Diabetic Neuropathy.

Neuropathy means pathology of the nerves or nerve damage. Diabetic Neuropathy is  seen in about 70% of   patients who have had diabetes for over 20 yrs. Diabetes Neuropathy   is caused due to reduced blood supply to the nerve or its segment, which occurs due to atherosclerosis, another complication of diabetes. This results in nerve damage and loss of nerve function.

Diabetes and Neuropathy.

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Our other posts on Diabetes.

1)Basic Info and symptoms. 2) Causes. 3) Complications. 4) Diabetic neuropathy. 5)Treatment and Management. 6) Natural remedies. 7) Prevent diabetes.  Diabetes and Hypoglycemia. 9) Diabetes and Cholesterol.

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As explained in   Complications of Diabetes, blood vessels in a diabetic patient get clogged and this results in reduced blood supply to the  particular part,  which  that blood vessel supplies.

Image showing Diabetic Neuropathy.

When the blood vessel supplying blood to a particular nerve or its segment gets clogged, blood supply to that nerve gets drastically reduced or blocked. This results in reduced functioning of that nerve, giving rise to neuropathy. Thus, depending on the site of the nerve, the symptoms present themselves.

Causes of Diabetic Neuropathy.

There are various causes of neuropathy besides diabetic reasons:

1)     Metabolic causes such as long standing diabetes and high levels of fats in the blood.

2)     Vascular causes resulting in damage to the blood vessels   which supply the nerve.

3)     Damage to the nerve itself due to some external factors.

4)     Smoking and Alcohol

5)     In some persons, there is an inherent tendency of nerve weakness

6)     Some autoimmune factors which results in nerve weakness.

Symptoms of Diabetic Neuropathy.

Diabetic Neuropathy is classified   depending on the site of nerve damage. It may be:

1) Peripheral  Diabetic Neuropathy.

2) Autonomous  Diabetic Neuropathy.

3) Proximal  Diabetic Neuropathy.

4) Focal Diabetic Neuropathy.

Therefore, symptoms present themselves accordingly.

What is  Peripheral Diabetic Neuropathy.

This relates in damage to the nerves in the peripheral areas of the body – the hands or the legs – resulting in peripheral neuritis and the symptoms are peripheral.

Peripheral Diabetic Symptoms.

1]    Tingling and numbness in hands or feet.

2]    Muscle  weakness and lost reflexes.

3]    Sensation  to pain,  heat and cold are lost.

4]  Diabetic Foot Neuropathy.  This is diabetic neuropathy in feet. Pain of injuries to the feet are not felt and tend to get  neglected,  resulting in deep ulcers and wounds. Due to reduced blood supply to the affected part, white blood cells do  not reach the wound in the usual manner and auto immune function is greatly reduced . For the same reason, medicine does not reach the site in required dosage. Bacteria multiply fast in this diabetic  glucose rich environment and the infection   increases. It can go deep to the bones as well. Amputation may become  necessary. Treatment should therefore be prompt and aggressive.

What is Autonomous Diabetic Neuropathy.

This type of neuropathy  occurs  when the nerves supplying the central parts in the body are affected, such as the nerves controlling the heart and blood pressure, the blood glucose levels, digestive tract, urinary tract, eyes and the sweat glands.

Symptoms of Autonomous Diabetic Neuropathy.

a) Hypoglycemic unawareness in diabetes occurs as result of glucose controlling mechanism not responding because the concerned  nerve  is affected. Thus symptoms of hypoglycemia like palpitations, sweating, shivering, etc are not recognized and the hypoglycemia is not noticed. Blood sugar levels are not corrected and the conditions  worsens.

b) Heart rate in diabetes stays high and there  is sudden fall in blood pressure on long standing or sitting. The patient may faint. This is a result of nerve to the heart and/or the nerve controlling the blood pressure getting damaged.

c) Digestive tract symptoms in diabetes vary according to the site of nerve damage, as shown below.

• Esophagus nerve damage in diabetes results in difficulty in swallowing
• Stomach nerve damage in diabetes results in a condition called gastroparesis, wherein emptying of stomach is slow and digestion is improper. This causes widely fluctuating blood glucose  levels. There is bloating of stomach, loss of appetite, nausea and vomiting.
• Intestine nerve damage in diabetes results in constipation alternating with severe diarrhea.

d) Urinary tract nerve damage in diabetes  results in a patient not recognizing that the bladder is full and is unable to control the muscles that release the urine. This causes retention of urine in the bladder and the kidneys resulting in infection setting in. The urine is passed without the patient realizing it. This is called urinary incontinence. This diabetic complication is called Diabetic Nephropathy.

e) Sweat glands play an important role in controlling the body temperature. When their nerve gets damaged in diabetes, body temperature is not regulated and there may be profuse sweating at night.

f) Eye nerve damage in diabetes results in improper response by the pupils of the eyes in response to changes in light. The patient may therefore not be able to see well at night or day. This complication of diabetes is called Diabetic Retinopathy.

g) Sex organs: There is diabetic loss of erectile capacity in men, while in a woman, there is decreased arousal, lubrication and   difficulty to have an orgasm. In short: “ In Diabetic neuropathy, though there is a desire, the performance is lost”

What is Proximal Diabetic Neuropathy.

This is also called lumbosacral  diabetic neuropathy  because this diabetic neuropathy affects the lumbosacral region of the back.

Symptoms of Proximal Diabetic Neuropathy.

This diabetic neuropathy causes pain in the hip or the buttock, thigh or the leg. It   normally affects one side of the body. The patient is unable to stand up from the sitting position without support. Pain   killers may to be given along with Bcomplex vitamins. Recovery period depends on the severity of the neuropathy .

What is Focal Diabetic Neuropathy and  its Symptoms.

As the name suggests , it is localized in a particular area such as the face , legs or the torso and causes pain and decreased or loss of function of that part.

How to Prevent Diabetic Neuropathy.

Prevention of Diabetic Neuropathy lies  in controlling the blood sugar  and cholesterol levels and maintaining them within normal limits This is done by regular blood sugar check  ups and proper and regulartreatment, diet and management of diabetes.  Regular follow-ups to your doctor should be maintained.

Treatment of Diabetic Neuropathy.

Treatment is mainly of the diabetes, which is the causative factor of the neuropathy and explained in  Treatment and management of diabetes. However, the neuritis or inflammation of the nerves in diabetic neuropathy has to be treated by fortified B’complex   injections or tablets.

Related posts:

1. Complications of Diabetes.