Diabetes mellitus has affected the world population like a fast-growing epidemic. Diabetes is a disease of increased blood sugar levels. If the sugar levels are not managed within the healthy range, diabetes brings many complications involving our other vital organs. One such complication is diabetic neuropathy which affects the nervous system. This article tells us some important facts about the neurological complications of diabetes.
What are the causes of diabetic neuropathy?
The exact cause of diabetic neuropathy is still not known. It is assumed that uncontrolled blood sugar level over a prolonged period damages the nerves. Thus the ability of nerves to transmit the signal is weakened. High blood sugar levels also make walls of blood capillaries weak, thus affecting the nutrition supply to the nerves.
What are the different types of diabetic neurological complications?
Diabetic neuropathy typically develops slowly due to continuously elevated blood glucose levels. With increasing age, diabetes symptoms of neurological nature start occurring. The neurological symptoms involve the following parts of the nervous system:
- Neuropathy affects the peripheral body areas such as feet, fingers, and toes, most commonly making them numb due to loss of sensation. Sometimes, there will be a feeling of tingling and numbness in the feet and legs. This is called peripheral diabetic neuropathy and is the most commonly observed neurological complication.
- It may affect the nerves that function in the internal body organs such as the heart, kidneys, eyes, lungs, and sex organs. This is autonomic diabetic neuropathy. It is least recognized but has a significant negative impact on the quality of life of diabetic patients.
- The focal neuropathies affect a single nerve that goes into the hand and feet and may result in isolated medical conditions such as carpal tunnel syndrome. It is focal diabetic neuropathy. It is unpredictable but painful.
- The neurological complications may sometimes affect the nerves of the buttock, hip, or thigh, eventually disabling these body parts. This is a rare complication and is called proximal diabetic neuropathy. The pain originates in the buttock and radiates down the leg, similar to sciatica. It is usually seen in elderly diabetic patients and resolves slowly with time and treatment.
What are the common symptoms of diabetic neuropathy?
Diabetic neuropathy spans a wide range of symptoms. Sensory complaints are the most common but may gradually worsen and involve movement-related symptoms. Here are some common symptoms that we may experience during neurological complications:
- Symptoms of the peripheral organs: Tingling or burning sensations of fingers and toes are the most common signs of neuropathy. Some of us may also feel electric sensitivity or pain after touching that is intense during the night.
- Loss of sensation: This follows numbness and weakness. It may worsen to the extent that we cannot feel our feet, and there is an increased risk of foot injuries.
- Diabetic foot syndrome: This is a severe neurological complication of diabetes. A foot injury is just the beginning of the syndrome. It gradually changes into foot ulceration accompanied by pain, inflammation, and trauma. Furthermore, it may develop an infection that rapidly results in a damaged foot needing immediate amputation.
- Digestive system complications: The involvement of the nerves that function in the digestive system results in oesophageal erosion and impairs metabolism.
- Sexual dysfunction: Studies have indicated that around 35-90% of men with diabetes have erectile dysfunction.
- Urinary tract problems: The nerves in the urinary system may get affected, resulting in a frequent urge to pee. It may increase during the night, and sometimes there may be incomplete bladder emptying or urinary leakage.
How is diabetic neuropathy diagnosed?
Although diabetic neuropathy typically arises in old age, there is recent evidence that some peripheral nerve involvement can be seen in young adults even at the pre-diabetic stage. Therefore, you should monitor diabetes symptoms regularly. The most commonly used tests to diagnose this condition involve:
- Physical examination of peripheral organs for injury, ulcers, or sensation
- Sensory testing
- Nerve conduction tests
- Nerve biopsy
What are treatment options?
Managing pain and inflammation is one strategy to treat diabetic neuropathy and improve quality of life. Some treatment modalities such as tricyclic antidepressants, anti-convulsant, and drugs to improve nerve conduction help manage diabetes symptoms. Several nutraceuticals are also available for the management of diabetic neuropathy. Consult your physician before you consume any.
Conclusion
The best way to treat and prevent neuropathy is to control your blood glucose levels and avoid the involvement of nerves. Diabetes is a lifestyle disease and should be managed with healthy lifestyle choices. Take well-balanced nutrition, exercise regularly, and follow the doctor’s advice. Diabetic patient care and management of symptoms like diabetic neuropathy are possible with your awareness and close work of the team of diabetologists, neurologists, nutritionists, and physical therapists.
2018 ·