What is diabetic neuropathy?
Diabetic neuropathy is a type of nerve damage that can occur if you have diabetes. High blood sugar (glucose) can injure nerves throughout the body. This most often damages nerves in the legs and feet.
Depending on the affected nerves, the symptoms can include pain tingling and numbness in the legs, feet, and hands. It can also cause problems with the digestive system, urinary tract, blood vessels, and heart. While some people have mild symptoms, some cases can be quite painful and disabling. It is a serious diabetic complication that may affect as many as 50 per cent of people with diabetes.
What are the types of diabetic neuropathy and its symptoms?
There are four main types of diabetic neuropathy. You can experience more than one type of neuropathy, and your symptoms will vary depending on the specific type and the nerves that are affected. Usually, the symptoms develop gradually and you may not notice anything wrong until a considerable amount of nerve damage has occurred.
Peripheral neuropathy
This is the most common type of diabetic neuropathy, and it usually begins by affecting the feet and legs, followed by hands and arms. Symptoms are often worse at night and can include:
- Numbness
- Reduced ability to feel pain and temperature change
- Tingling or burning sensation Sharp pain or cramp
- Muscle weakness
- Extreme sensitivity to touch
- Serious foot problems, such as ulcers, infections, as well as bone and joint damage
Autonomic neuropathy
The autonomic nervous system controls blood pressure, heart rate, sweating, eyes, bladder, digestive system, and sex organs. Diabetes can affect nerves in any of these areas. Symptoms can include:
- Lack of awareness of low blood sugar levels
- Drops in blood pressure upon standing, which may cause dizziness or fainting
- Bladder or bowel problems
- Slow stomach emptying resulting in nausea, vomiting, a sense of fullness, reduced appetite, and swallowing difficulties
- Fluctuations in sweating Problems with sexual response
Proximal neuropathy or diabetic polyradiculopathy
This type of neuropathy often affects nerves in the thighs, hips, buttocks, or legs. However, it can also affect the abdominal and chest area. Its symptoms usually occur on one side of the body but may spread to the other. These can include:
- Severe pain in the buttock, hip, or thigh
- Weak and shrinking thigh muscle
- Difficulty rising from a sitting position
Mononeuropathy
Mononeuropathy refers to damage to a single, specific nerve. The nerve may be in the face, torso, arm, or leg. Symptoms can include:
- Difficulty focusing or double vision Paralysis on one side of the face
- Numbness or tingling in the hands or fingers
- Weakness in the hands
- Pain in the shin, foot, or thigh
Treatment for diabetic neuropathy
You can prevent or delay diabetic neuropathy and its complications by closely managing your blood sugar and taking good care of your feet. It is important to control your blood sugar levels with diet, exercise, and medications, as most complications of diabetic nerve disease arise from poorly controlled diabetes.
Foot problems, including sores that do not heal, ulcers, and even amputation, are common complications of diabetic neuropathy. However, prevention can be done by having a thorough foot examination at least once a year and taking good care of your foot health.
For symptoms of diabetic neuropathy, such as pain, tingling, and burning sensation, a doctor can prescribe medications to help manage the symptoms. However, effective diabetes management remains the cornerstone of treatment.
This article was reviewed by Dr Sunny, Specialist in Neurology, Consultant, Raffles Neuroscience Centre
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