Diabetes Neuropathy

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DIABETIC NEUROPATHY

Diabetic neuropathy refers to nerve disorders associated with diabetes.  About 60 to 70% of people with diabetes have some form of nerve problems.  Nerve problems due to diabetes can occur in every organ including digestive tract, heart and sex organs.  People with diabetes can develop neuropathies at any time but the risk rises with age and longer duration of diabetes.

WHAT CAUSES DIABETIC NEUROPATHY

Diabetic neuropathy seems to be related to blood sugar level being too high for too long leading to nerve damage.  Nerve damage is likely due to the following factors:

  • Metabolic factors—high blood glucose levels, high blood fat levels and low levels of insulin.
  • Damage to blood vessels that carry oxygen and nutrients to nerves.
  • Inflammation of nerves.
  • Mechanical injury to nerves.
  • Lifestyle factors like alcohol and smoking.

TYPES OF DIABETIC NEUROPATHIES

Depending on the type of nerve that is affected diabetic neuropathies are of following types:

  1. Peripheral neuropathy: This type of neuropathy occurs due to nerve damage in the arms and legs so peripheral neuropathy affects arms, legs, feet, toes, hands and arms.  Symptoms of peripheral neuropathy include:
  • Numbness or insensitivity to pain or temperature
  • Tingling, burning or prickling sensation
  • Sharp pains or cramps
  • Extreme sensitivity to even light touch
  • Loss of balance and coordination
  • Muscle weakness, loss of reflexes, hammer toe and collapse of midfoot.

If foot infections are not treated on time amputation may be needed.

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  1. Autonomic neuropathy: This type of neuropathy affects nerves that control heart, blood vessels, digestive system, urinary system, eyes, sweat glands, lungs and sex organs. Some symptoms associated with autonomic neuropathy are:
  • Hypoglycemia unawareness: Symptoms associated with hypoglycemia (like sweating, palpitations and shakiness) go undetected.
  • Heart and blood vessels: When nerves controlling the cardiovascular system are damaged body’s ability to control blood pressure and heart rate are affected.
  • Digestive system: Nerve damage to digestive system causes gastroparesis (slow emptying of stomach).  This in turn leads to several other problems like nausea, vomiting, constipation, bloating etc.,

Nerve damage to oesophagus causes difficulty swallowing.  Nerve damage to bowel causes constipation that alternates with diarrhoea especially at night time.

  • Urinary tract and sex organs: Damage to nerves of bladder and kidney lead to urinary incontinence (failure to sense that bladder is full or failure to control muscles that release urine) or increased urinary tract infections.

Autonomic neuropathy affects sex.  Men may not have erections or reach climax without ejaculating properly.  Women may have difficulty with orgasm, lubrication or arousal.

  • Sweat glands: Autonomic neuropathy may affect the nerves that control sweat glands causing profuse sweating at night or while eating.
  • Eyes: Autonomic neuropathy affects pupils of eye making them less responsive to changes in light.  Such people may not be able to see well when light is turned on in a dark room.
  1. Proximal neuropathy: This type of neuropathy starts with pain in thighs, buttocks, hips or legs especially on one side of the body.  It causes weakness in legs and inability to go from a sitting to standing position without help.
  2. Focal neuropathy: Focal neuropathy occurs suddenly and affects specific nerves in head, torso or leg. It may cause the following:
  • Inability to focus the eye
  • Double vision
  • Pain behind one eye
  • Bell’s Palsy (paralysis on one side of the face)
  • Severe pain in lower back or pelvis
  • Pain in front of thigh
  • Pain in front of chest, stomach or side
  • Pain on outside of shin or inside of foot
  • Chest or abdominal pain
  1. Other types of nerve damage: People with diabetes can also have other nerve-related conditions such as nerve compressions or entrapment syndromes like Carpal tunnel syndrome.

So if you think if you have any nerve problem, consult with your doctor, so he can find the cause.

REFERENCES

 

 

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