Diabetic neuropathy -Does Diabetes affect our Nervous System-It is a type of neuropathy
Diabetic neuropathy is a complication of diabetes that causes damage to the nervous system. It is a progressive disease, and symptoms get worse as time goes on .It occurs only in prolonged cases of diabetes and mostly damages the nerves of legs and feet.
Neuropathy happens when high levels of fats or sugar in the blood cause damage to the nerves in the body. It can affect virtually any nerve in the body, and there is wide range of symptoms. So once diabetes is diagnosed it should be strictly kept under control by either oral hypoglycemics or by insulin as suggested by physician (MD General Medicine doctor)
Nerves are essential to the normal working of the human body . They enable movement of people ,control senses ,control automatic functions, as breathing and diabetic neuopathy affects it.
Affection of nerves in diabetes is of several types. Some involve the peripheral nerves, while others damage the nerves that supply the internal organs, such as the heart, the bladder ,e.t.c. In this way, it can affect several body functions.
Between one-third and a half of people with diabetes have neuropathy.
In this article, we describe the different types, effects, and risks of diabetic neuropathy.
Types of diabetic neuropathy-
Peripheral neuropathy can lead to a loss of sensation in the feet and hands.
Four main types of neuropathy can have impact on the nervous system, including:
Peripheral symmetric neuropathy: This affects the feet and hands. It is the most commonly encountered form of diabetic neuropathy.
Autonomic neuropathy: This occurs in the nerves that control involuntary functions of the body, such as digestion, urination, or heart rate.
Thoracic and lumbar root, or proximal, neuropathy: This causes damage to the nerves along a specific distribution in the body, such as the chest wall or legs.
Mononeuropathies: These affect any individual nerve.
The symptoms of neuropathy depend on the type and the nerves involved.
The signs and symptoms of diabetic neuropathy are not immediate, but usually take several years to appear. Signs and symptoms (Clinical features) depend on which type of neuropathy and nerves it affects.
For symptoms and signs of diabetes pl click on the link given below
The symptoms of peripheral neuropathy are as follows –
numbness, pain, tingling, and burning sensations starting in the toes and fingers then continuing up the legs or arms
loss of muscle tone in the hands and feet
not being able to get the sensation of heat, cold, or physical injury
loss of balance
Charcot’s joint, in which a joint breaks down because of nerve issues, often in the feet
Peripheral neuropathy that causes affection of the feet can make it difficult for a person to stand and walk. It can increase the risk of the individual falling-all these things are seen in diabetic neuropathy.
When a person cannot feel heat, cold or injury, this can lead to new problems.This can cause injuries or aggravate previous injuries.
For example, a blister on the foot can become ulcerated because the person did not get the sensation of pain in the early stages. As the infection progresses, gangrene can result in which may even require amputation of a portion of the inferior extremity .
Following are the effects of autonomic neuropathy :
heartburn and bloating
nausea, constipation or diarrhea , for further details of effects of diabetes on the gastrointestinal system pl click on the link given below
hypoglycemic unawareness, in which a person does not feel the effects of low sugar levels,as routinely an individual feels when he has not taken breakfast ,lunch, till late
difficulties speaking or swallowing
feeling full after eating small amounts of food
vomiting several hours after eating
orthostatic hypotension, or feeling light-headed and giddiness when standing up-this is more common in uncontrolled diabetes.
a heart rate higher than normal range
excessive sweating, even in cool temperatures or while at rest not doing any exertion
bladder problems, for example, difficulty emptying the bladder completely ,this can lead to incontinence
sexual dysfunction in both men and women
dysesthesia, or a distorted sense of touch,due to involvement of sensory nerves
significant drooping of the face and eyelids in severe cases
There are many types of neuropathy.
Proximal neuropathy can lead to pain in the lower body, which is frequently on one side, and weakness in the legs.
Symptoms of focal neuropathy can vary widely, depending on the nerve affected as each spinal nerve has specific areas of distribution. Focal neuropathy and cranial neuropathy can both lead to visual disturbances, such as double vision.
People with diabetic neuropathy often do not realize they have it until the symptoms are more advanced.These are never observed in early stages of diabetes.
All of the symptoms of peripheral neuropathy are not visible, but people should have knowledge of any wounds on their feet.
A physician (MD General Medicine ) or Neurologist will carry out a generalised physical examination ,take thorough medical history ,foot examination ,check blood pressure,pulse rate, fasting and postprandial blood sugar.
He will test the following things –
loss of sensation
changes in skin texture
changes in skin color.
If the Physician suspects diabetic neuropathy, they may suggest some diagnostic tests, as:
an electromyogram (EMG), which is the recording of electrical activity in the muscles
a nerve conduction velocity test (NCV) which records the speed at which induced signals are traveling through the nerves
Most types of diabetic neuropathy gets worse as time passes by .
Blood sugars should be brought into a target range agreed with a physician (MD General Medicine) doctors and management of high blood pressure and to bring cholesterol and entire lipid profile within normal levels.
