- Diabetic neuropathy is nerve damage caused by complications of diabetes.
- Uncontrolled high blood sugar levels for a longer time can injure nerves causing nerve damage.
- It often damages the nerves of the legs and feet.
The 4 main types of diabetic neuropathy:
- Peripheral symmetric neuropathy: affects the feet and hands
- Autonomic neuropathy: affects the nerves that control involuntary functions of the body, such as digestion, urination, or heart rate.
- Proximal, neuropathy: This damage the nerves along a specific distribution in the body like the chest wall or legs
- Mononeuropathies: affects any individual nerve
Symptoms:
The most common symptoms of diabetic neuropathy include:
- Numbness or pain in legs
- Tingling, burning sensation, and cramps
- Weakness in the legs
- Changes in the blood pressure
- Bloating (gas), nausea and vomiting
Call your doctor if you notice the below symptoms:
- A cut on your foot that does not heal
- Burning, tingling, weakness, or pain in the hands or feet
- Changes in digestion, urination, or sexual function
- Dizziness
Causes:
The exact cause is not clear; however, it is believed that uncontrolled blood sugar levels damages nerves and disrupts their ability to send the signals, resulting in diabetic neuropathy or nerve damage.
Risk factors:
The below factors increase your risk of diabetes neuropathy:
- Improper blood sugar control: Uncontrolled blood sugar increases your risk of diabetic neuropathy
- History of diabetes: The risk of diabetic neuropathy increases the longer a person diabetic (if blood sugar is not well controlled)
- Kidney disorder: Diabetes can damage the kidneys and piles up the toxins into the blood, which can lead to nerve damage.
- Obesity: A body mass index (BMI) of 25 or more increase the risk of diabetic neuropathy
- Smoking: Smoking narrows the arteries, lowers the blood flow to the legs and feet causing nerve damage
Diagnosis:
A physical exam and foot exam is performed by your doctor to check for:
- Ankle reflexes
- Loss of sensation
- Changes in skin texture
- Changes in skin colour
If your doctor suspects diabetic neuropathy, some more diagnostic tests are ordered such as:
- An electromyogram (EMG), that records electrical activity in the muscles
- A nerve conduction velocity test (NCV) that records the speed at which induced signals pass through the nerves
Treatment:
The first step of treatment is to bring blood sugars within a target range, manage high blood pressure and cholesterol levels.
Managing glucose levels will reduce the risk of diabetic neuropathy.
Certain medications and physical therapy help to control the pain of diabetic neuropathy, alongside other treatments. However, they cannot repair the nerves.
Medications
Medications that can help to manage pain include:
- Anticonvulsant drugs
- Tricyclic antidepressants
- Opioids and nonopioid pain relief medication
- Topical lotions
Complications:
- Loss of toe, feet, or leg
- Urinary tract infections
- Blood pressure changes
- Digestive problems (Constipation or diarrhea)
- Sexual dysfunction
Prevention:
You can reduce the risk of diabetic neuropathy by following these simple measures:
- Maintain your blood pressure below 140/90 mm Hg (or the target range)
- Get enough physical activity
- Maintain ideal weight
- Avoid alcohol
- Stop smoking
- Eat healthy food
- Take medicines as prescribed by your doctor
