Neuropathy – An Overview
The human nervous system consists of two parts – the central nervous system and the peripheral nervous system.
The peripheral nervous system transmits messages between the central nervous system (the brain and spinal cord) and the rest of your body. These nerves regulate a large variety of functions throughout the body, such as perception of stimuli (sensory nerves), involuntary organ activity (autonomic nerves) and voluntary muscle movement (motor nerves). Neuropathy, often referred as Peripheral Neuropathy, is a condition that occurs when peripheral nerves become disrupted or damaged.
What is Diabetic Neuropathy?
Numbness in the feet, one of the most common long-term complications of type 2 Diabetes, is a symptom of neuropathy or nerve damage. Neuropathy is caused by poor control of blood sugar that persists over a long time. Prolonged exposure to high blood sugars, over a period of time, can damage the nerves throughout the body – leading to a condition called Diabetic Neuropathy. Although diabetic neuropathy is most common in people having type 2 diabetes for over 25 years, it may also occur in people who are prediabetes.
The higher and, the longer the blood sugars stay high, the greater the chance of an individual developing neuropathy. The longest nerves in the body tend to get affected by high sugars. These nerves go from the spine to the toes, which is why feet get affected first.
Types of Diabetic Neuropathy
There are three types of diabetic neuropathy.
- Peripheral neuropathy is damage to peripheral nerves. These are the nerves that, apart from affecting movement and muscle strength, also sense pain, touch, hot, and cold. Nerves in the feet and lower legs are most often affected. This can lead to serious foot problems which can result in ulcers, infections etc. that can even end in foot amputation.
- Autonomic neuropathy is damage to autonomic nerves that control heartbeat, sweating, blood pressure, urination, sexual function and digestion.
- Focal neuropathy affects just one nerve, usually in the foot, wrist, or thigh. It may also affect the nerves of the chest and back and those controlling the eye muscles. This nerve damage usually happens suddenly.
Signs of Diabetic Neuropathy
While some people may not show any symptoms of nerve damage, others may notice pain, numbness, or tingling in the extremities. At the beginning, diabetic neuropathy starts in the feet and then slowly progresses upward. In the feet, diabetic neuropathy can not only cause numbness but pain and injuries as well.
In addition, it can change the shape of the feet, deforming them to such a level that it can no longer fit into regular shoes. It can also dry out and damage the skin, interfere with circulation, cause calluses and
ulcers on the feet. However, the numbness of the affected skin also makes it hard for the diabetic patient to sense if there is a cut or injury which can increase the risk of infections and amputation.
How is diabetic neuropathy diagnosed?
A physician actually determines whether or not you have neuropathy, starting by asking about your symptoms and medical history. You will also have a physical examination. Doctor will check your level of sensitivity to temperature and touch, muscle tone, your heart rate and blood pressure. Your physician may perform a filament test to assess the sensitivity in your feet. For this, a nylon fiber is used to check the limbs for any loss of sensation. A tuning fork may also be used to test the vibration threshold. The physician may also test the ankle reflexes.
How is Diabetic neuropathy treated?
While there is no cure for diabetic neuropathy, its progression can be slowed down. The best way to decrease the possibility of developing diabetic neuropathy or to slow down its progression is to keep the blood sugar levels within a healthy range. This may also relieve few symptoms.
Regular exercise and quitting smoking are also parts of a comprehensive treatment plan. There are drugs to treat pain caused by diabetic neuropathy. Talk to a doctor about the available medications and their potential side effects.
Depending on your type of neuropathy, your doctor may suggest medicines, therapies or lifestyle modifications that can help deal with symptoms and ward off complications. For instance, if you have problems with digestion owing to neuropathy, your doctor may advise you to eat smaller meals more often and limit the amount of fiber and fat in the diet. If you are a women and have vaginal dryness, your doctor may advise a lubricant. If you are a man and have erectile dysfunction, your doctor may prescribe medicines that can help.
How to prevent diabetic neuropathy?
Diabetic neuropathy can often be avoided if blood glucose levels are managed vigilantly. To do this, you have to be consistent in:
- Monitoring blood glucose levels
- Taking medicines as prescribed
- Managing diet
- Being active
If you are diagnosed with diabetic neuropathy, work very closely with your doctor and follow the recommendations strictly for slowing its progression. With proper care, you can reduce the damage to your nerves and avoid complications