Understanding diabetic neuropathy

Nerve damage caused by diabetes is referred to as diabetic neuropathy. Any nerve fibers in the body can be affected, although it’s usually legs and feet where some type of discomfort is felt.

Regardless of what part of the body is affected, all occurrences and forms of diabetic neuropathy appear to be linked to sustained periods of high blood sugar levels. Nerve damage from diabetes cannot be reversed. However, there are steps that can be taken to manage symptoms.

Peripheral neuropathy

Sometimes responsible for nerve pain felt in the back, arms, or abdomen but primarily affecting legs and feet, peripheral neuropathy is the most common form of diabetic neuropathy.

Initially, symptoms may improve when blood sugar levels return to normal. This type of nerve damage can contribute to issues with circulation and may contribute to other foot problems for diabetics. Symptoms related to peripheral neuropathy include:

  • Tingling sensations.
  • Numbness that sometimes becomes permanent.
  • Burning sensations.
  • Sharp pain.
  • Difficulty with balance.
  • Muscle weakness.

Autonomic neuropathy

Diabetic neuropathy in the autonomic nervous system may affect nerves in the intestines, stomach, bladder, sex organs, lungs, eyes, and heart. Some diabetics with this type of nerve damage experience hypoglycemia unawareness – the inability to tell if blood sugar levels are too low.

Some diabetics with autonomic neuropathy may experience stomach and digestive issues and difficulty with sexual functioning, have trouble regulating body temperature, not be able to adjust vision quickly between light and dark environments, and be more susceptible to urinary tract infections with autonomic neuropathy.

Other types of neuropathy

Nerve pain relegated to one side of the hips, thighs, or buttocks may be proximal (radiculoplexus) neuropathy.

Weakness due to weak atrophied muscles felt in the torso, head, or legs is sometimes due to focal neuropathy.

When a single nerve is affected, diabetic neuropathy is referred to as mononeuropathy. If the median nerve in the hand is affected, for instance, carpal tunnel syndrome may develop as a result of damage to this nerve.

Article to aid with understanding diabetic neuropathy
Nerve damage (neuropathy) can be caused by diabetes.

Diagnosis and treatment of diabetic neuropathy

Diagnosis of diabetic neuropathy usually starts with a physical exam and a description of symptoms.

Testing might include a measure of electrical discharges from muscles (electromyography), a determination of sensitivity to touch (filament test), nerve conduction studies, or an assessment of blood pressure in different positions (autonomic testing).

Treatment will depend on the severity of symptoms experienced and the specific nerves affected. Getting blood sugar levels under control is often the first step taken. Additional treatment recommendations may include:

  • Anti-seizure medications and antidepressants.
  • Treatment specific to what area is affected (e.g., dietary changes and medication for digestive issues, anticholinergic medications for UT infections).
  • Physical therapy.
  • Acupuncture, biofeedback, and other complementary therapies such as essential oils.

Maintaining blood sugar control by avoiding spikes and periodic fluctuations in levels is the most effective way to prevent diabetic neuropathy or slow its progress.

This can be accomplished by maintaining a healthy weight, getting regular exercise, and sticking to a diet that includes green, leafy vegetables, bright fruits, and lean proteins.

Any signs of diabetic neuropathy should be reported to your doctor when first noticed to minimize further damage and increase your odds of responding well to treatment.

The American Diabetes Association recommends yearly foot exams for diabetics as a preventive measure.

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