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Diabetic Neuropathy

What is Diabetic Neuropathy?

Patients with diabetes often develop abnormalities of the peripheral nerves in the extremities after a period of many years. Symptoms usually develop 10-20 years after the initial diabetes diagnosis. Patients can experience numbness or abnormal tingling sensations and pain in the hands and especially in the feet. Other symptoms are lightheadedness, heartburn, swallowing problems, diarrhea or constipation, bladder problems and failure to achieve sexual arousal. This type of neuropathy (nerve injury) usually develops in stages. First one may experience intermittent pain and tingling in extremities, particularly in the feet. In later stages, the pain is more intense and constant. In the last stage, all pain sensation is lost to an area. This greatly increases the risk of severe tissue injury because the patient can no longer detect pain to let them know they are injured.

Who gets Diabetic Neuropathy?

Decreased blood flow and increased blood sugar level are the causes of diabetic neuropathy. When the blood sugar level is higher than normal for an extended period of time, the blood vessels and nerves start to degenerate. This degeneration is what causes the nerves to be less effective.

How is Diabetic Neuropathy diagnosed?

Electrodiagnostic testing in the form of nerve conduction studies (NCS) are a sensitive way of detecting the development of diabetic neuropathy. Electrodiagnostic testing can also exclude other abnormalities that can be confused with diabetic neuropathy.

How is Diabetic Neuropathy treated?

Treatment is aimed at slowing down or stopping the blood vessels and nerves from degenerating. Treatment is also aimed at eliminating the resulting pain the disorder causes. The most important thing that must happen is the blood sugar level needs to be brought back to normal levels. This can be done through diet, exercise, and medications. Also, the feet need to be watched carefully. Foot injuries are more likely to occur and due to the loss of sensation they go unnoticed. If the foot injury is not treated, amputation may be required. To relieve pain, baths may be helpful, along with analgesics, antidepressants, and anticonvulsants. These treatments may or may not help, it is dependent on how well the diabetes is maintained. Diabetic Neuropathy can be prevented by strict control of blood sugar levels prevents the development of neuropathy in 60% of type-1 diabetics and also can decrease the severity of the symptoms associated with the disease. It is very important to keep your blood glucose levels as close to the normal range as possible. This will protect the nerves throughout your body.

More information on Diabetic Neuropathy

Foundation for Peripheral Neuropathy
American Chronic Pain Association
National Institute of Neurological Disorders and Stroke
American Academy of Family Physicians