Diabetic neuropathy is a medical condition where the nerves are damaged due to a diabetics’ long term elevated blood sugar levels. The longer the person has diabetes, the higher the risk of developing diabetic neuropathy, which affects up to 50% of people with the diabetes.
The exact cause of diabetic neuropathy is still unknown. Researchers suggested that uncontrolled high blood sugar damages nerves and impairs their ability to transmit signals, resulting in this condition. High blood sugar also weakens the walls of the small blood vessels (capillaries) that supply oxygen and nutrients to the nerves.
In some patients, no symptoms occur at the onset of neuropathy. Some people may experience pain, tingling, or numbness in their fingers, hands, arms, legs, and feet. These symptoms may be mild at first and cause no concern until the condition has advanced to a more severe stage. However, the onset of pain in some types of neuropathies can be sudden and severe. Other organs, such as the heart, digestive tract, and sex organs, may be affected by nerve damage.
Types of Diabetic Neuropathy
Peripheral Diabetic Neuropathy
The most common type of diabetic neuropathy is peripheral diabetic neuropathy, which causes pain and numbness in the extremities such as the toes, feet, and hands. Peripheral neuropathy affects one-third to one-half of diabetics.
Autonomic neuropathy affects the autonomic nervous system-regulated systems, such as bowel movement, bladder control, sexual function, and blood pressure. The damage can also cause hypoglycemia to go undetected.
Proximal neuropathy is a rare and debilitating type of nerve damage that affects your hip, buttock, or thigh. The damage usually affects only one side of your body and only rarely spreads to the other. The symptoms gradually improve over months or years.
Damage to a single nerve is referred to as focal neuropathy or mononeuropathy. This type of neuropathy usually appears suddenly and causes pain in the face, leg, or torso. Entrapment syndromes, such as carpal tunnel syndrome, are the most common types of focal neuropathy.
Diabetic neuropathy can be diagnosed through tests and examination for symptoms. Doctors usually start by looking for sores and ulcers on the patients’ feet. Patients may be unaware of them due to their legs being numb by nerve damage. The monofilament test, nerve conduction tests, and electromyography are some of the other tests available.
Treating diabetic neuropathy includes a strict control of blood sugar levels through regular glucose monitoring, adherence to an anti-diabetic diet, physical activity, and blood pressure checks.
Tricyclic antidepressants such as amitriptyline, imipramine, and desipramine, as well as antiseizure medications such as pregabalin, gabapentin, carbamazepine, and lamotrigine, are used to treat diabetic neuropathy. Opioids such as oxycodone and tramadol may be used to treat painful neuropathy.
NIDDK. (2022, August 23). Diabetic Neuropathy. National Institute of Diabetes and Digestive and Kidney Diseases. https://www.niddk.nih.gov/health-information/diabetes/overview/preventing-problems/nerve-damage-diabetic-neuropathies
Mayo Clinic. (2022, April 29). Diabetic neuropathy – Symptoms and causes. https://www.mayoclinic.org/diseases-conditions/diabetic-neuropathy/symptoms-causes/syc-20371580