The physician usually advises oral hypoglycemics or insulin injections.
For details regarding insulin pl click on the link given below
Maintaining the blood glucose levels within the target range will minimize the risk of diabetic neuropathy. Treatment objectives are on reducing pain and managing some of the symptoms.
Physiotherapy can be given to some patients to help to control the pain of diabetic neuropathy, alongside other treatments. However, the nerves cannot be repaired.
So previously it was said that once an individual becomes above 40 yrs old he should undergo fasting ,postprandial blood sugar, lipid profile, SGOT, SGPT, Sr Creatinine ,CBC, ECG.
But nowadays it is advisable that an individual of 20 yrs age should also undergo these investigations.
Afterall prevention is better than cure.
People often avoid health check ups.
They say they are totally normal and so why to do check ups.
But instead of waiting for the day to come when problem occurs, it is much wise do do health check ups and SOS early treatment than too late treatment.
The individual should also stop smoking ,alcohol and other bad habits .
Drugs that can help to manage pain include-
Diclofenac sodium ,
Ibuprofen or as suggestions by the treating physician.
Topical lotions, compound creams, and some ,ALA or topical capsaicin, may also provide relief to the individual.
Medications like capsaicin cream may not be available in your local medical stores, but they are available at trusted and reputed online sites.
Physical therapy, combined with medications, may help relieve pain and decrease need for opioids.
It may also help to decrease the following things –
burning and tingling sensations in the inferior extremities
Electrical nerve stimulation is a physical therapy that is painless and may help to decrease feelings of stiffness and improve the healing of ulcers of foot
Gait training includes training about how to walk.It should be done by physiotherapist. It helps to prevent and stabilize complications of foot as ulcers ,injury,gangrene,and This type is crucial for people using prosthesis after losing limbs if amputation is required in case of gangrene due to severe diabetic neuropathy.
A good physical therapist/physiotherapist will take care that exercises for people with diabetic neuropathy do not cause injury to the feet, which can be sensitive.
Other therapies include devices that the individual can utilise to prevent painful or sensitive extremities from touching the bed or chair.
A chiropractor, massage therapist, or osteopath can carry out regular massages or manual therapy to cause stretching of the muscles. Massage can inhibit muscle contractions, spasms, and atrophy as the blood supply has become poor .
Some exercises that are advised are swimming or aerobics, to maintain muscle strength and decrease the loss of muscle mass.
Therapeutic ultrasound is a type of physical therapy that uses very high-frequency sound waves to stimulate the tissue beneath the skin which can help some people to regain sensitivity in their feet.
Changing the way you eat can have a significant effect on maintenance of the target range levels of blood glucose. For that pl click on the links given below.
Some types of diabetic neuropathy can affect a person’s vision.
For effects of diabetes on vision pl click on the link given below
Diabetic neuropathy can result in a number of high-risk complications .
Possible complications include loss of sensation in the feet.
This can lead to an inability to feel injuries or sores, and infection might occur as a result. Untreated infection in a limb can result in need for amputation.
Severe infections of kidney and bladder may also occur, causing health problems and may make it necessary for the patient to get admitted to hospital.
To prevent the complications of diabetic peripheral neuropathy, it is necessary to do regular examination of the foot and maintain normal target levels of blood sugar.
People with the condition should do regular inspection of their feet on daily basis for injuries or sores.
In individuals doing smoking there is higher chance of occurrence of foot problems of diabetes with certain types of diabetic neuropathy. Consultation with a podiatrist should be done.
Diabetic neuropathy is a type of nerve damage .It occurs in individuals who have diabetes.
There are four types: autonomic, peripheral, proximal, and focal neuropathy.
Each affects a different set of nerves and has a different range of effects. Autonomic neuropathy affects automatic processes in the body, such as digestion. Peripheral neuropathy causes damage to the nerves in the toes, fingers, hands, and feet.
Diagnosis is done by physican with the help of scans, and tests for ankle reflexes, sensation, and skin texture and tone.
Treatment involves several types of physical therapy/physiotherapy and medicines to control pain and nerve conduction.
As people with diabetic neuropathy tend not to feel injuries on the feet, regular examination of the feet is essential to avoid undetected infection and the possible loss of limbs.
If an individual is having type 2 diabetes then what should be done to prevent diabetic neuropathy?
This can be done by maintainence of blood sugar in target range and taking regular care of foot. If Metformin is taken for a prolonged duration for type 2 diabetes, then it can cause lowering of the serum Vitamin B12 level and so Serum Vitamin B12 assessment should be done at regular intervals as low levels of serum B12 can cause neuropathy.
All this above content is strictly informational and should not be considered medical advice or treatment.
For medical advice and treatment you may contact your physican (MD General Medicine) or Neurologist.
Then why to read this article ?
This article should be read as -Knowledge is Power. You should have thorough knowledge of the disease or disorder which you are having and for proper coordination to treatment.