DIABETIC & PERIPHERAL NEUROPATHY
Peripheral neuropathy, or neuropathy for short, refers to damage to the nerves in the peripheral nervous system, which is a network of nerves that connects the brain and spinal cord to the rest of the body. The peripheral nervous system has three types of nerves: motor, autonomous and sensory. These nerves make it possible for you to do things like hear, see, feel, move and even breathe. Damage to these nerves can cause symptoms such as pain, numbness and tingling.
There are a number of factors that can cause neuropathy, such as autoimmune diseases, alcoholism, viral or bacterial infections, injury or other trauma, and diabetes. When neuropathy occurs as a result of diabetes, it is called diabetic neuropathy.
Diabetic neuropathy affects about 50% of diabetic patients and is most commonly caused by blood glucose levels being too high for an extended period of time. High sugar levels in the blood damage the capillaries (small blood vessels) that supply the nerves, and this prevents them from getting the nutrients they need to function.
There are four main types of diabetic neuropathy – peripheral, autonomic, proximal (also called radiculoplexus) and focal (also called mononeuropathy). Patients can develop one or more of these types.
Symptoms will vary depending on the type of diabetic neuropathy you have and the nerves that are affected.
Diabetic peripheral neuropathy most commonly affects:
- Feet and legs with symptoms that include pain, burning, numbness and tingling.
- Nerves that control body functions with symptoms that include sexual dysfunction, urinary incontinence, diarrhea and constipation
- Thighs, hips and buttocks, causing weakness in the legs
- Nerves in the head, torso and leg
Diabetic peripheral neuropathy as well can cause eye pain, double-vision, chest pain, abdominal pain, and even paralysis on one side of the face.
Diabetic neuropathy may be diagnosed with a complete medical history and a thorough physical exam. During the exam, the doctor will ask about the symptoms and may check things like reflexes, muscle strength, and sensitivity to temperature and touch. Other tests may also be conducted to confirm the diagnosis and/or determine the cause of the condition.
Examples of these tests include: filament test, nerve conduction studies, electromyography (EMG), quantitative sensory testing, and autonomic testing.
There is no cure for diabetic neuropathy, but symptoms can be managed with proper treatment.
The main goal of treatment is to:
- Slow the disease’s progression
- Relieve pain
- Manage complications
- Restore lost function.
Keeping your blood glucose levels under control plays an important role.
Treatment options include:
- Nonsteroidal anti-inflammatory drugs
- Anti-seizure medications
- Neuropathic pain medications
- Membrane stabilizing medications
- Opioid analgesics
- Spinal cord stimulation