Diabetes is the most common cause of neuropathy. Therefore, diabetic neuropathy is a form of nerve damage or dysfunction that can occur in anyone who suffers from type I or type II diabetes. It is a crucial complication of diabetes that may affect as many as 50% of the population of diabetic patients. When the nerve cells called neurons get destroyed, this disrupts the commutation of neurons between each other and the brain. Neuropathy may affect one nerve or more than one nerve of the same type, a combination of nerves in a specific area, or many peripheral nerves throughout the body. These can be symmetrical (affecting either hands or feet) or asymmetrical (affecting only one hand or one foot).
This article will guide you about the different types of diabetic neuropathies, their causes and symptoms, and treatments and diagnosis.
Types and Symptoms of Diabetic Neuropathy
There are four main types of diabetic neuropathy. Depending on the kind, diabetic neuropathy treatments and symptoms may vary. In rare cases, you can have more than one type of diabetic neuropathy at the same time. The most frequently described symptoms of diabetic neuropathy are numbness and tingling (pins and needles) in a specific body part to problems with your digestive system, urinary tract, and heart. Some patients only have minor signs and symptoms. While on the other hand, diabetic neuropathy may be very debilitating and disabling for others. The symptoms either take time to develop- over months or even years- or develop more quickly or continue to get worse. There are over 100 types of neuropathies, and each type can develop differently with its prognosis.
It is the most common type of diabetic neuropathy and is also known as distal symmetric peripheral neuropathy. Peripheral neuropathy is a type of damage to the nerves within the peripheral nervous system.
Your peripheral nervous system is the network of nerves outside your brain and spinal cord. Its primary role is to connect the brain and the spinal cord to the rest of the body. The peripheral nerves are like the cables that link the various parts of a computer together. To make its study easier, doctors classify the nerve signals into the following categories:
- Motor neuropathy. The type of damage to the nerves that are responsible for controlling muscles and body movements. Numbness and muscle weakness are due to motor nerve damage.
- Sensory neuropathy. It affects the sensory nerves that carry messages from your five senses (sight, hearing, smell, taste, touch) to the brain. Damage of the sensory nerve causes extreme sensitivity to touch — even the weight of a bedsheet can feel heavy for some people or loss of balance that results in falling.
- Combination neuropathies. This type of nerve damage results in 2 or 3 types of neuropathies occurring together. Such as sensory-motor neuropathy.
The kinds of symptoms you feel depend on the type of nerve that is damaged. It first has an impact on the feet and legs, followed by the hands and arms. This kind of neuropathy is commonly known as “glove and stocking” because it involves not being able to feel things in your feet and hands. Other signs and symptoms of peripheral neuropathy may include:
- Sharp pain
- Burning sensation or tingling (pins and needles) in the affected area
- Developing foot disease, such as ulcers
- Pain in the bone and joint, especially at night
Autonomic Nerve neuropathy
Damage to these nerves can be a life-and-death situation as it controls involuntary functions, such as breathing and heartbeat.
It results in:
- Loss of bladder control
- Low blood pressure
- An abnormal heart rate that causes dizziness
- Excessive or decreased sweating
- Bloating or nausea
- Although it is rare, some people develop problems eating or swallowing if the damage leads to the nerves that control the esophagus.
- Decreased sexual response
This neuropathic type is also known as amyotrophic diabetes, being more common in men above the age of 50 than in women. It affects nerves in the hips, thighs, or legs. It may also affect the abdominal and chest region. Nerve damage of this kind usually impacts one side of the body and only rarely spreads to the other side.
These symptoms include:
- Sharp pain in the hip or thigh area
- Trouble getting up after being seated
- Shrinking muscles
- Severe stomach aches
It’s a condition in which there’s damage to only a single nerve or nerve group. Mono-neuropathy can be either cranial (focal neuropathy) or peripheral, impacting any part of the body.
It may lead to:
- Trouble focusing or double vision.
- Eye pain.
- Temporary weakness or paralysis of muscles on one side of the face.
- Weakness in your hand can lead you to drop objects.
Although the exact cause for some neuropathies is unknown. Researchers believe that high blood sugar being out of control can damage nerves and interfere in the central nervous system and the peripheral nervous system. High sugar also weakens the capillary walls responsible for a sufficient amount of oxygen and nutrients supply to the nerves.
Other risk factors are likely to do damage your nerves:
- Physical injury (trauma)
Injury from automobile accidents, falls, sports, and medical procedures can stretch, crush, or compress nerves or detach the nerves from the spinal cord.
- Kidney disease
A damaged kidney sends toxins into the blood that can lead to nerve damage.
A body mass index (BMI) of 25 or above may increase the risk of diabetic neuropathy.
- Smoking and alcohol consumption
Smoking shrinks down your arteries, limiting blood flow to any of your four limbs.
- Inherited disorder
- Carpal tunnel syndrome
A common cause for mono-neuropathy.
- Sufficient amount of vitamins
Proper vitamin levels E, B1, B6, B12, and niacin are significant for healthy nerve function.
Treatment and diagnostics
How is neuropathy diagnosed?
- History and physical exam:
Firstly, your doctor will conduct a thorough physical exam asking questions about symptoms and triggers. He may ask about a family history of neurological diseases.
- Blood tests:
Along with the practical exam, your doctor may perform specific tests to diagnose diabetic neuropathy, such as:
- Monofilament test
- MRI (Magnetic resonance imaging)
- Needle electromyography (EMG) and nerve conduction studies
- Tissue biopsies
Some cases of diabetic neuropathy can be easily cured with time, while others don’t have specific treatment options. Although, you can prevent further complications by a few common treatments include managing your blood sugar, foot care, and several medications. Treatment for peripheral neuropathy may include Pain-relieving prescriptions such as anti-seizure drugs and antidepressants.
Likewise, changing lifestyle and improving home remedies can help you control the risk of diabetic neuropathy.
- Keeping your blood under control
- Eat a healthy and balanced diet of fruits and vegetables with whole grains.
- Avoid fats
- Daily exercise. Exercising every day improves blood flow. You may get advice from your doctor before any alternative physical therapy.
- Apply medicated creams, especially for preventing burning sensation.
- Abstaining from excessive alcohol consumption can help stop neuropathy from progressing.
- Frequently visit car accidental clinic.
- In exceptional cases, surgeries may take place.
Living with such dysfunction can be frustrating to cope with. Support groups can encourage and give moral support through a difficult period.