Diabetes Neuropathy
What is Diabetes Neuropathy?
Neuropathy is a term that is collectively used for nerve damages or diseases. It has been observed that high amount of glucose in the blood may lead to many kinds of nerve diseases. Since, the root cause for such neuropathic diseases is diabetes; the diseases are termed as diabetes neuropathy.
It is believed that these diseases are caused due to diabetic micro-vascular injury that involves small blood vessels. These vessels supply blood to the nerves. When the blood supply is interrupted due to diabetes, the nerves may stop functioning properly. Some common examples of diabetes neuropathy are diabetic retinopathy (damage of retina) and diabetic nephropathy (damage of kidney nerves) etc.
Symptoms of Diabetes Neuropathy
The symptoms of diabetes neuropathy depend upon the nerves which have been affected by the disease. One of the most common symptoms is inability to feel pain, especially in the feet. This may be dangerous because sores and injuries might not get treated in time. Also, small infections can lead to ulceration and this may even require amputation.
Dizziness, weakness or fainting, especially while trying to stand from a reclining position due to heart and blood vessel problems leading to poor blood circulation, may also be distinct symptoms of diabetes neuropathy.
Sexual problems such as erectile dysfunctions in men and vaginal dryness in women may also be symptoms of diabetes neuropathy.
Other symptoms may include digestive problems such as bloating, nausea, constipation, belching, diarrhea, belly pain and vomiting. Heavy sweating at night or when some foods are eaten or reduced sweating in some parts of the body is also a common symptom of neuropathy.
Neuropathy may also lead to urination problems such as inability to empty the bladder fully or not having any feeling even when the bladder is completely full etc.
Trouble in sensing low blood glucose levels in blood may also be a symptom of neuropathy.
Diagnosis of Diabetes Neuropathy
The diagnosis of diabetes neuropathy is made using physical exams and some tests to confirm the status of the disease. The physical examinations that are undertaken may check heart rate and blood pressure, muscle strength, reflexes and sensitivity to position, a light touch, vibration and temperature etc.
The doctor may also check the skin, blood circulation and response to sensation. Usually, a nylon monofilament attached to a wand is used as an instrument to touch the foot to check the sensitivity of the foot. In a case where the patient is unable to feel the increase of pressure, he/she might have lost protective sensation and is at risk of developing foot sores that might not heal properly.
There are various tests to assess the nervous functioning and confirm the diagnosis of neuropathy. A nerve conduction test is performed to check the transmission of electrical current through a nerve. Slower and weaker signals are signs of a possible damage.
Electromyography (EMG) test is performed to test the response of muscles to the electrical signals carried by the nearby nerves. A slower or weaker signal may indicate possible damage.
Various other tests may be undertaken for diagnostic purposes. To check the response to stimuli the Quantitative Sensory Testing (QST) is performed. Ultrasounds of bladder and other parts of urinary tract are also undertaken, sometimes, for diagnostic purposes. Nerve or skin biopsy tests are also increasingly used for diagnosis purposes as well.
Causes of Diabetes Neuropathy
The exact causes of diabetes neuropathy are unknown. There are reasons to believe that a host of factors act simultaneously.
It is found that high blood glucose causes chemical changes in the nerves. These changes make the nerves inefficient in transmitting signals. It is also found that high blood glucose damages the blood vessels that carry oxygen and nutrients to the nerves. Additionally, inherited or acquired factors may also contribute to the onset of the disease. It is also a matter of continuous research whether genetic and acquired factors make some people more susceptible to nerve diseases than others.
In various researches, it has been found that high blood glucose affects the pathways of metabolic reactions. It leads to accumulation of a sugar called sorbitol and depletion of a substance called myoinositol. These changes have been found to be the mechanism that initiates neuropathy.
Types of Diabetes Neuropathy
Diabetes neuropathy is divided into four distinct segments, each with different symptoms and diagnostic procedures.
Peripheral neuropathy refers to the damages of peripheral nerves. The predominant functions of peripheral nerves include sensing touch, pain and temperature. Peripheral nerves also affect muscle strength and movements. In peripheral neuropathy the feet, usually lower legs are affected. It is a dangerous condition that develops slowly, usually over weeks and months.
Autonomic neuropathy affects the autonomic nerves. These nerves are responsible for controlling heart beats, blood pressure, sweating, digestion, urination and sexual functions.
Focal neuropathy usually affects only one nerve. The most vulnerable organs include the foot, thighs or the wrists. It happens suddenly and may also affect the back and chest muscles and those that control the eyes.
Proximal neuropathy leads to the weakening of legs. The common symptoms of this type of disease are pain in hips, thighs, buttocks or legs.
Treatment of Diabetes Neuropathy
As the first step of treatment, a combination of blood glucose monitoring, meal planning, exercise and oral drugs or insulin are used to bring the blood glucose level as close as possible to the normal range.
The next step in the treatment of diabetes neuropathy is taking ample care of the feet. It is believed that nearly half of all amputations carried out are on the patients with diabetic neuropathy. Thus, it becomes increasingly important to take good care of feet while having diabetes neuropathy. A good feet care should include cleaning the feet with warm water; inspecting the feet regularly for cuts, sores and injuries; protecting the feet from getting injuries and taking other necessary steps to prevent any mistreatment to the feet.
There are various medications available to subsidize the pain associated with neuropathy. Some good, common medications include aspirin, acetaminophen and non steroidal anti inflammatory drugs. Topical creams such and tricyclic antidepressant medications are also used for this purpose. Codeine is also prescribed frequently to relive severe pain. Other treatments for pain include transcutaneous electronic nerve stimulation and a host of alternative pain therapies.
For gastrointestinal problems, doctors may provide a dietary schedule. Sometimes, antibiotics are prescribed for diarrhea.
For fighting dizziness and weakness various behavioral aspects are taken into consideration. Sometimes, treatment with salt-retaining hormones is also prescribed.
For urinary tract infections, usually antibiotics are prescribed. Moreover, if there’s erectile dysfunction, the doctor may prescribe oral drugs and undertake vacuum therapies. The use of the drug vasodilator is also common for this purpose. For vaginal dryness, in most cases, lubricants are used.
Living with Diabetes Neuropathy
Living with diabetes neuropathy requires taking ample care of the blood glucose levels and keep the body fit to avoid other diseases that follow neuropathy. Monitoring the blood glucose levels, consulting the doctors frequently and taking all oral or inject-able drugs regularly is the next step.
Taking a healthy and proper diet and following the physical activities regularly is another step to keep the disease under control. Avoiding smoking and alcoholism is necessary for the sake of one’s own health.
The patients should also look after the body, especially the feet, once debates neuropathy is diagnosed. As diabetes neuropathy affects the daily life of the patients, it is wise to follow a routine that incorporates all healthy lifestyle habits.
Prevention of Diabetes Neuropathy
The required action to prevent diabetes neuropathy includes a host of points that must be followed regularly. Firstly, the blood glucose level should be kept as close as possible to the normal blood glucose range. Studies have shown that people who keep stringent measures to maintain blood glucose levels near normal have 60% lower chances of acquiring diabetes neuropathy.
The amount of alcohol drank should be limited and smoking should be strictly avoided to prevent debates neuropathy. Ample care of the feet should be taken. Moreover, the doctor should be immediately consulted when there is any trouble with hands, arms, feet, stomach, bowels and bladder. Also visit the specialist’s chamber if you have problems having sex, understanding the symptoms of low blood glucose or feeling dizzy during physical activities.
