DIABETIC NEUROPATHY

Neuropathy has four main types and signs and symptoms that vary depending on the type of neuropathy you have and which nerves are affected.

Peripheral neuropathy. This is the most common type of diabetic neuropathy whereas the ones affected first are your feet and legs and next are your hands and arms. These signs and symptoms of peripheral often get worse at night.

• A tingling or burning sensation
• Numbness
• Reduced ability to feel pain
• Increased sensitivity to touch
• Sharp pains or cramps
• Loss of balance and coordination
• Muscle weakness
• Serious foot problems, such as ulcers, infections, deformities, and bone and joint pain
• Loss of reflexes, especially in the ankle

Autonomic neuropathy. Your heart, eyes, stomach, bladder, lungs, intestines, and sex organs are controlled by the autonomic nervous system. The nerves in any of these areas can be affected by diabetes. Signs and symptoms include:

• Constipation, uncontrolled diarrhea or a combination of the two
• Slow stomach emptying (gastroparesis), leading to nausea, vomiting, bloating and loss of appetite
• A lack of awareness that blood sugar levels are low (hypoglycemia unawareness)
• Bladder problems, including urinary tract infections or urinary retention or incontinence
• Erectile dysfunction in men
• Vaginal dryness and other sexual difficulties in women
• Increased or decreased sweating
• Difficulty swallowing
• Inability of your body to adjust blood pressure and heart rate, leading to sharp drops in blood pressure after sitting or standing that may cause you to faint or feel lightheaded
• Changes in the way your eyes adjust from light to dark
• Problems regulating your body temperature
• Increased heart rate when you’re at rest

Radiculoplexus neuropathy (diabetic amyotrophy). Nerves in the hips, thighs, buttocks or legs are affected in this type. This condition occurs more often in those who have suffer from 2 diabetes and in older adults.

Symptoms include:

• Weight loss
• Sudden, severe pain in your hip and thigh or buttock
• Difficulty rising from a sitting position
• Eventual weak and atrophied thigh muscles
• Abdominal swelling, if the abdomen is affected

Mononeuropathy. This form damages specific nerve such as in the face, torso or leg. Mononeuropathy is also called focal neuropathy and is most common in older adults.

Mononeuropathy typically doesn’t cause any long-term problems although it can cause severe pain. Symptoms depend on which nerve is involved but usually fade on their own over a few months or even weeks. These include:

• Paralysis on one side of your face (Bell’s palsy)
• Difficulty focusing your eyes, double vision or aching behind one eye
• Pain in your lower back or pelvis
• Pain in your shin or foot
• Pain in your chest or abdomen
• Pain in the front of your thigh

Other times, when a nerve is compressed, that is where mononeuropathy occurs. A common kind of compression neuropathy in those who have diabetes is Carpal tunnel syndrome.

Carpal tunnel syndrome’s signs and symptoms:

• A sense of weakness in your hand and a tendency to drop things
• Numbness or tingling in your fingers or hand, particularly in your thumb, index finger, middle finger and ring finger

DIAGNOSIS

This condition is normally diagnosed based on the symptoms, your medical history and a physical exam that includes checking your muscle strength and tone, tendon reflexes, and sensitivity to touch, vibration and temperature.

Your doctor may also recommend tests such as:

Nerve conduction studies. This test is commonly used to diagnose carpal tunnel syndrome, measures how fast the nerves in your legs and arms conduct electrical signals.

Electromyography (EMG). Measures the muscles’ electrical discharges produced.

Filament test. Soft nylon fiber called a monofilament is used to test sensitivity to touch.

Quantitative sensory testing. To understand how your nerves react to vibration and modification in temperature

Autonomic testing. Your doctor may request special exams to see your blood pressure in different positions and determine your ability to sweat if you have symptoms of autonomic neuropathy.

TREATMENT

Diabetic neuropathy has no known cure; however, there are some treatments that center on:

Relieving pain. Some drugs are used to relieve nerve pain; however, they don’t work for everybody and most have side effects. There are also several alternative therapies, such as physical therapy or acupuncture, and capsaicin cream that may help with pain relief.

Delaying the disease progression. To help in avoiding or delaying the progression of diabetic neuropathy, keeping your blood sugar within target range is great and may even mend some of the symptoms you already have.

Follow your doctor’s recommendations for good foot care, follow a healthy-eating plan, keep your blood pressure under control, maintain a healthy weight, get plenty of physical activity and avoid smoking and alcoholic drinks. All these can help slow down nerve damages.