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Living with Diabetes
Diabetic Neuropathy: nerve disease
Definition
The nervous system helps to control everything that you do and damage can cause delays or impairment with a wide range of effects. About 60-70% of people with diabetes have mild to severe forms of nervous system damage; with only 5% having painful symptoms. The exact cause of diabetic neuropathy is not known, but researchers believe that the nerve damage is related to increased blood glucose levels that cause chemical changes within the nerves. Diabetic neuropathy may be diffuse (affecting several parts of the body) or focal (affecting a specific nerve or part of the body). Diabetic neuropathy can lead to muscular weakness, loss of feeling or sensation, and loss of autonomic functions such as digestion, bladder control, and sweating.
Classifications of Diabetic Neuropathy
Peripheral Neuropathy: This type of neuropathy primarily affects the limbs, resulting in damage to the nerves of the feet and hands.
Autonomic Neuropathy: This type of neuropathy primarily affects the heart and other internal organs.
Signs and Symptoms
Common symptoms of diffuse peripheral neuropathy include numbness and feelings of tingling or burning, insensitivity to pain, loss of balance and coordination, or extreme sensitivity to touch.
Common symptoms of diffuse autonomic neuropathy include impaired urination and sexual function, bladder infections, stomach disorders such as gastroparesis, nausea and vomiting, fainting spells, and loss of appetite.
Common symptoms of focal autonomic neuropathy include pain in the front of the thigh, severe pain in the lower back, pain in the chest or stomach, double vision, and paralysis on one side of the face.
Tests for Diabetic Neuropathy
Neuropathy is typically diagnosed based on symptoms. Pain assessment is generally the first step. An exam may include screening for sensation loss, nerve conduction studies, EMG, or ultrasounds of the bladder to test functioning capabilities.
Treatment
Treatment of diabetic neuropathy is usually focused on relieving the symptoms associated with the neuropathy, as well as controlling blood glucose levels. Pain medications are generally prescribed to help control pain caused by neuropathy. Early stages can usually be reversed with good glucose control. However, once nerve damage is present, the condition is irreversible and there is no cure.
Prevention
Tight control of blood glucose levels and avoiding smoking and alcohol aid in the prevention of nerve damage.
