difficult for wounds to heal.
• Kidney disease: The kidneys might become damaged by diabetes. Toxins enter the bloodstream when the kidneys are damaged, which can cause nerve injury.